david y. ige board of trustees governor celeste y.k. … · 6/20/2020 · damien elefante audrey...

DAVID Y. IGE BOARD OF TRUSTEES GOVERNOR CHRISTIAN FERN, CHAIRPERSON

CELESTE Y.K. NIP, VICE-CHAIRPERSON LAUREL JOHNSTON, SECRETARY-TREASURER RODERICK BECKER DAMIEN ELEFANTE AUDREY HIDANO STATE OF HAWAII OSA TUI CLIFFORD UWAINE RYKER WADA

HAWAII EMPLOYER-UNION HEALTH BENEFITS TRUST FUND

201 MERCHANT STREET, SUITE 1700

HONOLULU, HAWAII 96813 ADMINISTRATOR Oahu (808) 586-7390 DEREK M. MIZUNO

Toll Free 1(800) 295-0089 ASSISTANT ADMINISTRATOR www.eutf.hawaii.gov DONNA A. TONAKI

June 17, 2020

NOTICE OF MEETING OF THE BOARD OF TRUSTEES


DATE: June 23, 2020, Tuesday

TIME: 9:00 a.m.

PLACE: HAWAII EMPLOYER-UNION HEALTH BENEFITS TRUST FUND (EUTF)

CITY FINANCIAL TOWER

201 MERCHANT STREET, 17TH FLOOR

HONOLULU, HAWAII

A G E N D A

EUTF OFFICE IS CLOSED TO THE PUBLIC

OPEN SESSION PARTICIPATION VIA TELECONFERENCE WILL BE OFFERED

I. Call to Order

II. Executive Session

A. Dannenberg Litigation [Authorized under HRS 92-5a(4)(8)]

B. CVS/SSI Contracted Network Services

C. Use of EUTF Reserve Funds for 100% Coverage of Furloughed Active Employees’

Healthcare Premiums [Authorized under HRS 92-5(a)(4)(8)]

D. Investment Committee [Authorized under HRS 92-5(a)(4)(8)]

1. Private Equity Manager Recommendations

III. Introduction of New Trustees [open session will reconvene no earlier than 9:30 a.m.]

IV. Minutes – May 26, 2020

V. Benefits Committee

A. Summary of Benefits – Kaiser, HMSA, HDS and VSP

B. Extension of COVID-19 Related Coverage under HMSA Plans and Payment

Transformation

C. CVS Prescription Drug Plan

EUTF’s Mission: We care for the health and well being of our beneficiaries by striving to provide quality benefit plans that are

affordable, reliable, and meet their changing needs. We provide informed service that is excellent, courteous, and compassionate.

City Financial Tower, 201 Merchant Street, Suite 1700, Honolulu, Hawaii 96813

www.eutf.hawaii.gov


Board Meeting

June 17, 2020 Notice

1. Plan Summary

2. Hyperinflation Management Program

3. ACA Preventive Services: Medications for Breast Cancer Prevention

4. Emerging Trends Utilization Management Recommendations

VI. Old Business

A. Committee Assignments

B. Proposed Chiropractic Benefit for EUTF Retiree Plan

C. Waiver of EUTF Administrative Rule Related to Non-Payment of Plans and Possible

Other Waivers of EUTF Administrative Rules

D. Use of EUTF Reserve Funds for 100% Coverage of Furloughed Active Employees’

Healthcare Premiums

E. 2020 EUTF Related Legislation

VII. Reports

A. Segal

1. Compliance News – May 12, 2020 and June 10, 2020

2. ACA Dollar Amounts and Percentages

B. Administrator

1. Meetings with legislators and unions

2. Public engagement

3. Operations

C. EUTF Managers’, Program Specialist and Benefits Audit Specialist Reports

1. Member Services Branch (MSB)

a. MSB Data

b. MSB Staffing Update

c. Outreach & Training

d. 2020 Active Employee Open Enrollment

e. 2021 Retiree Open Enrollment

f. Carrier Reports

2. Information Systems (IS)

a. EUTF New Benefits Administration System (BAS) Project

b. V3 Benefits Administration System Modified Phase II (Employer File Feed)

c. COVID-19 Response

d. Vitech Contract

e. Humana Retiree Plan

f. ISB Staffing Update

g. Enrollment Counts

3. EUTF Benefits Audit Specialist Report

a. Audits Currently in Progress

b. Additional Audits to be Initiated by December 31, 2020

c. Completed and Recurring Audits

4. EUTF Program Specialist Report

a. Worksite wellness

b. Preventive health


Board Meeting

June 17, 2020 Notice

c. Chronic disease management

5. Financial Services Branch (FSB)

a. FSB Performance Data

b. Management Letter Corrective Action Plan Status

c. EUTF Collections

d. FSB Staffing Update

e. Financial Statements as of April 30, 2020

D. Carrier Reports

1. CVS Caremark

2. SilverScript

3. Hawaii Dental Service (HDS)

4. Hawaii Mainland Administrators (HMA)

5. Hawaii Medical Service Association (HMSA)

6. Kaiser Health Foundation

7. Securian

8. Vision Service Plan (VSP)

II. Executive Session (continued)

E. Retiree Rates Effective January 1, 2021 Hawaii Dental Service (HDS), Vision

Service Plan (VSP), and Securian [Authorized under HRS 92-5a(4)(8)]

F. RFP 20-003 Medical and Pharmacy Benefit Management Services [Authorized under

HRS 92-5(a)(4)(8)]

G. Royal State National Life Insurance Contract – January 1, 2012 – December 31, 2014

Retirees and January 1, 2012 – June 30, 2015 Actives [Authorized under HRS 92-

5(a)(4)(8)]

H. EUTF Participation in Prescription Drug Litigation [Authorized under HRS 92-

5a(4)(8)]

I. Pending Litigation Against the EUTF [Authorized under HRS 92-5(a)(4)(8)]

J. Claims Audit Services Contract [Authorized under HRS 92-5a(4)(8)]

K. Certification of HIPAA Manual [Authorized under HRS 92-5a(4)(8)]

VIII. Next Meeting Date

Tuesday, July 28, 2020, 9:00 a.m. – Medical and Prescription Drug Retiree Premiums

January 1, 2021 and Kelley Withy, UH, on the physician shortage

IX. Adjournment

Meeting materials can be accessed at the EUTF website (eutf.hawaii.gov) through the Events

Calendar at noon on Monday, June 22, 2020. Please contact Ms. Desiree Yamauchi at

(808)587-5434 or [email protected] by noon on Monday, June 22, 2020 for information on

how to participate by telephone.

mailto:[email protected]

https://eutf.hawaii.gov

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Minutes of the Board of Trustees

Tuesday, May 26, 2020

TRUSTEES PRESENT Mr. Christian Fern, Chairperson (via video conference) Mr. Damien Elefante (via video conference)

Ms. Celeste Nip, Vice-Chairperson (via video conference) Ms. Audrey Hidano (via video conference)

Ms. Laurel Johnston, Secretary-Treasurer (joined at Mr. Osa Tui (via video conference)

9:03 a.m. via video conference) Mr. Clifford Uwaine (via teleconference)

Mr. Roderick Becker (via video conference) Mr. Ryker Wada (via video conference)

None

TRUSTEES ABSENT

ATTORNEY Mr. Michael Chambrella, Deputy Attorney General

EUTF STAFF Mr. Derek Mizuno, Administrator Mr. Stephen Murphy, Consultant (via video conference)

Ms. Donna Tonaki, Assistant Administrator Mr. Raymond Kan

Ms. Desiree Yamauchi Ms. Jessica McDonald (via video conference)

Ms. Amy Cheung Ms. Lara Nitta (via video conference)

Ms. Linda Green (via video conference) Mr. Kuan Yuan

Ms. Bonny Kahalewai Mr. Dylan Zheng (via video conference)

OTHERS PRESENT (via video conference or teleconference)

Ms. Dina Aun, CVS Ms. Angela Kohls, Kaiser

Ms. Stacia Baek, HMSA Mr. Brandon Kumabe, HMSA

Mr. Colin Bebee, Meketa Mr. Christopher Letoto, HMSA

Ms. Sandra Benevides, CVS Mr. Steve McCall, CVS

Ms. Cheryl Byron, CVS Ms. Denise Mercil, Securian

Mr. Su Chai, Kaiser Dr. Christopher Miura, Kaiser

Mr. Thomas England, Kaiser Mr. Kurt Neuenfeld, CVS

Ms. Elaine Fujiwara, HDS Mr. Allan Nogra, American Specialty Health

Ms. Samantha Furutani, CVS Mr. Dave Shiroma, Kaiser

Mr. Galen Haneda, HMSA Mr. Troy Tomita, Kaiser

Ms. Vanelle Hirayasu, HMA Mr. Chad Wong, HMSA

Ms. Monica Kim, VSP Mr. Scott Yamaguchi, Kaiser

I. CALL TO ORDER

The meeting of the Board of Trustees was called to order at 9:00 a.m. by Chairperson

Christian Fern, in the Hawaii Employer-Union Health Benefits Trust Fund (EUTF) Board

Room, 201 Merchant Street, Suite 1700, Honolulu, Hawaii, on Tuesday, May 26, 2020.

II. MINUTES – APRIL 28, 2020

The Board reviewed the draft minutes of April 28, 2020.

MOTION was made and seconded to approve the minutes of April 28, 2020, as circulated.

(Nip/Elefante) The motion passed unanimously. (Employer Trustees-4/ Employee-

Beneficiary Trustees-4)


Board of Trustees Meeting

May 26, 2020 Minutes

Page 2

1 Trustee Johnston entered the meeting at 9:03 a.m.

2

3 III. EXECUTIVE SESSION

4 MOTION was made and seconded to move into Executive Session at 9:03 a.m. (Elefante/Tui)

5 The motion passed unanimously. (Employer Trustees-5/Employee-Beneficiary Trustees-4)

6

7 The regular meeting reconvened at 10:47 a.m. after a five minute recess.

8

Chairperson Fern reported that the following were performed during Executive Session: 9

1. Denied an appeal to allow late, prospective COBRA effective May 1, 2020.10

2. Approved commitment of funds to two investment managers, subject to contract11

negotiation and approval of the asset class.12

13

IV. INVESTMENT COMMITTEE14

A. Strategic Asset Allocation15

Mr. Kuan Yuan summarized the interim strategic allocation target with a 5% allocation to16

the new reinsurance asset class.17

18

MOTION was made and seconded to approve the Investment Committee’s 19

recommendation of a revised interim strategic target asset allocation including a 5% 20

allocation to the reinsurance asset class. (Johnston/Nip) The motion passed unanimously.21

(Employer Trustees-5/Employee-Beneficiary Trustees-4)22

23

B. March 31, 2020 Strategic Performance Report Including Excess Funds24

Mr. Colin Bebee, Meketa Investment Group, summarized the 1st quarter results in which25

the OPEB Trust ended at $3.3 billion with quarterly and fiscal year-to-date net of fee26

losses of -11.8% and -6.9%, respectively, which outperformed by 0.7% and 1.2% the27

policy benchmark, respectively. Since inception (June 23, 2011), the EUTF portfolio has28

returned 5.6% (net of fees) versus the policy benchmark return of 5.4%. Mr. Bebee noted29

that the market has rebounded from March 31, 2020 and through May 22, 2020 the30

portfolio was down approximately -1.5%.31

32

C. Quarterly Private Equity & Private Credit Report – Q4 201933

Mr. Kuan Yuan presented the Q4 2019 Private Equity and Private Credit performance34

report.35

36

D. Quarterly Real Estate Report – Q4 201937

Mr. Yuan presented the Q4 2019 Private Real Estate performance report.38

39

V. BENEFITS COMMITTEE40

41 A. Benefit Plan Changes Framework

42 Mr. Derek Mizuno presented the May 19, 2020 Benefits Committee report summarizing

43 how proposed benefit plan changes are developed within the context of the EUTF’s vision,

44 mission and strategic plan and the specific methods to change the plans and the related

45 goals. Additionally, Mr. Mizuno noted that a Committee meeting will be scheduled in

46 June 2020 to compare the medical, prescription drug, dental and vision EUTF plans (e.g.

47 out-of-pocket costs and covered benefits) with other plans in Hawaii and/or throughout the

48 nation.




Page 3

1

2 VI. NEW BUSINESS

3 A. Proposed Chiropractic Benefit for EUTF Retiree Plans

4 Mr. Mizuno summarized the memorandum dated May 21, 2020 relating to the proposed

5 addition of a chiropractic benefit to the EUTF retiree medical plans which are the only

6 plans without such benefit. The Trustees asked American Specialty Health as HMSA and

7 Kaiser’s subcontractor to provide information regarding their network, a description of the

8 benefit and covered practices, and any cost benefit analysis. Mr. Allan Nogra, American

Specialty Health, provided some of the information. Mr. Mizuno noted that Mr. Nogra9

was asked to provide information on the proposed pricing and is not as familiar with the10

items asked. Mr. Mizuno requested that this item be deferred to the June 23, 2020 board11

meeting.12

13

B. Progress on Strategic Plan Through December 31, 201914

Mr. Mizuno provided an update on the strategic plan and summarized a memorandum15

dated May 19, 2020 noting that this update primarily related to the retiree medical and16

prescription drug trends.17

18

C. HIPAA, COBRA and Appeal Extended Deadlines19

Ms. Jessica McDonald summarized the U.S. Department of Labor, Treasury and Health20

and Human Services extension of non-public sector group health plan deadlines for21

HIPAA special enrollment, COBRA, and appeals, due to the COVD-19 crisis. Public22

sector entities are encouraged to implement these extensions voluntarily. Mr. Mizuno23

noted that these extensions are presented for information and EUTF staff are not24

recommending any changes to such deadlines at this time.25

26

VII. OLD BUSINESS27

A. Committee Assignments28

Mr. Mizuno requested that this item be deferred since a new employee-beneficiary trustee29

has not been appointed.30

31

B. Waiver of EUTF Administrative Rule Related to Non-Payment of Plans and Possible32

Other Waivers of EUTF Administrative Rules33

Mr. Mizuno noted that the April and May 2020 number of cancellations due to non-34

payment and the number of shortage notices were comparable to the prior year. It does35

not appear that employees on leave without pay and retirees are being significantly36

impacted financially by the COVID-19 pandemic. EUTF staff is not recommending37

waiving the portion of EUTF Administrative Rule 4.11(b) related to cancellation due to38

non-payment for the normally scheduled terminations in June 2020. EUTF staff will39

continue to monitor this issue.40

41

42 C. Use of EUTF Reserve Funds for 100% Coverage of Furloughed Active Employees’

43 Healthcare Premiums

44 Trustee Clifford Uwaine requested that the Deputy Attorney General continue to

45 investigate the possibility of using EUTF reserves to pay for employer and employee

46 premiums for a pay period or month. He requested that this item remain on future

47 agendas.

48




Page 4

1 D. 2020 EUTF Related Legislation

2 Mr. Mizuno informed the Board that the legislature did not reduce previously budgeted

3 amounts for fiscal year 2020 and 2021. However, the EUTF’s supplemental budget

4 request of $400,000 for data cleansing for the new benefits administration system was not

5 approved.

6

7 VIII. REPORTS

8 A. Segal

1. Quarterly Plan Performance Report9

2. Quarterly Performance Guarantee Report10

Mr. Steve Murphy summarized the two quarterly reports.11

12

B. Administrator13

1. Meetings with legislators and unions14

2. Public engagement15

C. EUTF Managers’, Program Specialist and Benefits Audit Specialist Reports16

1. Member Services Branch (MSB)17

a. MSB Data18

b. MSB Staffing Update19

c. Outreach & Training20

d. 2020 Active Employee Open Enrollment21

e. Carrier Reports22

2. Information Systems (IS)23

a. EUTF New Benefits Administration System (BAS) Project24

b. V3 Benefits Administration System Modified Phase II (Employer File Feed)25

c. COVID-19 Response26

d. Vitech Contract27

e. ISB Staffing Update28

f. Enrollment Counts29

3. EUTF Benefits Audit Specialist Report30

a. Audits Currently in Progress31


c. Completed and Recurring Audits33

4. EUTF Program Specialist Report34

a. Worksite wellness35

b. Preventive health36

c. Chronic disease management37

5. Financial Services Branch (FSB)38

a. FSB Performance Data39

b. Management Letter Corrective Action Plan Status40

41 c. EUTF Collections

42 d. FSB Staffing Update

43 e. Financial Statements as of March 31, 2020

44 D. Carrier Reports

45 1. CVS Caremark

46 2. SilverScript

47 3. Hawaii Dental Service (HDS)

48 4. Hawaii Mainland Administrators (HMA)




Page 5

1 5. Hawaii Medical Service Association (HMSA)

2 6. Kaiser Health Foundation

3 7. Securian

4 8. Vision Service Plan (VSP)

5

6 III. EXECUTIVE SESSION (continued)

7 The Board Meeting recessed and moved into Executive Session at 11:56 a.m.

8

The regular meeting reconvened at 12:09 p.m.9

10

IX. NEXT MEETING DATE11

Tuesday, June 23, 2020, 9:00 a.m. – Retiree Premiums Effective January 1, 202112

13

X. ADJOURNMENT14

MOTION was made and seconded for the Board to adjourn the meeting at 12:10 p.m.15

(Uwaine/Johnston) The motion passed unanimously. (Employer Trustees-5/Employee-16

Beneficiary Trustees-4)17

18

Respectfully submitted, 19

20

21

____________________________________22

Laurel Johnston, Secretary-Treasurer 23

24

25

26

Documents Distributed: 27

1. Draft Board Minutes of April 28, 2020. (8 pages)28

2. Memorandum to BOT from EUTF Investment Committee Regarding May 21, 2020 Investment29

Committee Meeting, dated May 21, 2020. (1 page)30

3. Memorandum to BOT from EUTF Benefits Committee Regarding Benefits Committee Meeting31

– May 19, 2020, dated May 19, 2020. (1 pages)32

4. Memorandum to BOT from EUTF Health Benefits Specialist Regarding Proposed Chiropractic33

Benefit, Redacted Version, dated May 21, 2020. (2 pages)34

5. Memorandum to BOT from EUTF Administrator Regarding Progress on the Strategic Plan35

Through December 31, 2019, dated May 19, 2020. (1 page)36

6. Memorandum to BOT from EUTF Eligibility Specialist Regarding HIPAA, COBRA, and37

Appeals Extended Deadlines, dated May 19, 2020. (2 pages)38

7. EUTF Committee Assignments dated April 27, 2020. (1 page)39

8. Memorandum to BOT from EUTF Financial Management Officer Regarding Waiver of EUTF40

41 Administrative Rule 4.11(b) Related to Non-Payment of Plans, dated May 21, 2020. (1 page)

42 9. Legislative Update dated May 21, 2020. (3 pages)

43 10. EUTF Year to Date Contract Plan Experience Report, Contract Year to Date through

44 March 2020, prepared by Segal Consulting, dated May 26, 2020. (41 pages)

45 11. Administrator’s Monthly Report to the Board from April 18, 2020 – May 15, 2020, dated

46 May 15, 2020. (1 page)

47 12. Memorandum to BOT from Member Services Branch Manager Regarding April – May 2020

48 Member Services Operations Report, dated May 15, 2020. (6 pages)




Page 6

1 13. Memorandum to BOT from Information Systems Chief Regarding April – May 2020

2 Information Systems (IS) Operations Report, dated May 15, 2020. (11 pages)

3 14. Memorandum to Administrator from EUTF Benefits Audit Specialist Regarding April – May

4 2020 EUTF Benefits Audit Specialist Report, dated May 15, 2020. (2 pages)

5 15. Memorandum to Administrator from EUTF Program Specialist Regarding April – May 2020

6 EUTF Program Specialist Report, dated May 15, 2020. (4 pages)

7 16. Memorandum to BOT from EUTF Financial Management Officer Regarding April – May 2020

8 Financial Services Branch (FSB) Report, dated May 15, 2020. (15 pages)

17. CVS Caremark Monthly Carrier Report for April 2020 dated May 4, 2020. (10 pages) 9

18. SilverScript Monthly Carrier Report for April 2020 dated May 4, 2020. (3 pages)10

19. HDS Monthly Carrier Report for April 2020 dated May 7, 2020. (3 pages)11

20. HMA Monthly Carrier Report for April 2020 dated May 8, 2020. (2 pages)12

21. HMSA Monthly Carrier Report for April 2020 dated May 15, 2020. (3 pages)13

22. Kaiser Monthly Carrier Report for April 2020 dated May 8, 2020. (2 pages)14

23. Securian Financial Monthly Carrier Report for April 2020 dated May 10, 2020. (1 page)15

24. VSP Monthly Carrier Report for April 2020 dated May 7, 2020. (2 pages)16

PENDING: V. Benefits Committee







June 17, 2020

TO: EUTF Board of Trustees

THROUGH: Derek Mizuno, Administrator

FROM: Lara Nitta, Health Benefits Specialist

SUBJECT: Proposed Chiropractic Benefit (Part 2)

As a follow up to the Board memo dated May 21, 2020 on the chiropractic benefit proposal for EUTF retirees, this memo addresses the following:

1. The clinical and cost saving benefit of having chiropractic coverage2. Prevalence among Segal, HMSA, and KP clients with chiropractic coverage3. Provider network in the State4. Updated rate impact from Humana

The American Specialty Health, Inc. response to EUTF questions states that chiropractic care is recognized as an effective treatment to manage back pain. Chiropractic care is an alternative to more costly, and sometimes invasive, treatment such as surgery, inpatient care, and physical therapy.

The following is a summary of the prevalence among Segal, HMSA, and KP clients with chiropractic coverage:

Segal HMSA KP Prevalence 100% of State

governments surveyed (17)*

96% of accounts and 25% of self-insured/ Union accounts have

chiro coverage

47% of membership

Actives only 5.9% (NE only) of State governments

surveyed

66% of self-insured/ Union accounts with

chiro coverage

50% of active members

Retirees only -- -- 5% of retiree members Both actives and retirees

94.1% of State governments suveyed

34% of self-insured/ Union accounts with

chiro coverage

--

* States included in Segal’s survey are Alabama, Alaska, Arizona, California, Connecticut, Florida, Illinois, Kansas,Maryland, Mississippi, Nebraska, New Hampshire, North Carolina, Oregon, Texas, Washington, and Wisconsin.California, Oregon, and Washington are not Segal clients but were included in Segal’s survey. Segal did not surveyany state clients without chiro coverage.

EUTF’s Mission: We care for the health and well being of our beneficiaries by striving to provide quality benefit plans that are affordable, reliable, and meet their changing needs. We provide informed service that is excellent, courteous, and compassionate.


www.eutf.hawaii.gov

June 17, 2020 Page 2

HMSA and KP subcontract with American Specialty Health, Inc. (ASH) for its chiropractic provider network, and coverage is limited to ASH’s network. Humana, on the other hand, contracts with its chiropractors individually, but offers the same level of coverage in and out of network.

Island Licensed Practitioners ASH Humana Hawaii 61 35 57.4% 3 4.9% Kauai 25 10 40.0% 1 4.0% Maui 70 35 50.0% 6 8.6% Oahu 201 145 72.1% 12 6.0% Total 357 225 63.0% 22 6.2%

The rate impact for the HMSA and KP plans remain the same as provided in the 5/21/20 memo. However, Humana has offered to waive its rate impact for the life of the contract, 1/1/21-12/31/24. Humana believes that chiropractic claims will be offset by a decrease in medical claims.

Attachment

Cc: Steve Murphy, Segal

1111 1111 1111 1111 1111 1111

I-------+-- - ---=-~~--=-==----------i -■







May 21, 2020

TO: EUTF Board of Trustees


FROM: Lara Nitta, Health Benefits Specialist

SUBJECT: Proposed Chiropractic Benefit

In RFP 20-003 for Medical Benefits and Pharmacy Benefit Management Services, offerors were asked to provide the rate impact to add a chiropractic benefit to the EUTF retiree medical plans as the EUTF retirees are the only group currently without such a benefit (up to 20 visits per calendar year at $15/visit for EUTF actives and $12/visit for HSTA VB actives and retirees). Below is a summary of the final negotiated rates.

Proposal: Add a $15/visit (up to 20 visits per calendar year) chiropractic benefit for EUTF retirees medical plans effective 1/1/21. The chiropractic benefit would be administered through American Specialty Health, Inc. (ASH) under the medical plan, regardless of whether the plan is fully or self-insured.

Pros: Aligns with the EUTF active benefit.

Cons: Rate impact. Concerns related to the ongoing Dannenberg litigation.

EUTF Non-Medicare Retirees HMSA* KP Total Rate impact $251,293 per year $37,134 per year $288,427 per year

Single $2.38 $1.70Two-party $4.72 $3.42Family $5.02 $5.06

UAAL impact $6,976,000 $1,031,000 $8,007,000Proj. utilization 6.1% for entire

retiree population 5-10%

Average visits per utilizer

7.5 5-7

Average cost Proprietary to ASH

Proprietary to ASH



www.eutf.hawaii.gov

I ... 1111 1111 1111 1111 1111 1111 1111 1111 ■

■ -■ I

I

-

May 21, 2020 Page 2

EUTF Medicare Retirees HMSA* KP Humana** TotalRate impact $1,242,600

per year $172,549 per year - $1,415,149 per

year Single $2.38 $1.64 $0.08Two-party $4.72 $3.20 $0.16Family $5.02 $4.74 NA

UAAL impact $34,497,000 $4,790,000 NA $39,287,000 Proj. utilization 6.1% for entire

retiree population Similar to the

commercial pop. NA

Average visits per utilizer

7.5 Similar to the commercial pop.

-

Average cost Proprietary to ASH

Proprietary to ASH

-

* The rate impact provided by HMSA increases each year. See attached proposal for the rate impact insubsequent years.

** The significant difference in the rate impact for the Humana plan is likely due to the subsidies that Humana receives for its Medicare Advantage plan overall.

Attachment Cc: Steve Murphy, Segal







June 17, 2020

TO: Board of Trustees


FROM: Amy Cheung

EUTF Financial Management Officer

SUBJECT: Waiver of EUTF Administrative Rule 4.11(b) Related to Non-Payment of Plans

The Board previously waived health benefit plan cancellations due to non-payment of premiums

for the months of April and May 2020.

The following table compare the number of accounts with a shortage balance for the months of

April (unpaid premiums March 1-31), May (April 1 – 30) and June (May 1 – 30).

Shortage Notices April May June

2020 393 417 344

2019 391 408 378




www.eutf.hawaii.gov

6/12/2020 ACA OOP Limit for 2021 & Guidance on Rx Coupons | Segal

Compliance News | May 12, 2020

ACA OOP Limit for 2021 & Guidance on Rx Manufacturer Coupons On May 7, 2020, the Department of Health andHuman Services (HHS) issued a �nal notice withimportant information for group health plans that arenot grandfathered under the A�ordable Care Act(ACA).

The notice includes the �nal indexed amounts for2021 for the ACA-required out-of-pocket (OOP) limitfor non-grandfathered plans.

HHS also makes it clear that plan sponsors maycontinue to decide whether and when the value ofcoupons or other forms of direct support from drugmanufacturers count toward the ACA-required OOPlimit. Plan sponsors should clearly communicate theplan’s rules on such coupon programs toparticipants.

Out-of-pocket limits for 2021Out-of-pocket maximums for non-grandfathered plans are indexed each year. The limits for 2021 will be:$8,550 for single coverage and $17,100 for other coverage tiers.

The IRS has not yet announced the di�erent (and lower) limits that will apply to high-deductible healthplans (HDHPs) paired with Health Savings Accounts (HSAs).

Rx coupons and other forms of direct supportfrom manufacturersHHS is �nalizing the �exible approach proposed in February 2020 (discussed in our February 10, 2020 webpost). As a result, it is now clear that plan sponsors (and health insurers) have complete �exibility indeciding whether and when the value of manufacturer coupons (or other forms of direct support) counttoward the ACA-required OOP limit. The exception is when an applicable state law requires a di�erentapproach.

https://www.segalco.com/consulting-insights/aca-oop-limit-2021 1/2

https://www.segalco.com/consulting-insights/rx-coupons-aca

https://www.segalco.com/consulting-insights/aca-oop-limit-2021

6/12/2020 ACA OOP Limit for 2021 & Guidance on Rx Coupons | Segal

This announcement represents a major turnaround from the approach initially taken by HHS in early 2019.That approach generated confusion, leading HHS, along with the other federal departments implementingthe ACA, to issue an answer to a frequently asked question (FAQ) in August 2019. In that FAQ, thedepartments announced an enforcement safe harbor under which plan sponsors were permitted tocontinue to decide when to count coupons toward the ACA-required OOP limit, pending issuance offurther guidance from HHS. (We discussed that FAQ in our August 27, 2019 web post.)

The latest guidance is included in the �nal Notice of Bene�t and Payment Parameters for 2021, which isscheduled to be published in the May 14, 2020 Federal Register.

The immediate implicationsWith the enforcement safe harbor announced last August still in e�ect, and the clear approach taken in the�nal notice released on May 7, 2020, plan sponsors can continue to count or exclude these coupons fromthe ACA’s OOP limit, whichever approach is provided for in the governing plan documents. HHSencourages plan sponsors to be transparent in plan materials about whether and when these couponscount toward the plan’s deductible and/or OOP limit.

Questions remain about whether plan sponsors of HSA-quali�ed HDHPs may count these coupons andother forms of direct manufacturer support toward the HDHP’s deductible. HHS states in this notice thatTreasury and the IRS are reviewing the comments HHS received on this issue to determine if additionalguidance is needed.

Under the federal anti-kickback statute, manufacturer coupons cannot be o�ered with respect to drugspaid for by any federal health care program, including Medicare, Medicaid or Part D. Some state programsmay also not be eligible for coupon programs. Legal counsel should review the applicability of any programthat is proposed for retirees or a governmental employer.

On all issues involving the interpretation or application of laws and regulations, plan sponsors should discuss the issues raised here with theirlegal, tax and other advisors before determining how the issues apply to their speci�c situations.

https://www.segalco.com/consulting-insights/aca-oop-limit-2021 2/2

https://www.segalco.com/consulting-insights/nongrandfathered-plan-guidance

https://www.govinfo.gov/content/pkg/FR-2020-05-14/pdf/2020-10045.pdf

https://www.segalco.com/consulting-insights/aca-oop-limit-2021

6/12/2020 Indexed Amount for PCORI Fee | Segal

Compliance News | June 10, 2020

Indexed Amount for PCORI Fee

July 31, 2020 is the deadline for calendar-year grouphealth plans to pay the ACA’s comparativee�ectiveness research fee for the 2019 plan year.On June 8, 2020, in Notice 2020-44, the TreasuryDepartment and IRS announced the indexed amountper covered life needed to calculate the fee: $2.54(up from $2.45 for the previous year).

This new rate of $2.54 per covered life also appliesto any plan year that ends on or after October 1,2019 and before October 1, 2020. However, thepayment deadline di�ers depending on the calendaryear in which the plan year ends.

Limited transition reliefNotice 2020-44 also provides limited transition relief a�ecting how plan sponsors of self-insured plans (aswell as insurers) calculate the number of covered lives. For plan years ending on or after October 1, 2019and before October 1, 2020, plan sponsors (and insurers) may use any reasonable method to calculate theaverage number of covered lives.

Plan sponsors using a reasonable method to do this calculation must use that method consistently for theduration of the plan year.

Plan sponsors may still choose to use one of the three usual methods for calculating the fee: the actual-count method, the snapshot method or the Form 5500 method. (Those methods are described on the IRSwebsite.)

Brief background on the feeThe comparative e�ectiveness research fee is commonly referred to as the PCORI fee. That’s because thePatient-Centered Outcomes Research Institute (PCORI) is partially funded through collection of this feefrom insurers and self-insured group health plans. PCORI conducts research evaluating and comparinghealth outcomes and assesses the clinical e�ectiveness, risks and bene�ts of medical treatments.

The section of the ACA about PCORI and related regulations refer to plan years “ending” before or afterspeci�c dates (rather than the more common terminology of plan years “beginning” on or after certaindates). Consequently, it can be di�cult to follow IRS guidance about which rate applies to which plan years

https://www.segalco.com/consulting-insights/indexed-amount-for-pcori-fee 1/2

https://www.irs.gov/pub/irs-drop/n-20-44.pdf

https://www.irs.gov/newsroom/patient-centered-outcomes-research-institute-fee

https://www.segalco.com/consulting-insights/indexed-amount-for-pcori-fee

6/12/2020 Indexed Amount for PCORI Fee | Segal

and determine the deadline for paying the fee. The �ling deadline for a 2019 calendar-year plan is July 31,2020. However, the �ling deadline for a plan year that ends in January 2020 through September 2020would be July 31, 2021, because those plan years end in 2020.

This publication is for informational purposes only and does not constitute legal, tax or investment advice. You are encouraged to discuss theissues raised here with your legal, tax and other advisors before determining how the issues apply to your speci�c situations.

https://www.segalco.com/consulting-insights/indexed-amount-for-pcori-fee 2/2

https://www.segalco.com/consulting-insights/indexed-amount-for-pcori-fee

Affordable Care Act Dollar Amounts and Percentages

Many provisions in the Affordable Care Act contain numbers or percentages that are indexed to various measures of infation. The government announces new numbers at different times of the year and in different publications. The table below assembles these amounts in one place and is current as of June 8, 2020.

Indexed Amounts Affecting Group Health Plans

Item 2016 2017 2018 2019 2020 2021

Out-of-pocket (OOP) limit for non-grandfathered plans

Individual: $6,850

Family: $13,7001

(See announcement.)

Individual: $7,150

Family: $14,300

(See announcement.)

Individual: $7,350

Family: $14,700

(See announcement.)

Individual: $7,900

Family: $15,800

(See announcement.)

Individual: $8,150

Family: $16,300

(See announcement.)

Individual: $8,550

Family: $17,100

(See announcement.)

Flexible spending account (FSA) maximum salary reduction

$2,550

(See announcement.)

$2,600

(See announcement.)

$2,650

(See announcement.)

$2,700

(See announcement.)

$2,750

(See announcement.)

Employer shared responsibility penalty – 4980H(a)2

$2,160

(See announcement.)

$2,260

(See answers to FAQs.)

$2,320


$2,500


$2,570


Employer shared responsibility penalty – 4980H(b)3

$3,240

(See announcement.)

$3,390


$3,480


$3,750


$3,860


Affordability of group health plan coverage: test applied by Exchange/Marketplace when determining if offered coverage is affordable

Not affordable if cost of employee-only coverage exceeds 9.66% of household income

(See announcement.)


(See announcement.)


(See announcement.)


(See announcement.)


(See announcement.)

1 For 2014 only, the Affordable Care Act’s OOP limits were the same as the OOP maximums applicable to a Health Savings Account (HSA) offered with a high-deductible health plan (HDHP). (Space constraints prevent us from showing columns of 2014 and 2015 data in the table above. If you need data for those years, an older version of this document is available.) For 2015 and beyond, the Affordable Care Act’s OOP limits are not indexed to the HSA/HDHP amounts. The HSA/HDHP amounts are shown later in this chart for ease of reference.

2 The employer shared responsibility penalty is found in section 4980H of the Internal Revenue Code. There are two branches of the employer shared responsibility penalty. The 4980H(a) penalty is based on the total number of full-time employees. It is triggered if the employer fails to offer coverage to a certain percentage of its full-time employees and one full-time employee receives subsidized Exchange/Marketplace coverage.

3 The 4980H(b) penalty is based on the number of full-time employees who are not offered affordable, minimum value coverage by the employer and who receive subsidized Exchange/Marketplace coverage instead of employer coverage.

Item 2016 2017 2018 2019 2020 2021

Affordability of group health plan coverage: safe harbors available to employers seeking to minimize employer penalty

W-2, rate of pay and FPL safe harbors use 9.66% in the calculation

(See announcement.)




(See announcement.)


(See announcement.)


(See announcement.)

See separate table on the next page for FPL safe harbor calculation.





100% of the FPL (for single $11,770 $11,880 $12,060 $12,140 $12,490 $12,760 person living in one of the 48 contiguous states or

(See announcement.) (See announcement.) (See announcement.) (See announcement.) (See announcement.) (See announcement.)

Washington, DC),4 which Exchange/Marketplace uses when calculating premium assistance tax credit

Affordability of group health Not affordable if cost Not affordable if cost Not affordable if cost Not applicable plan coverage: test applied by federal government in determining if individual or

of coverage exceeds 8.13% of household income



(individual mandate penalty reduced to zero in the 2017 Tax Law)

family is exempt from the individual mandate

(See announcement.) (See announcement.) (See announcement.)

Individual-mandate penalty Greater of $695 Greater of $695 or Greater of $695 or $0 (indexed after 2016) or 2.5% of income;

2.5% of income; maximum penalty is

2.5% of income; maximum penalty is

(penalty reduced to zero in the 2017 Tax Law)

maximum penalty is $272 per person per $283 per person per $223 per person per month or $1,360 per month or $1,415 per month or $1,115 per month for a family of month for a family of month for a family of 5 or more 5 or more 5 or more (See announcement.) (See announcement.) (See announcement.)

This table continues on the next page.

4 Revised federal poverty guidelines are usually released in late January of each year. They apply to Exchange/Marketplace calculations of the premium assistance tax credit for the following year (e.g., the FPL published in the January 17, 2020 Federal Register ($12,760) is used to calculate the premium assistance tax credit for 2021). Higher amounts apply to individuals living in Alaska and Hawaii.

Item 2016 2017 2018 2019 2020 2021

HSA/HDHP

Minimum deductible Individual: $1,300

Family: $2,600

(See announcement.)

Individual: $1,300

Family: $2,600

(See announcement.)

Individual: $1,350

Family: $2,700

(See announcement.)

Individual: $1,350

Family: $2,700

(See announcement.)

Individual: $1,400

Family: $2,800

(See announcement.)

Individual: $1,400

Family: $2,800

(See announcement.)

Maximum contribution5 Individual: $3,350

Family: $6,750

Individual: $3,400

Family: $6,750

Individual: $3,450

Family: $6,9006

Individual: $3,500

Family: $7,000

Individual: $3,550

Family: $7,100

Individual: $3,600

Family: $7,200

OOP maximum Individual: $6,550

Family: $13,100

Individual: $6,550

Family: $13,100

Individual: $6,650

Family: $13,300

Individual: $6,750

Family: $13,500

Individual: $6,900

Family: $13,800

Individual: $7,000

Family: $14,000

Affordability of Group Health Plan Coverage: FPL Safe Harbor Available to Employers Seeking to Minimize Employer Penalty

Plan Year 100% of FPL for Single Individual Working

in 48 Contiguous States or Washington, DC Maximum Affordable Monthly

Premium for Self-Only Coverage

Plan year beginning January 1, 20157 $11,670 $92.978

Plan year beginning February 1 – December 1, 2015 $11,770 $93.77











5 Those over age 55 before the end of the taxable year can make an HSA catch-up contribution of $1,000 each year. 6 On March 5, 2018 in Revenue Procedure 2018-18, the maximum family contribution was reduced to $6,850 from the $6,900 maximum announced on May 4, 2017 in Revenue Procedure 2017-37.

On April 26, 2018 in Revenue Procedure 2018-27, the IRS reverted back to the $6,900 maximum family contribution in response to requests it received from plan sponsors. 7 Employers may use any FPL in effect within six months before the start of the plan year. Higher levels apply to individuals working in Alaska and Hawaii. 8 The calculations for 2015 use 9.56% as the applicable multiplier, as permitted by Treasury Notice 2015-87. 9 The calculations for 2016 use 9.66% as the applicable multiplier, as permitted by Treasury Notice 2015-87.

10 The calculations for 2017 use 9.69% as the applicable multiplier, as permitted by answers to FAQs. 11 Note that the maximum monthly amount decreased for 2018 because the calculation uses 9.56% as the applicable multiplier (the multiplier for 2017 was 9.69%, as noted in footnote 10).

See Revenue Procedure 2017-36. 12 This calculation for 2018 uses 9.56% as the applicable multiplier. See footnote 11. 13 The calculations for 2019 use 9.86% as the applicable multiplier. See Revenue Procedure 2018-34. 14 Note that the maximum monthly amount decreased for a plan year beginning January 1, 2020, because this calculation uses 9.78% as the applicable multiplier. See Revenue Procedure 2019-29. 15 This calculation for 2020 also uses 9.78% as the applicable multiplier. See footnote 14.

Affordable Care Act Fee

Fees 2015 2016 2017 2018 2019 2020

Comparative effectiveness $2.08 per person $2.17 per person $2.26 per person (for $2.39 per person (for $2.45 per person (for $2.54 per person (for research fee (PCORI )16 — (for a calendar-year (for a calendar-year a calendar-year plan, a calendar-year plan, a calendar-year plan, a calendar-year plan, extended by Congress plan, the amount paid plan, the amount paid the amount paid by the amount paid by the amount paid by the amount paid by until 202917 by 7/31/15 for the by 7/31/16 for the 7/31/17 for the 2016 7/31/18 for the 2017 7/31/19 for the 2018 7/31/20 for the 2019

2014 plan year) 2015 plan year) plan year) plan year) plan year) plan year)

(See announcement.) (See announcement.) (See announcement.) (See announcement.) (See announcement.) (See announcement.)

16 PCORI stands for the Patient-Centered Outcomes Research Institute that is partially funded through the comparative effectiveness research fee. This fee is based on the plan year (not the calendar year). The chart illustrates the amount and payment deadline for a calendar-year plan.

17 The Further Consolidated Appropriations Act enacted in December 2019 (Public Law 116-94) extended these fees through plan years ending on or before 9/30/29.

For more information about the amounts in these table, including links to relevant IRS guidance, and how the amounts affect your plan, please contact your Segal consultant. Segal can be retained to work with plan sponsors and their legal counsel on compliance issues.

This resource is for informational purposes only and does not constitute legal, tax or investment advice. You are encouraged to discuss the issues raised here with your legal, tax and other advisors before determining how the issues apply to your specific situations.

© 2020 by The Segal Group, Inc.

Administrator's Monthly Report to the Board

Coverage Period: May 16 – June 12, 2020

Ongoing Projects/Issues No. Current Status Progress Made During Coverage Period Problems/Issues Next Steps 1. Meetings with

legislators and unions

Meetings held with all unions and key legislators. None None

2. Public engagement On hold

Rev 20.06.12

1

https://20.06.12







June 12, 2020


FROM: Bonny Kahalewai

Member Services Branch Manager

SUBJECT: May - June 2020 Member Services Operations Report

This report covers the time-period from May 16 – June 12, 2020. Additional details will be

provided upon request.

a. Member Services Branch (MSB) Data

Customer Service Automated Call Distribution (ACD) Report for May 2020:

ACD Incoming

ACD

Calls

Outgoing

ACD

Calls

Total

Ans.

Average

Call

Duration

(minutes)

%

Ans.

% Ans.

within

10 Sec.

% Ans.

within

11-30

Sec.

% Ans.

within

>30

Sec.

Total

Abandoned

MSB 3,593 734 3,466 4:02 96.47 67.41 14.39 14.67 127

See the attached MSB Automated Call Distribution report for more information on call

trends.

MSB continued to receive calls during the month of May which were attributed in part to

inquiries about the Active Employee Open Enrollment, Retirements and the Social Security

Administration letters for Medicare Part B premium reimbursements. MSB was able to

answer over 96% of calls during the month of May despite having less staff working in the

office. This is attributed to no walk-in customers. Currently, seven (7) MSRs and two (2)

MSR Supervisors work in the office and five (5) MSRs work from home.

Number of walk-ins serviced = 115 (709 in May 2019)

Number of General Emails received and responded to = 434 (356 in May 2019)




www.eutf.hawaii.gov

Number of

Documents

Received

Number of

Documents

Processed

Number of

Documents

in Process

Documents

Not Past

the

Processing

Due Date

Documents

1-15 Days

Past the

Processing

Due Date

Documents

16-30 Days

Past the

Processing

Due Date*

Documents

31-60 Days

Past the

Processing

Due Date*

Documents

61+ Days

Past the

Processing

Due Date*

May 2019

8,115 8,996 2,407 823 880* 476*** 227*** 1****

June 2019

4,157 5,557 1,144 610 408* 94*** 32*** 0

July 2019

4,840 4,996 976 591 377* 8* 0 0

August 2019

5,593 5,089 1,561 603 880* 61* 17* 0

September 2019

5,374 5,317 1,448 624 819* 5* 0 0

October 2019

4,768 4,796 1,389 763 623* 3* 0 0

November 2019

4,283 3,990 1,733 752 962* 19* 0 0

December 2019

5,888 5,649 1,974 604 1,265** 105** 0 0

January 2020

9,737 8,676 3,004 438 2,211** 355** 0 0

February 2020

5,087 6,440 1,647 336 1,223** 88** 0 0

March 2020

4,242 4,621 1,264 360 728 176* 0 0

April 2020

5,235 5,505 1,009 665 343* 1* 0 0

May 2020

6,562 6,205 1,353 508 831* 14* 0 0

The Processing Due Date represents the later of the qualifying event or received dates.

* The number of documents past due are a combination of life events which have a

retroactive effective date, and/or we are waiting for supporting documentation which

makes us unable to complete the workflow. The normal turnaround time to process

documents from received date to completion is 15 business days.

** The number of documents in workflow past the processing due date are a result in part of

the section’s backlog due to the large volume of SSA letters. *** The number of workflows which are indicated as 16-60 days past the processing due date

are a result in part, of the section’s backlog due to the increasing volume of 2019 Active Employee Open Enrollment forms which the branch began receiving in March.

****The workflow which is indicated as 61+ days past the processing due date is attributed to

the 2017 Medicare Part B premium reimbursement adjustment.

b. MSB Staffing Update

There are currently three (3) vacancies in the Member Services Branch. Due to the hiring

freeze, recruitment has been placed on hold for the two (2) MSRs and one (1) MSR Clerk.

c. Outreach & Training

The Outreach & Training Team conducted four pre-retirement webinars during the month of

May with 85 people in attendance. The team also created training videos on topics such as

loss of coverage, leave without pay, acquisition of coverage, demographic or address changes,

divorce, and when to expect new insurance ID cards. The training videos are available for

active employees, retirees, and employers to view on-demand in the Learning Center on the

EUTF website.

d. 2020 Active Employee Open Enrollment

The Active Employee Open Enrollment ended May 15, 2020. Employers had until May 22,

2020 to submit all employee open enrollment forms and applicable supporting documents to

EUTF. As of June 12, 2020, EUTF received 3,924 documents which included OE enrollment

forms and supporting documents versus a total of 5,377 during the 2019 OE.

e. 2021 Retiree Open Enrollment

The 2021 Retiree Open Enrollment will be held October 15th through October 30th. The

informational sessions will be conducted entirely as webinars this year. Highlights of the

retiree open enrollment will be captured in the Fall ERS Holomua newsletter and a new

Retiree Benefits Highlight Guide will be mailed to all retirees and surviving spouses which

will be thinner and more enticing to read.

f. Carrier Reports

The carrier operation reports were all submitted timely for the month of May.

Enclosures

MSB Automated Call Distribution Report May 2020

Day Day of Week Incoming Calls Answered % Answered

Average Time

Per Call (min)

% Answered within x Abandoned Time (in seconds) Voice

Message Outgoing Calls 10 10-30 > 30 < 10 10-30 > 30 Total

1 Friday 145 144 99.31% 4:02 79.31% 13.79% 6.21% 0 0 1 1 0 23

4 Monday 250 233 93.20% 4:00 55.20% 12.00% 26.00% 2 6 9 17 0 23

5 Tuesday 157 155 98.73% 4:01 80.25% 14.01% 4.46% 2 0 0 2 0 24

6 Wednesday 137 132 96.35% 4:16 68.61% 14.60% 13.14% 1 1 3 5 0 35

7 Thursday 125 124 99.20% 4:05 82.40% 12.00% 4.80% 0 0 1 1 0 34

8 Friday 178 174 97.75% 3:40 73.60% 12.92% 11.24% 1 2 1 4 0 24

11 Monday 219 211 96.35% 3:56 69.41% 12.33% 14.61% 1 1 6 8 0 26

12 Tuesday 221 218 98.64% 3:43 80.09% 10.41% 8.14% 1 0 2 3 0 53

13 Wednesday 168 164 97.62% 3:32 72.62% 13.10% 11.90% 0 1 3 4 0 57

14 Thursday 176 171 97.16% 4:18 80.11% 11.93% 5.11% 1 0 4 5 0 39

15 Friday 211 204 96.68% 4:05 66.35% 12.80% 17.54% 0 2 5 7 0 47

18 Monday 210 206 98.10% 3:57 68.57% 12.86% 16.67% 1 0 3 4 0 53

19 Tuesday 169 163 96.45% 4:11 66.27% 15.98% 14.20% 1 3 2 6 0 33

20 Wednesday 155 151 97.42% 4:08 66.45% 18.71% 12.26% 0 1 3 4 0 40

21 Thursday 135 133 98.52% 4:19 71.85% 19.26% 7.41% 1 0 1 2 0 45

22 Friday 150 148 98.67% 4:07 72.00% 17.33% 9.33% 0 0 2 2 0 33

25

26

Monday

Tuesday

HOLIDAY - MEMORIAL DAY

256 223 87.11% 3:50 28.91% 15.23% 42.97% 0 3 30 33 0 29

27 Wednesday 168 166 98.81% 4:04 75.00% 13.69% 10.12% 0 0 2 2 0 28

28 Thursday 187 176 94.12% 4:24 56.15% 21.39% 16.58% 1 3 7 11 0 38

29 Friday 176 170 96.59% 4:22 64.77% 17.05% 14.77% 0 0 6 6 0 50

Monthly Totals 3593 3466 96.47% 4:02 67.41% 14.39% 14.67% 13 23 91 127 0 734

Report Created 6/2/2020

MSB Automated Call Distribution Report January to December 2020

Month Incoming Calls Answered % Answered

Average Time

Per Call (min)

% Answered within x seconds Abandoned Time (in seconds) Voice


January 5191 4622 89.04% 3:06 43.77% 11.40% 33.87% 27 51 491 569 0 668

February 3981 3654 91.79% 3:18 55.44% 12.94% 23.41% 18 24 285 327 0 697

March 3973 3475 87.47% 3:36 48.25% 11.55% 27.66% 23 29 446 498 0 757

April 3709 3565 96.12% 4:02 66.11% 14.72% 15.29% 10 17 117 144 0 677

May 3593 3466 96.47% 4:02 67.41% 14.39% 14.67% 13 23 91 127 0 734

June

July

August

September

October

November

December


MSB Automated Call Distribution Report January to December 2019

Month Incoming Calls Answered % Answered

Average Time

Per Call (min)

% Answered within x seconds Abandoned Time (in seconds) Voice


January 6219 5249 84.40% 3:41 53.26% 14.39% 16.76% 48 61 860 969 1 1344

February 4203 3866 91.98% 3:53 70.33% 12.71% 8.95% 24 28 285 337 0 925

March 4360 3850 88.30% 3:38 61.15% 13.67% 13.49% 29 25 456 510 0 1042

April 5467 5269 96.38% 3:53 80.30% 11.56% 4.52% 22 8 168 198 0 1665

May 3770 3724 98.78% 3:15 81.56% 12.63% 4.59% 9 10 27 46 0 1168

June 3789 3667 96.78% 3:33 71.81% 12.98% 11.98% 15 15 92 122 0 941

July 4135 4007 96.90% 3:42 72.43% 12.89% 11.58% 19 14 95 128 0 963

August 4148 4010 96.67% 3:36 69.43% 14.78% 12.46% 17 13 108 138 0 738

September 4521 4216 93.25% 3:12 63.19% 12.94% 17.12% 29 71 205 305 0 759

October 4523 4172 92.24% 3:26 55.05% 13.18% 24.01% 40 40 271 351 0 726

November 3783 3480 91.99% 3:36 53.48% 12.79% 25.72% 18 34 251 303 0 615

December 4504 4186 92.94% 3:13 55.28% 13.83% 23.82% 26 29 263 318 0 706








June 12, 2020


FROM: Ray Kan, Information Systems Chief

SUBJECT: May – June 2020 Information Systems (IS) Operations Report

This report covers the period from May 16, 2020 through June 12, 2020. This report provides

updates on certain key IS items. Additional details will be provided at the Board of Trustees

meeting or upon request.

a. EUTF New Benefits Administration System (BAS) Project

EUTF has executed a contract with Morneau Shepell (BAS solution) and Segal (project

management). A kick-off meeting was held on June 4, 2020 which was attended by Morneau

Shepell, Segal, and the IV&V vendor Accuity LLP, along with EUTF administrative staff,

managers, and supervisors.

b. V3 Benefits Administration System Modified Phase II (Employer File Feed)

The Modified Phase II project’s goal is to deliver an electronic system to receive Employee

demographic data and import into the BAS to reduce manual processing.

After further testing and consultation with Vitech, and to potentially receive data from the

State’s new HIPAY payroll system in the future, EUTF has made changes to the phases in

the deployment of the Employer File Feed. Phase 1 will include terminations, leave without

pay (including military and family medical leave), and terminations due to death. Phase 2

will include address updates, standardization, new hire/rehire demographic information, and

validation. Phase 3 will include batch processing and reporting.

Phase 1 was deployed to EUTF’s V3 Production Environment on March 19, 2019 to allow

EUTF to do mass terminations of employees enrolled only in life insurance plans which do

not require COBRA notices to be mailed or address updates. Once Phase 2 (address updates)

is implemented, all terminations will be processed from the files received from employers.

An updated Phase 2 fix was deployed to EUTF’s V3 UAT Test Environment on June 8, 2020

which fixed issues regarding date of birth not being updated in specific instances and address




www.eutf.hawaii.gov

Memorandum to the Board of Trustees

June 12, 2020

Subject: May – June 2020 - IS Operations Report

Page 2

updates not being scheduled if there is an exception on the import. This is currently

undergoing testing for a target date of completion by June 30, 2020.

c. COVID-19 Response

EUTF’s ISB department has completed the following as part of COVID-19 response during

this report period: 1) Configured 3 additional EUTF staff with VPN accounts to work

remotely, 2) Configured video cameras for EUTF managers to attend remote meetings, 3)

Increased security awareness due to Covid-19 related malware.

d. Vitech Contract

EUTF is preparing all necessary approval forms for the upcoming Vitech contract renewal. A

meeting with the ETS Project Advisory Council (PAC) is scheduled for June 19, 2020.

e. Humana Retiree Plan

EUTF’s ISB is preparing for system changes to add the new Humana retiree plan including

working with Humana on file exchange formats and protocols to be ready by retiree open

enrollment in October 2020.

f. ISB Staffing Update

All positions are filled.

g. Enrollment Counts

See attachments for periods ending May 31, 2020.

Enclosures

Enrollment Counts ‐ Actives (Summary)

The table below shows Active enrollments for period ending 05‐31‐2020

Total Number of Active = 67,649

Count by Subscribers and Dependents

Type Benefit Plan Subscribers Dependents Total Medical Plans EUTF PPO‐90/10 HMSA Medical and Chiro bundled with PPO Drug (CVS) 3,600 2,184 5,784 PPO‐80/20 HMSA Medical and Chiro bundled with PPO Drug (CVS) 13,661 11,390 25,051 PPO‐75/25 HMSA Medical and Chiro bundled with PPO Drug (CVS) 15,825 16,790 32,615 HMO HMSA Medical and Chiro bundled with HMO Drug (CVS) 1,025 597 1,622 HMO Comprehensive Kaiser Medical, Drug and Chiro 5,115 4,072 9,187 HMO Standard Kaiser Medical, Drug and Chiro 8,452 7,722 16,174 HMA Supplemental Medical and Drug 758 1,370 2,128

EUTF Total 48,436 44,125 92,561

HSTA VB HSTA VB PPO‐90/10 Medical and Chiro (HMSA) bundled with PPO Drug (CVS), Vision (VSP) 1,118 1,167 2,285 HSTA VB PPO‐80/20 Medical and Chiro (HMSA) bundled with PPO Drug (CVS), Vision (VSP) 2,275 3,549 5,824 HSTA VB HMO Medical, Drug and Chiro (Kaiser) bundled with Vision (VSP) 844 1,079 1,923

HSTA VB Total 4,237 5,795 10,032

Medical Plans Total 52,673 49,920 102,593

Drug Plans EUTF PPO‐90/10 CVS Prescription Drug bundled with PPO Medical (HMSA) 3,600 2,184 5,784 PPO‐80/20 CVS Prescription Drug bundled with PPO Medical (HMSA) 13,661 11,390 25,051 PPO‐75/25 CVS Prescription Drug bundled with PPO Medical (HMSA) 15,825 16,790 32,615 HMO CVS Prescription Drug bundled with HMO Medical (HMSA) 1,025 597 1,622

EUTF Total 34,111 30,961 65,072

HSTA VB HSTA VB PPO‐90/10 Prescription Drug (CVS) bundled with HSTA VB PPO Medical (HMSA) 1,118 1,167 2,285 HSTA VB PPO‐80/20 Prescription Drug (CVS) bundled with HSTA VB PPO Medical (HMSA) 2,275 3,549 5,824

HSTA VB Total 3,393 4,716 8,109

Drug Plans Total 37,504 35,677 73,181

Dental Plans EUTF Dental (HDS) 51,359 46,496 97,855

EUTF Total 51,359 46,496 97,855

HSTA VB HSTA VB Dental (HDS) 4,538 5,937 10,475 HSTA VB Supplemental Dental (HDS) 117 216 333

HSTA VB Total 4,655 6,153 10,808

Dental Plans Total 56,014 52,649 108,663

Vision Plans EUTF Vision (VSP) 48,902 42,767 91,669

EUTF Total 48,902 42,767 91,669

HSTA VB HSTA VB Vision (VSP) ‐ Stand Alone 253 478 731 HSTA VB Vision (VSP) bundled with Medical 4,236 5,189 9,425

HSTA VB Total 4,489 5,667 10,156

Vision Plans Total 53,391 48,434 101,825

Life Insurance Plans EUTF Total 60,293 0 60,293 HSTA VB Total 5,574 0 5,574

Life Insurance Plans Total 65,867 0 65,867

Waived Plans

14,976

30,145

11,635

14,258

1,782

*NOTE: The Drug Plan Total does not reflect enrollments in Medical Plans such as Kaiser Medical and HMA Supplemental Medical which includes drug, but does not have a separate Drug enrollment count. Total Drug count for these plans is 15,169

Data Taken 05‐16‐2020

Report Generated on 5/20/2020 Page 1 of 9

Enrollment Counts ‐ EUTF Actives

The table below shows EUTF Actives enrollments for period ending 05‐31‐2020

Count by Enrollment Coverage

Count of Subscribers Type of Enrollment Benefit Plan Self Two Party Family Grand Total Medical Plans PPO‐90/10 HMSA Medical and Chiro bundled with PPO Drug (CVS) 2,533 501 566 3,600 PPO‐80/20 HMSA Medical and Chiro bundled with PPO Drug (CVS) 8,158 2,409 3,094 13,661 PPO‐75/25 HMSA Medical and Chiro bundled with PPO Drug (CVS) 8,288 2,764 4,773 15,825 HMO HMSA Medical and Chiro bundled with HMO Drug (CVS) 740 132 153 1,025 HMO Comprehensive Kaiser Medical, Drug and Chiro 3,179 870 1,066 5,115 HMO Standard Kaiser Medical, Drug and Chiro 4,836 1,506 2,110 8,452 HMA Supplemental Medical and Drug 186 174 398 758

Medical Plans Total 27,920 8,356 12,160 48,436

Drug Plans PPO‐90/10 CVS Prescription Drug bundled with PPO Medical (HMSA) 2,533 501 566 3,600 PPO‐80/20 CVS Prescription Drug bundled with PPO Medical (HMSA) 8,158 2,409 3,094 13,661 PPO‐75/25 CVS Prescription Drug bundled with PPO Medical (HMSA) 8,288 2,764 4,773 15,825 HMO CVS Prescription Drug bundled with HMO Medical (HMSA) 740 132 153 1,025

Drug Plans Total 19,719 5,806 8,586 34,111

Dental Plan (HDS) 27,293 11,662 12,404 51,359

Vision Plan (VSP) 26,788 10,693 11,421 48,902

Life Insurance Plan (Securian) 60,293 60,293


Type Benefit Plan Subscribers Dependents Total Medical Plans PPO‐90/10 HMSA Medical and Chiro bundled with PPO Drug (CVS) 3,600 2,184 5,784 PPO‐80/20 HMSA Medical and Chiro bundled with PPO Drug (CVS) 13,661 11,390 25,051 PPO‐75/25 HMSA Medical and Chiro bundled with PPO Drug (CVS) 15,825 16,790 32,615 HMO HMSA Medical and Chiro bundled with HMO Drug (CVS) 1,025 597 1,622 HMO Comprehensive Kaiser Medical, Drug and Chiro 5,115 4,072 9,187 HMO Standard Kaiser Medical, Drug and Chiro 8,452 7,722 16,174 HMA Supplemental Medical and Drug 758 1,370 2,128


Drug Plans PPO‐90/10 CVS Prescription Drug bundled with PPO Medical (HMSA) 3,600 2,184 5,784 PPO‐80/20 CVS Prescription Drug bundled with PPO Medical (HMSA) 13,661 11,390 25,051 PPO‐75/25 CVS Prescription Drug bundled with PPO Medical (HMSA) 15,825 16,790 32,615 HMO CVS Prescription Drug bundled with HMO Medical (HMSA) 1,025 597 1,622

Drug Plans Total 34,111 30,961 65,072

Dental Plan (HDS) 51,359 46,496 97,855

Vision Plan (VSP) 48,902 42,767 91,669



Enrollment Counts ‐ HSTA VB Actives

The table below shows HSTA VB Actives enrollments for period ending 05‐31‐2020


Count of Subscribers Type of Enrollment Benefit Plan Self Two Party Family Grand Total Medical Plans HSTA VB PPO‐90/10 Medical and Chiro (HMSA) bundled with PPO Drug (CVS), Vision (VSP) 609 160 349 1,118 HSTA VB PPO‐80/20 Medical and Chiro (HMSA) bundled with PPO Drug (CVS), Vision (VSP) 801 383 1,091 2,275 HSTA VB HMO Medical, Drug and Chiro (Kaiser) bundled with Vision (VSP) 413 117 314 844

Medical Plans Total 1,823 660 1,754 4,237

Drug Plans HSTA VB PPO‐90/10 Prescription Drug (CVS) bundled with HSTA VB PPO Medical (HMSA) 609 160 349 1,118 HSTA VB PPO‐80/20 Prescription Drug (CVS) bundled with HSTA VB PPO Medical (HMSA) 801 383 1,091 2,275

Drug Plans Total 1,410 543 1,440 3,393

Dental Plans HSTA VB Dental (HDS) 1,795 979 1,764 4,538 HSTA VB Supplemental Dental (HDS) 17 38 62 117

Dental Plans Total 1,812 1,017 1,826 4,655

Vision Plans HSTA VB Vision (VSP) ‐ Stand Alone 40 69 144 253 HSTA VB Vision (VSP) bundled with Medical 1,842 847 1,547 4,236

Vision Plans Total 1,882 916 1,691 4,489



Type Benefit Plan Subscribers Dependents Total Medical Plans HSTA VB PPO‐90/10 Medical and Chiro (HMSA) bundled with PPO Drug (CVS), Vision (VSP) 1,118 1,167 2,285 HSTA VB PPO‐80/20 Medical and Chiro (HMSA) bundled with PPO Drug (CVS), Vision (VSP) 2,275 3,549 5,824 HSTA VB HMO Medical, Drug and Chiro (Kaiser) bundled with Vision (VSP) 844 1,079 1,923


Drug Plans HSTA VB PPO‐90/10 Prescription Drug (CVS) bundled with HSTA VB PPO Medical (HMSA) 1,118 1,167 2,285 HSTA VB PPO‐80/20 Prescription Drug (CVS) bundled with HSTA VB PPO Medical (HMSA) 2,275 3,549 5,824

Drug Plans Total 3,393 4,716 8,109

Dental Plans HSTA VB Dental (HDS) 4,538 5,937 10,475 HSTA VB Supplemental Dental (HDS) 117 216 333


Vision Plans HSTA VB Vision (VSP) ‐ Stand Alone 253 478 731 HSTA VB Vision (VSP) bundled with Medical 4,236 5,189 9,425




Enrollment Counts ‐ EUTF Actives

The table below shows EUTF Actives enrollments for period ending 05‐31‐2020

Count by Bargaining Unit

Count of Subscribers

Benefit Plan BU 00 BU 01 BU 02 BU 03 BU 04 BU 05 BU 06 BU 07 BU 08 BU 09 BU 10 BU 11 BU 12 BU 13 BU 14 Grand Total

Medical Plans PPO‐90/10 HMSA Medical and Chiro bundled with PPO Drug (CVS) 127 435 32 670 36 429 112 379 193 87 143 65 204 653 35 3,600 PPO‐80/20 HMSA Medical and Chiro bundled with PPO Drug (CVS) 297 2,111 235 3,206 184 1,134 352 921 650 283 584 258 975 2,284 187 13,661 PPO‐75/25 HMSA Medical and Chiro bundled with PPO Drug (CVS) 390 2,241 155 3,311 184 2,247 231 663 1,030 294 668 884 617 2,714 196 15,825 HMO HMSA Medical and Chiro bundled with HMO Drug (CVS) 22 154 15 215 10 132 18 64 53 21 47 14 80 163 17 1,025 HMO Comprehensive Kaiser Medical, Drug and Chiro 98 817 100 1,157 76 503 108 434 201 119 262 118 333 715 74 5,115 HMO Standard Kaiser Medical, Drug and Chiro 180 1,025 56 1,695 63 1,596 89 484 700 151 298 318 285 1,397 115 8,452 HMA Supplemental Medical and Drug 21 63 11 217 17 88 13 23 28 11 15 43 33 165 10 758

Medical Plans Total 1,135 6,846 604 10,471 570 6,129 923 2,968 2,855 966 2,017 1,700 2,527 8,091 634 48,436

Drug Plans PPO‐90/10 CVS Prescription Drug bundled with PPO Medical (HMSA) 127 435 32 670 36 429 112 379 193 87 143 65 204 653 35 3,600 PPO‐80/20 CVS Prescription Drug bundled with PPO Medical (HMSA) 297 2,111 235 3,206 184 1,134 352 921 650 283 584 258 975 2,284 187 13,661 PPO‐75/25 CVS Prescription Drug bundled with PPO Medical (HMSA) 390 2,241 155 3,311 184 2,247 231 663 1,030 294 668 884 617 2,714 196 15,825 HMO CVS Prescription Drug bundled with HMO Medical (HMSA) 22 154 15 215 10 132 18 64 53 21 47 14 80 163 17 1,025

Drug Plans Total 836 4,941 437 7,402 414 3,942 713 2,027 1,926 685 1,442 1,221 1,876 5,814 435 34,111

Dental Plan (HDS) 1,224 7,255 646 11,561 640 6,320 969 3,051 2,887 1,008 2,125 1,783 2,637 8,587 666 51,359

Vision Plan (VSP) 1,154 6,967 621 11,000 601 5,912 929 2,846 2,723 957 2,044 1,706 2,554 8,248 640 48,902

Life Insurance Plan (Securian) 1,495 8,421 740 13,709 732 7,366 1,180 3,589 3,721 1,162 2,457 2,013 2,878 10,058 772 60,293

Enrollment Counts ‐ HSTA VB Actives

The table below shows HSTA VB Actives enrollments for period ending 05‐31‐2020

Count by Bargaining Unit

Count of Subscribers Benefit Plan BU 05 BU 05

1,118

2,275

844

4,237

1,118

2,275

3,393

4,538

117

4,655

253

4,236

4,489

5,574

Medical Plans HSTA VB PPO‐90/10 Medical and Chiro (HMSA) bundled with PPO Drug (CVS), Vision (VSP) 1,118 HSTA VB PPO‐80/20 Medical and Chiro (HMSA) bundled with PPO Drug (CVS), Vision (VSP) 2,275 HSTA VB HMO Medical, Drug and Chiro (Kaiser) bundled with Vision (VSP) 844

Medical Plans Total 4,237

Drug Plans HSTA VB PPO‐90/10 Prescription Drug (CVS) bundled with HSTA VB PPO Medical (HMSA) 1,118 HSTA VB PPO‐80/20 Prescription Drug (CVS) bundled with HSTA VB PPO Medical (HMSA) 2,275

Drug Plans Total 3,393

Dental Plans HSTA VB Dental (HDS) 4,538 HSTA VB Supplemental Dental (HDS) 117

Dental Plans Total 4,655

Vision Plans HSTA VB Vision (VSP) ‐ Stand Alone 253 HSTA VB Vision (VSP) bundled with Medical 4,236

Vision Plans Total 4,489

Life Insurance Plan (Securian) 5,574



Enrollment Counts ‐ Retirees (Summary)

The table below shows Retiree enrollments for period ending 05‐31‐2020

Total Number of Retiree = 50,181


Waived Plans

Type Benefit Plan Subscribers Dependents Total Medical Plans EUTF PPO‐90/10 Medical (HMSA) ‐ Retiree Retiree (Medicare) 31,730 12,542 44,272 Retiree (Non‐Medicare) 5,388 4,508 9,896

PPO‐90/10 Medical (HMSA) ‐ Retiree Total 37,118 17,050 54,168

HMO Medical (Kaiser), Drug (Kaiser) ‐ Retiree Retiree (Medicare) 6,573 2,317 8,890 Retiree (Non‐Medicare) 1,073 775 1,848

HMO Medical (Kaiser), Drug (Kaiser) ‐ Retiree Total 7,646 3,092 10,738

Out‐of‐State Plan Retiree (Medicare) 175 63 238 Retiree (Non‐Medicare) 8 3 11

Out‐of‐State Plan Total 183 66 249

EUTF Total 44,947 20,208 65,155

HSTA VB HSTA VB PPO‐90/10 Medical and Chiro (HMSA) bundled with PPO Drug (SilverScript or CVS), Vision (VSP) ‐ Retiree Retiree (Medicare) 2,062 1,002 3,064 Retiree (Non‐Medicare) 25 10 35

HSTA VB PPO‐90/10 Medical and Chiro (HMSA) bundled with PPO Drug (SilverScript or CVS), Vision (VSP) ‐ Retiree Total 2,087 1,012 3,099

HSTA VB PPO‐90/10 Medical and Chiro (HMSA) bundled with Vision (VSP) ‐ Retiree Retiree (Medicare) 10 3 13

HSTA VB PPO‐90/10 Medical and Chiro (HMSA) bundled with Vision (VSP) ‐ Retiree Total 10 3 13

HSTA VB HMO Medical, Drug and Chiro (Kaiser) bundled with Vision (VSP) ‐ Retiree Retiree (Medicare) 224 89 313 Retiree (Non‐Medicare) 6 1 7

HSTA VB HMO Medical, Drug and Chiro (Kaiser) bundled with Vision (VSP) ‐ Retiree Total 230 90 320

HSTA VB Out‐of‐State Plan Retiree (Medicare) 4 3 7

HSTA VB Out‐of‐State Plan Total 4 3 7

HSTA VB Total 2,331 1,108 3,439


Drug Plans EUTF PPO Drug (SilverScript) ‐Medicare 30,895 12,032 42,927 PPO Prescription Drug (CVS) ‐ Non‐Medicare 5,505 4,575 10,080

EUTF Total 36,400 16,607 53,007

HSTA VB HSTA VB PPO‐90/10 Prescription Drug (CVS) bundled with HSTA VB PPO Medical (HMSA) ‐ Non‐Medicare 31 11 42 HSTA VB PPO‐90/10 Prescription Drug (SilverScript) bundled with HSTA VB Medical (HMSA) ‐Medicare 2,059 1,001 3,060

HSTA VB Total 2,090 1,012 3,102

Drug Plans Total 38,490 17,619 56,109

Dental Plans EUTF Total 45,500 20,669 66,169 HSTA VB Total 2,324 1,109 3,433


Vision Plans EUTF Total 45,643 20,905 66,548 HSTA VB Total 2,330 1,106 3,436


Life Insurance Plans EUTF Total 42,373 0 42,373 HSTA VB Total 2,344 0 2,344

Life Insurance Plans Total 44,717 0 44,717

2,903

11,691 *

2,357

2,208

224 **

*NOTE: The Drug Plan Total does not reflect enrollments in Medical Plans such as Kaiser Medical and Out‐of‐State Medical which includes drug, but does not have a separate Drug enrollment count. Total Drug count for these plans is 8,063

**NOTE: The Waived Life Insurance Total does not include Survivors who are not eligible for Life Insurance. Total count of Survivors not eligible is 5,240



Enrollment Counts ‐ EUTF Retirees

The table below shows EUTF Retirees enrollments for period ending 05‐31‐2020


Count of Subscribers Type of Enrollment Benefit Plan Self Two Party Family Grand Total Medical Plans PPO‐90/10 Medical (HMSA) ‐ Retiree Retiree (Medicare) 19,734 11,544 452 31,730 Retiree (Non‐Medicare) 2,141 2,400 847 5,388

PPO‐90/10 Medical (HMSA) ‐ Retiree Total 21,875 13,944 1,299 37,118

HMO Medical (Kaiser), Drug (Kaiser) ‐ Retiree Retiree (Medicare) 4,351 2,142 80 6,573 Retiree (Non‐Medicare) 485 457 131 1,073

HMO Medical (Kaiser), Drug (Kaiser) ‐ Retiree Total 4,836 2,599 211 7,646

Out‐of‐State Plan Retiree (Medicare) 115 58 2 175 Retiree (Non‐Medicare) 5 3 8

Out‐of‐State Plan Total 120 61 2 183

Medical Plans Total 26,831 16,604 1,512 44,947

Drug Plans PPO Drug (SilverScript) ‐Medicare 19,381 11,087 427 30,895 PPO Prescription Drug (CVS) ‐ Non‐Medicare 2,197 2,455 853 5,505

Drug Plans Total 21,578 13,542 1,280 36,400

Dental Plan (HDS) 26,876 17,138 1,486 45,500

Vision Plan (VSP) 26,864 17,238 1,541 45,643



Type Benefit Plan Subscribers Dependents Total Medical Plans PPO‐90/10 Medical (HMSA) ‐ Retiree Retiree (Medicare) 31,730 12,542 44,272 Retiree (Non‐Medicare) 5,388 4,508 9,896

PPO‐90/10 Medical (HMSA) ‐ Retiree Total 37,118 17,050 54,168

HMO Medical (Kaiser), Drug (Kaiser) ‐ Retiree Retiree (Medicare) 6,573 2,317 8,890 Retiree (Non‐Medicare) 1,073 775 1,848

HMO Medical (Kaiser), Drug (Kaiser) ‐ Retiree Total 7,646 3,092 10,738

Out‐of‐State Plan Retiree (Medicare) 175 63 238 Retiree (Non‐Medicare) 8 3 11

Out‐of‐State Plan Total 183 66 249


Drug Plans PPO Drug (SilverScript) ‐Medicare 30,895 12,032 42,927 PPO Prescription Drug (CVS) ‐ Non‐Medicare 5,505 4,575 10,080

Drug Plans Total 36,400 16,607 53,007

Dental Plan (HDS) 45,500 20,669 66,169

Vision Plan (VSP) 45,643 20,905 66,548



Enrollment Counts ‐ HSTA VB Retirees

The table below shows HSTA VB Retirees enrollments for period ending 05‐31‐2020


Count of Subscribers Type of Enrollment Benefit Plan Self Two Party Family Grand Total Medical Plans

HSTA VB PPO‐90/10 Medical and Chiro (HMSA) bundled with PPO Drug (SilverScript or CVS), Vision (VSP) ‐ Retiree Retiree (Medicare) 1,086 955 21 2,062 Retiree (Non‐Medicare) 15 10 25

HSTA VB PPO‐90/10 Medical and Chiro (HMSA) bundled with PPO Drug (SilverScript or CVS), Vision (VSP) ‐ Retiree Total 1,101 965 21 2,087



HSTA VB HMO Medical, Drug and Chiro (Kaiser) bundled with Vision (VSP) ‐ Retiree Retiree (Medicare) 136 87 1 224 Retiree (Non‐Medicare) 5 1 6

HSTA VB HMO Medical, Drug and Chiro (Kaiser) bundled with Vision (VSP) ‐ Retiree Total 141 88 1 230



Medical Plans Total 1,250 1,059 22 2,331

Drug Plans HSTA VB PPO‐90/10 Prescription Drug (SilverScript) bundled with HSTA VB Medical (HMSA) ‐Medicare 1,084 954 21 2,059 HSTA VB PPO‐90/10 Prescription Drug (CVS) bundled with HSTA VB PPO Medical (HMSA) ‐ Non‐Medicare 20 11 31

Drug Plans Total 1,104 965 21 2,090

Dental Plan (HDS) 1,240 1,064 20 2,324

Vision Plan (VSP) 1,251 1,057 22 2,330




Enrollment Counts ‐ HSTA VB Retirees (continued)

The table below shows HSTA VB Retirees enrollments for period ending 05‐31‐2020


Type Benefit Plan Subscribers Dependents Total Medical Plans

HSTA VB PPO‐90/10 Medical and Chiro (HMSA) bundled with PPO Drug (SilverScript or CVS), Vision (VSP) ‐ Retiree Retiree (Medicare) 2,062 1,002 3,064 Retiree (Non‐Medicare) 25 10 35

HSTA VB PPO‐90/10 Medical and Chiro (HMSA) bundled with PPO Drug (SilverScript or CVS), Vision (VSP) ‐ Retiree Total 2,087 1,012 3,099



HSTA VB HMO Medical, Drug and Chiro (Kaiser) bundled with Vision (VSP) ‐ Retiree Retiree (Medicare) 224 89 313 Retiree (Non‐Medicare) 6 1 7

HSTA VB HMO Medical, Drug and Chiro (Kaiser) bundled with Vision (VSP) ‐ Retiree Total 230 90 320




Drug Plans HSTA VB PPO‐90/10 Prescription Drug (SilverScript) bundled with HSTA VB Medical (HMSA) ‐Medicare 2,059 1,001 3,060 HSTA VB PPO‐90/10 Prescription Drug (CVS) bundled with HSTA VB PPO Medical (HMSA) ‐ Non‐Medicare 31 11 42

Drug Plans Total 2,090 1,012 3,102

Dental Plan (HDS) 2,324 1,109 3,433

Vision Plan (VSP) 2,330 1,106 3,436



Enrollment Counts ‐ All Subscribers

The table below shows All Subscribers enrollments for period ending 05‐31‐2020

Count of Subscribers Benefit Plan Employer Medical Plans Drug Plans Dental Plan Vision Plan Life Insurance City and County of Honolulu Active 7,182 5,272 7,610 7,337 8,700 Retiree (Medicare) 5,625 4,254 Retiree (Non‐Medicare) 1,649 1,359 7,331 7,379 6,293

City and County of Honolulu Total 14,456 10,885 14,941 14,716 14,993

Honolulu Board of Water Supply Active 466 346 495 474 572 Retiree (Medicare) 460 366 Retiree (Non‐Medicare) 96 93 557 562 475

Honolulu Board of Water Supply Total 1,022 805 1,052 1,036 1,047

County of Hawaii Active 2,104 1,623 2,164 2,101 2,440 Retiree (Medicare) 1,182 1,103 Retiree (Non‐Medicare) 446 416 1,621 1,638 1,497

County of Hawaii Total 3,732 3,142 3,785 3,739 3,937

Hawaii Dept of Water Supply Active 132 110 136 134 160 Retiree (Medicare) 80 73 Retiree (Non‐Medicare) 16 15 99 98 90

Hawaii Dept of Water Supply Total 228 198 235 232 250

County of Kauai Active 1,023 886 1,069 1,042 1,253 Retiree (Medicare) 641 614 Retiree (Non‐Medicare) 210 205 838 860 764

County of Kauai Total 1,874 1,705 1,907 1,902 2,017

County of Maui Active 2,032 1,014 2,161 2,053 2,451 Retiree (Medicare) 1,119 707 Retiree (Non‐Medicare) 459 303 1,587 1,604 1,467

County of Maui Total 3,610 2,024 3,748 3,657 3,918

State of Hawaii Active 38,935 27,743 41,522 39,477 49,226 Retiree (Medicare) 31,631 25,807 Retiree (Non‐Medicare) 3,612 3,135 35,736 35,775 34,076

State of Hawaii Total 74,178 56,685 77,258 75,252 83,302

Hawaii Public Charter Schools Active 799 510 857 773 1,065 Retiree (Medicare) 40 32 Retiree (Non‐Medicare) 12 8 55 57 55

Hawaii Public Charter Schools Total 851 550 912 830 1,120

Grand Total 99,951 75,994 103,838 101,364 110,584



DAVID Y. IGE GOVERNOR

STATE OF HAWAII HAWAII EMPLOYER-UNION HEALTH BENEFITS TRUST FUND


HONOLULU, HAWAII 96813

Oahu (808) 586-7390

Toll Free 1(800) 295-0089

www.eutf.hawaii.gov

June 12, 2020

TO: Derek Mizuno

Administrator

FROM: Heather McMahon

EUTF Benefits Audit Specialist

SUBJECT: April - May 2020 EUTF Benefits Audit Specialist Report

This report covers the time period from May 16, 2020 through June 12, 2020.

may be provided upon request.

a. Audits Currently in Progress

• Identify Retirees That Returned to Work


• Certify Dependent Children

• Point in Time Reconciliation - Between HDS and EUTF enrollment

• Point in Time Reconciliation - Between VSP and EUTF enrollment

c. Completed and Recurring Audits

BOARD OF TRUSTEES CHRISTIAN FERN, CHAIRPERSON CELESTE Y.K. NIP, VICE-CHAIRPERSON LAUREL JOHNSTON, SECRETARY-TREASURER RODERICK BECKER DAMIEN ELEFANTE AUDREY HIDANO OSA TUI CLIFFORD UWAINE RYKER WADA

ADMINISTRATOR

DEREK M. MIZUNO

ASSISTANT ADMINISTRATOR

DONNA A. TONAKI

Additional details

Initial Audit Recurrence

Approx.

Active/ Initial Annual Recovery Total

Description Retiree Cleanup Date Terminations Savings Amount Recurrence Terminations

Adult Disabled

Recertification Active 6/30/2017 10 $25,830 N/A

Every 7

years

45 former 217 former

Unreported spouses and 5 spouses and 17

Divorce Audit Active 6/30/2017 stepchildren $132,950 $96,548 Monthly stepchildren

Unreported

Divorce Audit Retiree 4/30/2018

32 former

spouses $155,648 $505,830 Monthly

53 former

spouses

Domestic

Partner Every 2

Recertification Active 12/31/2018 167 $480,960 N/A years

Domestic

Partner Every 2 21

Recertification Retiree 8/31/2017 20 $150,750 N/A years




www.eutf.hawaii.gov

Memorandum to the Administrator

June 12, 2020

Subject: May – June 2020 EUTF Benefits Audit Specialist Report

Page 2

Initial Audit Recurrence

Active/ Initial Annual Recovery Total

Description Retiree Cleanup Date Terminations Savings Amount Recurrence Terminations

Surviving

Spouse/

Surviving 11/30/2017 and Every other 9

Child N/A 2/28/2018 25 $92,844 $200,820 month

Spouses with

Self and Two-

Party Plans

Active and

Retiree 3/31/2018

(14 couples

were converted

to family plans) $20,746 N/A Annually

(16 couples

were converted

to family plans;

2 couples are

paying the

employer

contribution

difference)

4/5/2018 -

Out-of-State (Terminations

Unreported Retirees and retroactive to Every other 48 Deaths Dependents date of death) 48 N/A N/A month

36 (Medicare 19 (Medicare

Medicare Part B Part B

Savings Retirees and reimbursements reimbursements

Program Dependents 12/31/2018 terminated) $45,317 N/A Monthly terminated)

Termination of 3/27/2019

Life Insurance (Terminations

Enrollment for processed

Terminated retroactive to

Employees Active 3/31/2018) 2,073 $8,541 NA Annually





HONOLULU, HAWAII 96813

Oahu (808) 586-7390 ADMINISTRATOR

DEREK M. MIZUNO Toll Free 1(800) 295-0089

www.eutf.hawaii.gov ASSISTANT ADMINISTRATOR

DONNA A. TONAKI

June 12, 2020

TO: Derek Mizuno, Administrator

FROM: Linda Green, EUTF Program Specialist

SUBJECT: April - May 2020 EUTF Program Specialist Report

This report covers the period May 16, 2020 – June 12, 2020

A. Worksite wellness

1. Kaiser Permanente will begin offering live webinar health education classes monthly.

The June offering will be “Coping with COVID” on June 26 and 29. EUTF will

distribute promotional flyers to the human resource offices for employees.

2. A wellness fair is planned for the City and County of Honolulu employees and retirees on

November 18.

B. Preventive health

1. The second mailing for HMSA’s Online Care campaign, aiming to increase the number

of members who sign up, is scheduled to go out to 15,000 members by June 26.

2. Annual promotions are being developed with HMSA to increase awareness of

prediabetes/programs and the annual preventive health evaluation/physical exam.

3. Annual direct mail promotion to increase awareness of preventive benefits are being

developed with HDS and VSP.

C. Chronic disease management

1. A promotion to decrease the number of members who opt out of the HMSA Care Model

is being developed.

2. Planning is in progress with HMSA and Kaiser to design a blood pressure awareness

initiative.




www.eutf.hawaii.gov


CELESTE Y.K. NIP, VICE-CHAIRPERSON LAUREL JOHNSTON, SECRETARY-TREASURER RODERICK BECKER DAMIEN ELEFANTE AUDREY HIDANO STATE OF HAWAII OSA TUI CLIFFORD UWAINE RYKER WADA HAWAII EMPLOYER-UNION HEALTH BENEFITS TRUST FUND

201 MERCHANT STREET, SUITE 1700 HONOLULU, HAWAII 96813

ADMINISTRATOR Oahu (808) 586-7390 DEREK M. MIZUNO


June 12, 2020


FROM: Amy Cheung EUTF Financial Management Officer

SUBJECT: May 2020 – June 2020 Financial Services Branch (FSB)

This report covers the period of May 16, 2020 through June 12, 2020. Additional details will be provided upon request.

a. FSB Performance DataDuring May, staff answered 844 out of 900 calls (93.78%) received. See attached for the AutomatedCall Distribution reports for more information. Additionally, staff responded to 51 emails receivedthrough the EUTF accounting email inbox.

On March 18, 2020, the EUTF stopped accepting walk-ins due to the possible spread of COVID-19.Members have other options to make their premium payments online by credit card or e-check, mail,or pension or ACH deductions.

In May, staff reviewed and issued 275 premium deduction letters and 417 shortage notices comparedto 310 premium deduction letters and 408 shortage notices last year. May cancellations due to non-payment of premiums were waived by the Board at the April 28, 2020 meeting. There were 90cancellations (compared to 99 last year) related to unpaid premiums from March 1st through May 13th.Of the 90 cancellations, 45 accounts were paid in full and the remaining 45 accounts were canceled.

At the May 26, 2020 meeting, the Board did not extend the waiver of cancellations for June 2020.

b. Management Letter Corrective Action Plan StatusRefunds: During May, staff processed 914 outstanding refunds that totaled $188,660. Since July 1,2019, a total of 3,402 refunds totaling $745,539 were processed. The net payable to employee-beneficiaries as of June 30, 2019 was $1,045,587 and as of April 20, 2020 was $972,264. There wasan overall net payable decrease of $73,323 during this fiscal year.

Medicare Part B Overpayments: The financial management team continues to collect on the priorfiscal years overpayment balance by contacting the debtor or estate (at least two times). If there is noresponse, we forward the collection to the Department of the Attorney General for collection and/orwrite off. Since July 1, 2019, the EUTF has written off 253 Medicare Part B overpayments totaling$277,970. We recovered 9 overpayments that totaled $1,372 in May.



www.eutf.hawaii.gov

Memorandum to the Board of Trustees June 12, 2020 Subject: May 2020 – June 2020 Financial Services Branch (FSB) Report Page 2

c. EUTF CollectionsThe following provides the collections status on completed audits as of April 30, 2020.

Description

Date of Collection

Letters

Number of Accounts

Outstanding^

Total Recovery Amount*

Total Amount

Collected (To-Date)

Total Amount

Referred to AG for

Collection^

RemainingOutstanding

Balance Surviving Spouse/Surviving Child Audit 02/08/18 10 $120,027 $30,622 $71,520 $17,885 Unreported Divorces for Retirees 06/04/18 15 $505,830 $37,202 $409,048 $59,580

Total 25 $625,857 $67,824 $480,568 $77,465

% of Total 11% 77% 12%

^ Adjusted to exclude accounts on appeal status and approved appeals. * Total recovery amount represents total employer contributions owed less adjustments related to approvedappeals.

d. FSB Staffing UpdateThe Account Clerk Supervisor (Account Clerk V) position remains vacant due to the statewide hiringfreeze effective April 3, 2020.

All other FSB positions are filled.

e. Financial Statements as of April 30, 2020Unaudited financial statements for the month of April 2020 are included in your packet for review.

Accounting Automated Call Distribution Report May 2020

Day Day of Week Incoming Calls

Accounting Answered % Answered Average Time Per Call (min)

% Answered within x seconds Abandoned Time (in seconds) Voice Message

Outgoing Calls Accounting 10 10-30 > 30 < 10 10-30 > 30 Total

1 Friday 60 57 95.00% 4:21 36.67% 33.33% 25.00% 1 0 2 3 0 10 4 Monday 50 49 98.00% 5:21 62.00% 22.00% 14.00% 0 0 1 1 0 10 5 Tuesday 65 46 70.77% 3:43 32.31% 12.31% 26.15% 3 4 12 19 0 7 6 Wednesday 31 31 100.00% 5:52 51.61% 38.71% 9.68% 0 0 0 0 0 11 7 Thursday 28 27 96.43% 4:15 60.71% 28.57% 7.14% 1 0 0 1 0 7 8 Friday 34 34 100.00% 4:25 58.82% 35.29% 5.88% 0 0 0 0 0 15

11 Monday 45 43 95.56% 5:27 75.56% 20.00% 0.00% 1 1 0 2 0 9 12 Tuesday 60 54 90.00% 4:49 58.33% 15.00% 16.67% 1 0 5 6 0 9 13 Wednesday 34 32 94.12% 5:09 70.59% 17.65% 5.88% 1 0 1 2 0 14 14 Thursday 33 30 90.91% 6:02 48.48% 27.27% 15.15% 1 0 2 3 0 7 15 Friday 53 52 98.11% 5:06 67.92% 16.98% 13.21% 0 0 1 1 0 17 18 Monday 48 47 97.92% 3:57 75.00% 18.75% 4.17% 1 0 0 1 0 11 19 Tuesday 34 30 88.24% 4:18 41.18% 32.35% 14.71% 0 0 4 4 0 11 20 Wednesday 46 44 95.65% 5:31 73.91% 17.39% 4.35% 0 0 2 2 0 8 21 Thursday 38 38 100.00% 5:06 68.42% 21.05% 10.53% 0 0 0 0 0 17 22 Friday 43 43 100.00% 5:56 58.14% 32.56% 9.30% 0 0 0 0 0 13 25 26

Monday Tuesday

HOLIDAY - MEMORIAL DAY 64 55 85.94% 6:12 42.19% 23.44% 20.31% 1 1 7 9 0 18

27 Wednesday 48 48 100.00% 5:29 64.58% 14.58% 20.83% 0 0 0 0 0 4 28 Thursday 39 37 94.87% 6:22 61.54% 12.82% 20.51% 0 2 0 2 0 4 29 Friday 47 47 100.00% 4:30 51.06% 29.79% 19.15% 0 0 0 0 0 10

Monthly Totals 900 844 93.78% 5:05 57.00% 22.67% 14.11% 11 8 37 56 0 212


Page 1 of 3

Accounting Automated Call Distribution Report January to December 2020

Month Incoming Calls




January 2013 1914 95.08% 5:34 53.60% 21.96% 19.52% 11 16 72 99 0 366 February 1306 1256 96.17% 5:17 64.85% 18.76% 12.56% 11 7 32 50 0 288

March 1073 1030 95.99% 5:32 69.34% 14.91% 11.74% 10 7 26 43 0 291 April 1264 1220 96.52% 4:59 60.36% 20.57% 15.59% 6 8 30 44 0 300 May 900 844 93.78% 5:05 57.00% 22.67% 14.11% 11 8 37 56 0 212 June July

August September

October November December


Page 2 of 3

Accounting Automated Call Distribution Report January to December 2019

Month Incoming Calls




January 1723 1628 94.49% 5:26 55.19% 22.11% 17.18% 26 22 47 95 0 429 February 1137 1097 96.48% 5:13 63.41% 21.20% 11.87% 9 7 24 40 0 466

March 1149 1112 96.78% 5:05 65.80% 18.19% 12.79% 6 8 23 37 0 390 April 1371 1296 94.53% 5:00 57.55% 22.32% 14.66% 17 18 40 75 0 463 May 1084 1051 96.96% 5:08 64.58% 23.25% 9.13% 9 7 17 33 0 372 June 1425 1364 95.72% 4:53 56.63% 23.23% 15.86% 8 12 41 61 0 425 July 2828 1539 54.42% 5:30 44.94% 4.00% 5.48% 1091 157 41 1289 0 449

August 2071 1350 65.19% 5:44 53.02% 8.11% 4.06% 668 42 11 721 0 488 September 1467 1394 95.02% 5:42 63.46% 21.88% 9.68% 11 19 43 73 0 465

October 1641 1549 94.39% 5:36 57.89% 20.60% 15.90% 13 18 61 92 0 495 November 1299 1235 95.07% 5:24 56.27% 21.48% 17.32% 6 8 50 64 0 374 December 1873 1758 93.86% 4:54 48.85% 22.21% 22.80% 13 28 74 115 0 390


Page 3 of 3

ASSETS Current Assets:

1 Cash

2 EUTF excess reserves 3 Net return on investment 4 5 Total cash and investments

Receivables:

6 Premium receivable from State of Hawaii and counties 7 Rebates receivable 8 Experience refunds due from insurance companies 9 Self-funded reserves 10 Prepaid expenses 11 Total current assets 12 Capital assets, net of accumulated depreciation 13 TOTAL ASSETS 14 Deferred outflows of resources related to pension 15 Deferred outflows of resources related to OPEB 16

LIABILITIES Current Liabilities:

17 Vouchers and contracts payable Due to State of Hawaii Accrued wages and employee benefits payable Premiums payable to insurance carriers Payable to employee - beneficiaries Claims and administrative fee liability for self-funded plan

$ 27,902,453

75,280,000 7,632,151

82,912,151 110,814,604

40,362,693 11,170,215

-5,021,274

424,198 167,792,985

312,499 $ 168,105,484

1,332,924 783,665

$ 170,222,073 $

$ 293,095 $ -

420,453 44,872,205

962,541 5,320,062

110,412

UNAUDITED Current Month

Ended April 30, 2020

$ 30,615,870

75,280,000 5,301,602

80,581,602 111,197,472

40,172,586 11,196,493

-5,021,274

506,639 168,094,463

319,887 $ 168,414,350 $

1,332,924 783,665

170,530,939 $

290,098 $ -

416,082 44,685,492 1,013,514 6,164,852

110,412

Hawaii Employer-Union Health Benefits Trust Fund ENTERPRISE (ACTIVES) - STATEMENT OF NET POSITION

10 Month Ended April 30, 2020 (PRELIMINARY-Unaudited)

UNAUDITED Quarter Ended March 31, 2020

$ 28,960,550

55,280,000 Actives and Retirees Excess Reserve Accounts. 5,998,434

61,278,434 90,238,985

Receivable for one month of employer contributions and one pay period of employee payroll premium 39,185,062 deductions withheld net of prepayments.

CVS drug rebates ($11.065M), other carrier receivables ($105.05K).

Reserves held by self-funded carriers (CVS $4.958M and HMA $63.2K) to cover claim payment lag. Prepaid expenses such as insurance and computer maintenance.

Capitalized assets such as computers, benefits administration system, and other fixed assets.

Accounts payable ($51.78K), annual PCORI fees ($129.87K) payable to the US Treasury, and divorce/surviving spouse audit collections ($111.45K) payable to employers. Forfeitures for FY19 paid in 2/20.

Premiums for one month owed to the fully insured plan carriers. Refunds owed to employee-beneficiaries. Claims reimbursements and administrative fees owed to CVS 1/2 month and HMA outstanding checks. Current portion of unpaid vacation liability.

AUDITED Fiscal Year Ended

June 30, 2019

27,845,302 4,708,610 5,021,274

307,913 167,307,146

361,558 167,668,704

1,332,924 783,665

169,785,293

569,093 53,333

394,039 43,628,439 1,027,610 4,499,088

110,412

Notes

Transferred $20M in Dec 2019 from Excess Reserves (Agency Fund) to rebalance the allocation between

181920212223 Compensated absences, current portion 24 Total current liabilities

Noncurrent Liabilities: 25 Net other postemployment benefits payable 26 Compensated absences 27 Net pension liability 28 Total Liabilities 29 Deferred inflows of resources related to pension 30 Deferred inflows of resources related to OPEB 31 TOTAL LIABILITIES

NET ASSETS: 32 Net investment in capital assets

Unrestricted gain primarily from benefit plans

33 ACA PCORI 34 Self-funded claim stabilization reserve

35 Administrative fees (05/20-06/29 Actives)

$ 51,978,769 $ 52,680,450 $ 50,282,014

7,489,378 7,489,378 7,489,378 EUTF share of OPEB liability. 244,488 244,488 244,488 Non-current portion of unpaid vacation liability.

5,885,981 5,885,981 EUTF share of pension liability. 66,300,297 $ 63,901,861

90,518 90,518 148,742 148,742

66,539,557 $ 64,141,120

5,885,981 $ 65,598,615 $

90,518 148,742

$ 65,837,875 $

$ 312,499 $

6,200,000 40,744,000

44,660,000

319,887

3,999,509 40,744,000

45,066,000

$ 361,558

3,999,509 38,470,000

47,670,430

At the 4/28/20 meeting, the Board approved to reserve additional funds to pay for PCORI fees through 6/30/29 for actives and 12/31/28 for retirees. Reserve reflects 35% of FY19 self-funded prescription drug plan claims and expenses. At the 6/26/18 meeting, the Board approved waiver of administrative fees from 7/1/19 (actives) and 1/1/19 (retirees) through 6/30/24 (actives) and 12/31/23 (retirees). At the 9/25/18 meeting, the Board extended the waiver through 6/30/29 (actives) and 12/31/28 (retirees).

3637 Unreserved 38 Unrestricted gain primarily from benefit plans 39 Total Net Assets 40 TOTAL LIABILITIES AND NET ASSETS

New benefits administration system

$

5,580,237 6,887,461

104,071,698 104,384,197 170,222,073 $

6,080,237 7,781,749

103,671,495 103,991,382 170,530,939 $

6,080,237 9,062,438

105,282,614 105,644,172 169,785,293

Board approved reserve of funds for a new Benefits Administration System (BAS) at the 6/26/18 meeting. New BAS is estimated at $10,483,167 ($160K in FY19; $9.956M in FY20; and $367,167 in FY21).

Unrestricted gain or surplus for EUTF. This amount is cumulative from year-to-year.

1 6/19/2020 8:49 AM

REVENUES: 1 Premium revenue for self-funded plans

2 Administrative fee - EUTF

3 Investment income 4 Unrealized gain (loss) on investments 5 CVS rebates

Purchasing card rebates Performance penalties Experience refunds

$

4/30/2020 10-MonthBudget

- $

15,442,717

------

4/30/2020 10-Month

Actual

- $

-

---976 --976 $

Hawaii Employer-Union Health Benefits Trust Fund ENTERPRISE (ACTIVES) - STATEMENT OF REVENUE, EXPENSES and CHANGES IN NET POSITION


Variance

- $

(15,442,717)

--- 14,068,000 976 -- 723,350 - 1,910

$ 102,997,917

4/30/2020 Self-Funded

Plans and Other 10-Month Actual

86,367,911

-

1,836,346 money market account. 400 Appreciation (Depreciation) in fair market value of investments of EUTF excess reserve account.

Notes

Administrative fees paid by employees and employers are added to the premiums. Effective 1/1/19 and 7/1/19, administrative fees for retirees and actives are waived. $1.633M of dividends from EUTF excess reserve investment and $203.03K of interest income from

6 7 8 9 Total Revenues

EXPENSES: 10 TPA expenses 11 Benefits paid for self-funded plans 12 Personnel services 13 Office supplies 14 Dues & subscriptions

15

16 Telephone

17 Printing & binding 18 Transportation - intra state 19 Transportation - out of state 20 Office space

Rental of equipment (copier) Insurance Services on a fee basis - legal

Postage

$ 15,442,717 $

$ $

4,407,442 11,667

1,708

101,667

36,667

103,333 7,958

20,000 388,333

26,667 51,667

124,167

4,140,918 12,256

467

92,637

39,317 (2,650)

74,948 28,385 3,908 4,050

17,872 2,128 390,016 (1,683)

25,262 1,405 51,189 478

(15,441,741)

$

266,524 (589)

1,241

9,030

$ 780,137 96,219,050

---

-

- maintenance of telephone equipment. Retiree OE guide ($55.84K), Holomua (spring & summer issues $13.38K) and COBRA election

- notices ($5.73K).

Private equity conference and IFEBP conference.

Administrative expenses paid to self-funded plan carriers ($710.72K to CVS and $69.42K to HMA). Claims paid to self-funded plan carriers ($95.85M CVS and $366.44K HMA). Salaries for EUTF staff. Office supplies includes copier paper, envelopes and other supplies, repair and maintenance. Survey monkey subscription. $40.71K for 2020 Retiree OE guide; and $51.92K in regular postage refill for monthly shortage notices, cancellations (sent via priority mail), confirmations, COBRA notices, and student certifications. Telephone charges includes phone lines, long distance charges, toll-free line and annual

21 22 23

24 Consultant services 25 Training and registration

26 27 Depreciation 28 Service fees - HIC

29 (Gain) loss from carrier payments

30 Total Expenses 31 EXCESS OF REVENUES OVER EXPENDITUR

Computer hardware/software maintenance

$ 15,442,717 $ $ - $

500,000 17,500

9,643,942 --

-

170,652

659,879 6,093

1,488,579 --

-

7,173,991 $ (7,173,015) $ (7,173,016)

(46,485)

(159,879) 11,407

8,155,363

-

-

8,268,725 $ 97,084,876 $ 5,913,041

- 76,774 Depreciation expense for fixed assets. 101 Fees associated with electronic check premium payments.

This amount is the resulting (gain) loss after the collection of employer/employee contributions and 8,815 the payment to carriers. This amount fluctuates every month.

--- Office lease rental. - Xerox copiers and postage meter machine. - Amortization of Fiduciary Liability. - Deputy AG's salary and fringe benefits; and outside attorney fees for new BAS RFP $37.5K.

Segal $240.72K, Linea Solutions (new BAS RFP) $159.3K, DOH $0.66K and Audit fees $215.5K and - Claims Audit Fees $43.7K. - IFEBP registration.

-

$715.43K expenses for the Vitech System which includes amortization of software/hardware maintenance, M&O maintenance, services related to Vitech contract; IV&V reimbursement $500K for the new BAS; and other computer and software expenses $273.15K. The high variance is due to the approved FY20 budget of $9.956M for the new BAS.

2 6/19/2020 8:49 AM

ASSETS: 1 Cash

2 EUTF excess reserves 3 Net return on investment 4

5 Total cash and investments Receivables:

6 Premium receivable from State of Hawaii and counties

7 Rebates receivable 8 Experience refunds due from insurance companies

9 Medicare reimbursements from individuals, net of allowance 10 Receivables from agencies 11 Total receivables

$

UNAUDITED Current Month Ended

April 30, 2020

34,076,670 $

132,720,000 30,665,145

163,385,145

197,461,815

33,211,586

26,586,375 11,110

212,833 130,000

60,151,903

8,165,204 $ 265,778,923 $

195,999 26,622,418

Hawaii Employer-Union Health Benefits Trust Fund AGENCY (RETIREES) - STATEMENT OF FIDUCIARY NET POSITION


UNAUDITED Quarter Ended March 31, 2020

32,308,333 $

132,720,000 24,345,670

157,065,670

189,374,003

33,306,739

26,596,017 11,110

212,833 185,706 - -

60,126,699 42,534,449

8,165,204 8,165,204 257,665,906 $ 255,554,620

197,165 328,670 26,509,883 24,907,386

AUDITED Fiscal Year

Ended June 30, 2019

28,432,859

152,720,000 23,702,107

176,422,107

204,854,966

-

41,558,885 789,858 Final accounting for HMSA for CY18.

payment lag.

Notes

Transferred $20M in Dec 2019 to Excess Reserves (Enterprise Fund) to rebalance the allocation between Actives and Retirees Excess Reserve Accounts.

Receivable for one month of employer contributions and one pay period of employee payroll premium deductions withheld net of prepayments. $2.3M (CVS/Silverscript network guarantees 1/1/19 through 12/31/19), $4.2M (CVS drug rebates), $7.25M (Silverscript drug rebates); $12.84M (Silverscript coverage gap) through 3/31/20.

Receivable from beneficiaries of deceased retirees who were overpaid for Medicare Part B premium reimbursements (net of allowance for bad debt). 2019 Actuarial Valuation Reports and GASB 75 Reports (payments rec'd in May & June).

Reserves held by self-funded carriers (CVS $1.742M and Silverscript $6.423M) to cover claim 12 Self-funded reserves 13 TOTAL ASSETS

LIABILITIES:

14 Vouchers and contracts payable 15 Premiums payable 16 Due to retirees

17 Medicare Part B premium reimbursement payable 18 AP unclaimed checks 19 Benefit claims payable 20 IBNR liability for self-funded plans 21 Total Liabilities

NET ASSETS: Unrestricted gain primarily from benefit plans

22 ACA PCORI fees 23 Self-funded claim stabilization reserve

24 Administrative fees (05/20-12/28 Retirees)

54,107,910

4,700,000 72,851,000

18,192,546

9,723 10,238 17,977

8,112,190 - -137,775 138,575 127,304

18,679,806 20,596,136 17,715,110 350,000 350,000 350,000

47,801,996 43,446,445

18,367,474

334,544 72,851,000

334,544 69,565,000

20,291,686

Includes $187.37K to U.S. Dept. of Treasury for annual PCORI fees; other (LIS, OOS, Inv Fees) $8.6K; $135.1K FY18 PCORI fees paid in 7/19. One month of premiums owed to the fully insured plan carriers. Refunds owed to retirees. At quarter-end, we reimburse retirees Medicare Part B premiums. Therefore, quarter-end balances are zero. Uncashed checks either older than 6 months or deceased (unclaimed) owed to members. Claims reimbursements and administrative fees owed to CVS and Silverscript. Incurred but not reported (IBNR) liability for claims reimbursement from self-funded plans.

At the 4/28/20 meeting, the Board approved to reserve additional funds to pay for PCORI fees through 6/30/29 for actives and 12/31/28 for retirees. Reserve reflects 35% of FY19 self-funded prescription drug plan claims and expenses. At the 6/26/18 meeting, the Board approved waiver of administrative fees from 7/1/19 (actives) and 1/1/19 (retirees) through 6/30/24 (actives) and 12/31/23 (retirees). At the 9/25/18 meeting, the Board extended the waiver through 6/30/29 (actives) and 12/31/28 (retirees).

2526 Unreserved 27 Unrestricted gain primarily from benefit plans

28 TOTAL LIABILITIES AND NET ASSETS

New benefits administration system

$

4,402,930 111,524,537 211,671,013

265,778,923 $

4,402,930 113,907,963 209,863,911

257,665,906 $ 255,554,620

4,402,930 117,514,014 212,108,174

Board approved reserve of funds for a new Benefits Administration System (BAS) at the 6/26/18 meeting. New BAS is estimated at $10,483,167 ($160K in FY19; $9.956M in FY20; and $367,167 in FY21).

Unrestricted gain or surplus for EUTF. This amount is cumulative from year-to-year.

3 6/19/2020 8:49 AM

REVENUES: 1 Premium revenue for self-funded plans 2 Investment income

3 Unrealized gain (loss) in investment 4 CVS & Silverscript rebates 5 Direct subsidy - Silverscript 6 LIPS low income subsidy - Silverscript 7 LICS low Income subsidy - Silverscript 8 Coverage GAP discounts - Silverscript 9 Reinsurance - Silverscript 10 Performance penalties 11 Experience refunds 12 Total revenues

EXPENSES: 13 TPA expenses 14 Benefits paid for self-funded plans 15 Investment fees

16 (Gain) loss from carrier payments 17 Total expenses

18 EXCESS OF REVENUES OVER EXPENDITURES (LOSS)

$ -2,966,976

4,014,190

--

---

$ 6,981,166 $

$ - $ -

21,296

-21,296

$ 6,959,869 $

4/30/2020 10-Month

Actual

$ 111,403,936 -

- account. 25,913,000 CVS $4.01M and Silverscript $21.9M.

2,327,109 CMS Subsidy for Medicare prescription drug plan. 185,662 Low income subsidy for Medicare Part D prescription drug plan.

Coverage gap Q3 2019 - Q1 2020 ($20.91M) and Q1 2016 - Q2 2019 ($737.7K). CY18 annual reinsurance ($2.4M) and CY19 reinsurance ($16.6M).

Administrative expenses paid to self-funded plan carriers (CVS and Silverscript). Claims paid to self-funded plan carriers ($38.22M to CVS and $147.85M to Silverscript). Fees associated with the investment of excess reserves. This amount is the resulting (gain) loss after the collection of contributions and the payment to carriers. This amount fluctuates every month.

4/30/2020 Self-Funded

Plans and Other 10-Month Actual

45,702 21,648,536 19,034,585

462,470 1,102,513

182,123,512

3,434,986 186,079,679

-

5,877 189,520,542

(7,397,030)

Hawaii Employer-Union Health Benefits Trust Fund AGENCY (RETIREES) - STATEMENT OF REVENUE AND EXPENSES and CHANGES IN NET POSITION


Notes

Dividends from EUTF excess reserve investment. Appreciation (Depreciation) in fair market value of investments of EUTF excess reserve

4 6/19/2020 8:49 AM

ASSETS: 1 OPEB operating account

2 OPEB contributions, at cost 3 Net return on investment

4 Total Assets

LIABILITIES:

5 Vouchers and contracts payable

NET POSITION - Restricted for Other 6 Postemployment Benefits

Employers 7 Hawaii DWS 8 Honolulu BWS 9 Kauai DWS 10 County of Maui 11 County of Hawaii 12 County of Kauai 13 C&C Honolulu 14 State of Hawaii 15 HART 16 OPEB operating account (unallocated) 17 Total

Hawaii Employer-Union Health Benefits Trust Fund OPEB STATEMENT OF NET POSITION


UNAUDITED Current Month UNAUDITED AUDITED

Ended Quarter Ended Fiscal Year Ended April 30, 2020 March 31, 2020 June 30, 2019 Notes

$ - - $ -December's OPEB contributions and net return on investment balances were adjusted to correct the gains/losses allocation between OPEB

3,023,217,155 $ 2,985,405,152 2,551,554,799 contributions and net return on investment. 473,907,732 282,596,225 540,434,609

3,497,124,886 3,268,001,376 3,091,989,408

Payable to Acuitas, Alliance Bernstein, AQR, ASB Int'l, BlackRock, Geode, Heitman, MS Prime, Mt. Lucas, Northern Trust, Meketa Investment Group, Inc., Reinhart, and SLC/Ryan Labs.

1,946,694 1,712,977 1,817,906

$ 3,495,178,192 $ 3,266,288,399 $ 3,090,171,502

OPEB Net Assets 19,381,134 85,362,847 10,232,862

286,520,695 192,089,296 137,272,995 666,826,982

2,095,256,861 2,234,518

-$ 3,495,178,192

5 6/19/2020 8:49 AM

Hawaii Employer-Union Health Benefits Trust Fund OPEB STATEMENT OF REVENUE AND EXPENSES


4/30/2020 4/30/2019 10-Month - Other 10-Month - Other Notes

ADDITIONS:

1

2 3 4 5

6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

Employer contributions at cost Investment earnings:

Investment income Securities lending income Unrealized gain (loss)

Investment fees: Securities lending expense Management - Acuitas Management - Northern Trust Management - SLC (fka Ryan Labs) Management - Geode Management - AQR Management - Mt. Lucas Management - BlackRock Management - AllianceBernstein Management - ASB Intl Management - MS Prime Management - Heitman Custodial - Northern Trust Management - Reinhart Consulting - Meketa Investment Group, Inc.

Total Investment Fees

$ 471,404,922

53,342,866 522,445

(113,428,043) (59,562,731)

114,833 2,033,038

374,836 36,665

145,123 313,229 266,272 257,816

42,742 793,837

1,341,923 609,680

55,830 67,595

382,083 6,835,502

$ 556,788,274

52,902,210 552,914

52,669,494 106,124,617

138,145 1,726,171

288,274 31,992

117,611 253,023 199,179 247,570

60,797 768,212 705,800 445,550

55,830 66,545

369,167 5,473,867

22

23

24 25

26 Net Position - Ending

Investment Earnings, Net

EXCESS OF REVENUES OVER EXPENDITURES (LOSS)

Net Position - Beginning Transfer from Agency Fund

(66,398,233)

405,006,690

3,090,171,502 -

$ 3,495,178,192 $

100,650,750

657,439,025

2,370,481,565 14,600,000

3,042,520,590

6 6/19/2020 8:49 AM

Experience Accounting of CVS Caremark Actives Self-Funded Plans Summary of FYE 6/30/2019 & FYE 6/30/2020

JULY 2018 AUGUST 2018 SEPT 2018 OCT 2018 NOV 2018CVS Caremark Actives

DEC 2018 JAN 2019 FEB 2019 MAR 2019 APR 2019 MAY 2019 JUNE 2019 FYE 6/30/2019

Revenue Actives

7,542,919.78 Actives

7,519,704.19 Actives

7,536,560.69 Actives

7,575,070.21 Actives

7,604,456.80 Actives

7,568,228.16 Actives

7,486,108.65 Actives

7,483,271.73 Actives

7,486,065.68 Actives

7,475,137.02 Actives

7,458,388.24 Actives

7,412,603.06 TOTAL

90,148,514.21

Less: Benefit Claims Administrative Expense

10,878,063.71 70,837.70

10,948,901.41

10,967,852.27 70,531.80

11,038,384.07

9,869,279.42 70,892.80

9,940,172.22

10,116,084.37 71,187.30

10,187,271.67

9,011,385.17 71,445.70

9,082,830.87

9,312,264.45 71,487.50

9,383,751.95

9,996,033.01 70,788.30

10,066,821.31

9,335,975.94 70,923.20

9,406,899.14

9,359,107.49 71,126.50

9,430,233.99

8,969,238.87 71,204.40

9,040,443.27

9,124,564.33 71,048.60

9,195,612.93

10,325,572.10 70,545.10

10,396,117.20

117,265,421.13 852,018.90

118,117,440.03

Subtotal (3,405,981.63) (3,518,679.88) (2,403,611.53) (2,612,201.46) (1,478,374.07) (1,815,523.79) (2,580,712.66) (1,923,627.41) (1,944,168.31) (1,565,306.25) (1,737,224.69) (2,983,514.14) (27,968,925.82)

Add: CVS Caremark Rebate Network Guarantee

0.00 0.00

0.00 0.00

5,924,355.80 0.00

0.00 0.00

0.00 0.00

5,895,036.78 0.00

0.00 0.00

0.00 0.00

6,064,750.08 0.00

0.00 0.00

0.00 0.00

6,208,871.20 4,603,438.89

19,258,306.59 4,603,438.89

TOTAL (3,405,981.63) (3,518,679.88) 3,516,695.06 (2,612,201.46) (1,478,374.07) 2,618,476.21 (2,580,712.66) (1,923,627.41) 2,528,831.69 (1,565,306.25) (1,737,224.69) 1,447,485.86 (4,107,180.34)

JULY 2019 AUGUST 2019 SEPT 2019 OCT 2019 NOV 2019CVS Caremark Actives


Revenue Actives

8,602,947.96 Actives

8,604,212.80 Actives

8,615,421.48 Actives

8,697,786.43 Actives

8,638,484.31 Actives

8,588,827.63 Actives

8,552,810.72 Actives

8,505,324.01 Actives

8,523,977.98 Actives

8,559,081.49 Actives Actives TOTAL

85,888,874.81


Subtotal

9,052,270.44 70,605.90

9,122,876.34

(519,928.38)

8,772,741.41 70,564.10

8,843,305.51

(239,092.71)

9,294,247.48 70,984.00

9,365,231.48

(749,810.00)

10,484,814.59 71,495.10

10,556,309.69

(1,858,523.26)

9,172,367.80 71,508.40

9,243,876.20

(605,391.89)

9,310,693.11 71,464.70

9,382,157.81

(793,330.18)

9,836,066.20 70,780.70

9,906,846.90

(1,354,036.18)

9,722,165.47 70,953.60

9,793,119.07

(1,287,795.06)

10,822,657.95 71,065.70

10,893,723.65

(2,369,745.67)

9,384,584.28 71,297.50

9,455,881.78

(896,800.29) 0.00 0.00

95,852,608.73 710,719.70

96,563,328.43

(10,674,453.62)


0.00 0.00

0.00 0.00

4,454,000.00 0.00

0.00 0.00

0.00 0.00

4,757,000.00 0.00

0.00 0.00

0.00 0.00

4,857,000.00 0.00

0.00 0.00

14,068,000.00 0.00

TOTAL (519,928.38) (239,092.71) 3,704,190.00 (1,858,523.26) (605,391.89) 3,963,669.82 (1,354,036.18) (1,287,795.06) 2,487,254.33 (896,800.29) 0.00 0.00 3,393,546.38

7 6/12/2020

Experience Accounting of CVS Caremark Non-Medicare Retirees Self-Funded Plan Summary of FYE 6/30/2019 & FYE 6/30/2020

JULY 2018 AUG 2018 SEP 2018 OCT 2018 NOV 2018 CVS Caremark Non-Medicare Retirees

DEC 2018 JAN 2019 FEB 2019 MAR 2019 APR 2019 MAY 2019 JUN 2019 FYE 6/30/2019

Revenue Retirees

1,843,193.90 Retirees

1,839,392.66 Retirees

1,803,593.65 Retirees

1,798,140.37 Retirees

1,808,501.57 Retirees

1,781,933.49 Retirees

2,031,775.20 Retirees

2,057,555.43 Retirees

1,989,240.32 Retirees

1,963,382.57 Retirees

1,909,869.52 Retirees

1,946,563.11 TOTAL

22,773,141.79

Less: Benefit Claims Benefit Claims Medicare

Net Benefit Claims

6,237,664.68 (3,246,705.77)

2,990,958.91

6,118,591.56 (3,183,335.40)

2,935,256.16

6,177,653.04 (3,295,254.46)

2,882,398.58

6,550,320.85 (3,638,169.94)

2,912,150.91

5,986,764.91 (3,381,661.35)

2,605,103.56

6,307,649.69 (3,732,563.96)

2,575,085.73

4,255,374.02 (996,941.26)

3,258,432.76

4,032,034.88 (976,605.19)

3,055,429.69

4,199,338.49 (1,238,627.23)

2,960,711.26

3,771,040.05 (1,118,514.38)

2,652,525.67

4,230,172.17 (1,308,001.73)

2,922,170.44

3,201,110.65 (1,184,759.41)

2,016,351.24

61,067,714.99 (27,301,140.08)

33,766,574.91

Administrative Expense 11,443.70 3,002,402.61

11,367.70 2,946,623.86

11,166.30 2,893,564.88

11,134.00 2,923,284.91

11,177.70 2,616,281.26

11,059.90 2,586,145.63

11,717.30 3,270,150.06

11,709.70 3,067,139.39

11,443.70 2,972,154.96

11,253.70 2,663,779.37

11,077.00 2,933,247.44

11,099.80 2,027,451.04

135,650.50 33,902,225.41

Subtotal (1,159,208.71) (1,107,231.20) (1,089,971.23) (1,125,144.54) (807,779.69) (804,212.14) (1,238,374.86) (1,009,583.96) (982,914.64) (700,396.80) (1,023,377.92) (80,887.93) (11,129,083.62)


0.00 0.00

0.00 0.00

1,766,966.00 0.00

0.00 0.00

0.00 0.00

1,801,202.84 2,025,390.08

0.00 0.00

0.00 0.00

1,963,031.01 0.00

0.00 0.00

0.00 0.00

1,858,163.26 0.00

7,389,363.11 2,025,390.08

TOTAL (1,159,208.71) (1,107,231.20) 676,994.77 (1,125,144.54) (807,779.69) 3,022,380.78 (1,238,374.86) (1,009,583.96) 980,116.37 (700,396.80) (1,023,377.92) 1,777,275.33 (1,714,330.43)

JULY 2019 AUGUST 2019 SEPT 2019 OCT 2019 NOV 2019CVS Caremark Non-Medicare Retirees


Revenue Retirees

1,632,674.56 Retirees

1,920,367.01 Retirees

1,907,427.10 Retirees

1,854,421.85 Retirees

1,871,756.50 Retirees

1,863,921.90 Retirees

2,356,834.95 Retirees

2,237,150.54 Retirees

2,264,252.30 Retirees

2,291,580.27 Retirees Retirees TOTAL

20,200,386.98

Less: Benefit Claims Benefit Claims Medicare

Net Benefit Claims

3,952,598.64 (1,270,976.22)

2,681,622.42

4,011,841.27 (1,177,034.42)

2,834,806.85

3,510,568.29 (1,264,657.69)

2,245,910.60

3,832,630.73 (1,145,215.50)

2,687,415.23

3,583,015.26 (1,038,010.71)

2,545,004.55

3,566,775.50 (1,074,681.40)

2,492,094.10

4,311,870.67 (1,582,964.91)

2,728,905.76

3,731,041.16 (1,124,976.98)

2,606,064.18

3,949,435.87 (2,745,467.54)

1,203,968.33

3,775,151.71 (1,064,071.92)

2,711,079.79

38,224,929.10 (13,488,057.29)

24,736,871.81

Administrative Expense 11,088.40 2,692,710.82

10,982.00 2,845,788.85

10,885.10 2,256,795.70

10,727.40 2,698,142.63

10,586.80 2,555,591.35

10,524.10 2,502,618.20

11,223.30 2,740,129.06

11,090.30 2,617,154.48

10,850.90 1,214,819.23

10,685.60 2,721,765.39

108,643.90 24,845,515.71

Subtotal (1,060,036.26) (925,421.84) (349,368.60) (843,720.78) (683,834.85) (638,696.30) (383,294.11) (380,003.94) 1,049,433.07 (430,185.12) 0.00 0.00 (4,645,128.73)


0.00 0.00

0.00 0.00

1,260,000.00 0.00

0.00 0.00

0.00 0.00

1,251,000.00 2,300,000.00

0.00 0.00

0.00 0.00

1,502,000.00 0.00

0.00 0.00

4,013,000.00 2,300,000.00

TOTAL (1,060,036.26) (925,421.84) 910,631.40 (843,720.78) (683,834.85) 2,912,303.70 (383,294.11) (380,003.94) 2,551,433.07 (430,185.12) 0.00 0.00 1,667,871.27

8 6/18/2020

Experience Accounting of Silverscript Medicare Retirees Self-Funded Plan Summary of FYE 6/30/2019 & FYE 6/30/2020

JULY 2018 MEDICARE

Retirees

AUG 2018 MEDICARE

Retirees

SEP 2018 MEDICARE

Retirees

OCT 2018 MEDICARE

Retirees

NOV 2018 MEDICARE

Retirees

SILVERSCRIPT - MEDICARE RETIREES ONLY DEC 2018 JAN 2019 FEB 2019

MEDICARE MEDICARE MEDICARE Retirees Retirees Retirees

MAR 2019 MEDICARE

Retirees

APR 2019 MEDICARE

Retirees

MAY 2019 MEDICARE

Retirees

JUN 2019 MEDICARE

Retirees

FYE 6/30/2019

TOTAL

Revenue 7,201,258.85 7,196,972.14 7,244,320.52 7,227,370.06 6,851,402.94 6,808,948.75 8,363,221.81 8,354,841.84 8,339,760.81 8,437,529.13 8,456,624.17 8,502,229.28 92,984,480.30

Less: Benefit Claims Benefit Claims Paid to CVS Administrative Expense

11,266,819.73 3,246,705.77

322,218.00 14,835,743.50

11,179,075.37 3,183,335.40

323,054.40 14,685,465.17

10,306,558.93 3,295,254.46

324,472.20 13,926,285.59

11,230,675.55 3,638,169.94

324,706.80 15,193,552.29

10,246,651.88 3,381,661.35

324,564.00 13,952,877.23

10,705,210.27 3,732,563.96

325,002.60 14,762,776.83

13,524,330.29 996,941.26 325,716.60

14,846,988.15

12,389,819.11 976,605.19 326,502.00

13,692,926.30

13,494,410.91 1,238,627.23

326,889.60 15,059,927.74

14,131,589.19 1,118,514.38

327,940.20 15,578,043.77

14,430,117.61 1,308,001.73

328,837.80 16,066,957.14

14,172,296.19 1,184,759.41

330,153.60 15,687,209.20

147,077,555.03 27,301,140.08 3,910,057.80

178,288,752.91

Subtotal (7,634,484.65) (7,488,493.03) (6,681,965.07) (7,966,182.23) (7,101,474.29) (7,953,828.08) (6,483,766.34) (5,338,084.46) (6,720,166.93) (7,140,514.64) (7,610,332.97) (7,184,979.92) (85,304,272.61)

Add: Coverage Gap Discount Silverscript Rebate* Direct Subsidy LIPS Subsidy LICS Subsidy

Reinsurance Network Guarantee

0.00 0.00

395,098.86 19,776.00

0.00 1,350,207.00

0.00

0.00 0.00

763,386.53 20,775.90

0.00 1,350,638.50

0.00

6,470,755.40 7,243,887.07

429,173.20 20,568.00

0.00 1,358,539.00

0.00

0.00 0.00

656,935.13 21,352.80

0.00 1,472,412.00

0.00

0.00 0.00

423,548.92 20,520.00

0.00 1,358,944.00

0.00

6,896,546.97 7,405,383.65

420,082.90 20,136.00

1,219,403.00 3,790,964.10 5,473,764.34

0.00 0.00

290,603.52 18,732.80

0.00 1,541,780.50

0.00

0.00 0.00

287,227.18 18,693.60

0.00 1,545,258.00

0.00

3,300,327.50 7,154,343.18

284,917.73 19,931.00

0.00 1,546,500.20

0.00

0.00 0.00

283,785.65 19,867.40

0.00 1,559,250.90

0.00

0.00 0.00

395,423.49 19,565.80

0.00 1,559,379.30

0.00

7,277,618.52 8,191,718.37

488,338.83 19,720.80

0.00 1,573,128.90

0.00

23,945,248.39 29,995,332.27 5,118,521.94

239,640.10 1,219,403.00

20,007,002.40 5,473,764.34

TOTAL (5,869,402.79) (5,353,692.10) 8,840,957.60 (5,815,482.30) (5,298,461.37) 17,272,452.88 (4,632,649.52) (3,486,905.68) 5,585,852.68 (5,277,610.69) (5,635,964.38) 10,365,545.50 694,639.83

JULY 2019 MEDICARE

Retirees

AUGUST 2019 MEDICARE

Retirees

SEPT 2019 MEDICARE

Retirees

OCT 2019 MEDICARE

Retirees

NOV 2019MEDICARE

Retirees

SILVERSCRIPT - MEDICARE RETIREES ONLY DEC 2019 JAN 2020 FEB 2020 MEDICARE MEDICARE MEDICARE

Retirees Retirees Retirees

MAR 2020 MEDICARE

Retirees

APR 2020 MEDICARE

Retirees

MAY 2020 MEDICARE

Retirees

JUNE 2020 MEDICARE

Retirees

FYE 6/30/2020

TOTAL

Revenue 8,793,588.96 8,473,740.40 8,145,711.23 8,556,398.10 8,696,551.68 8,550,287.43 9,908,316.61 10,017,051.91 10,098,012.83 10,047,541.87 91,287,201.02

Less: Benefit Claims Benefit Claims Paid to CVS Administrative Expense

15,338,635.07 1,270,976.22

331,357.20 16,940,968.49

14,584,773.95 1,177,034.42

331,408.20 16,093,216.57

14,094,933.12 1,264,657.69

330,806.40 15,690,397.21

15,300,314.96 1,145,215.50

331,714.20 16,777,244.66

13,679,857.21 1,038,010.71

332,326.20 15,050,194.12

14,967,076.24 1,074,681.40

332,897.40 16,374,655.04

14,911,856.66 1,582,964.91

332,866.80 16,827,688.37

14,020,729.12 1,124,976.98

333,336.00 15,479,042.10

16,301,093.72 2,745,467.54

334,386.60 19,380,947.86

14,655,480.03 1,064,071.92

335,243.40 16,054,795.35

147,854,750.08 13,488,057.29 3,326,342.40

164,669,149.77

Subtotal (8,147,379.53) (7,619,476.17) (7,544,685.98) (8,220,846.56) (6,353,642.44) (7,824,367.61) (6,919,371.76) (5,461,990.19) (9,282,935.03) (6,007,253.48) 0.00 0.00 (73,381,948.75)

Add: Coverage Gap Discount Silverscript Rebate* Direct Subsidy

Direct Subsidy Refund

LIPS Subsidy LICS Subsidy Reinsurance

Network Guarantee

0.00 0.00

300,568.30 0.00

19,636.80 0.00

1,569,194.80 0.00

0.00 0.00

298,330.70 0.00

19,501.60 0.00

1,569,916.80 0.00

8,945,564.09 7,400,000.00

294,050.63 0.00

18,835.07 0.00

1,575,801.10 0.00

0.00 0.00

293,779.20 0.00

19,831.60 0.00

1,578,111.50 0.00

0.00 0.00

286,642.11 0.00

19,055.40 0.00

1,572,479.90 0.00

8,665,276.42 7,300,000.00

281,416.79 0.00

19,486.80 0.00

1,579,996.90 0.00

0.00 0.00

148,769.53 0.00

17,010.70 45,701.67

1,737,845.16 0.00

0.00 0.00

145,224.49 0.00

17,629.70 0.00

1,792,780.47 0.00

3,300,000.00 7,200,000.00

140,560.74 0.00

17,013.20 0.00

1,788,630.01 0.00

0.00 0.00

137,766.17 0.00

17,661.40 0.00

1,797,834.69 0.00

20,910,840.51 21,900,000.00 2,327,108.66

0.00 185,662.27 45,701.67

16,562,591.33 0.00

TOTAL (6,257,979.63) (5,731,727.07) 10,689,564.91 (6,329,124.26) (4,475,465.03) 10,021,809.30 (4,970,044.70) (3,506,355.53) 3,163,268.92 (4,053,991.22) 0.00 0.00 (11,450,044.31)

9 6/18/2020

Experience Accounting of HMA, LLC Actives Self-Funded Plan Summary of FYE 6/30/2019 & FYE 6/30/2020

JULY 2018 AUG 2018 SEP 2018 OCT 2018 NOV 2018 DEC 2018 HMA, LLC

JAN 2019 FEB 2019 MAR 2019 APR 2019 MAY 2019 JUNE 2019 FYE 6/30/2019

Revenue Actives 47,273.06

Actives 46,511.92

Actives 48,655.23

Actives 47,276.96

Actives 47,905.29

Actives 46,633.68

Actives 46,172.80

Actives 46,370.01

Actives 46,183.13

Actives 45,908.36

Actives 46,271.91

Actives 45,477.51

TOTAL 560,639.86


176.42 6,894.00

7,070.42

5,466.90 6,759.00

12,225.90

10,903.26 6,885.00

17,788.26

23,077.96 6,939.00

30,016.96

33,096.67 6,939.00

40,035.67

20,844.07 6,894.00

27,738.07

30,663.89 6,804.00

37,467.89

20,187.10 6,795.00

26,982.10

25,436.25 6,777.00

32,213.25

40,628.86 6,768.00

47,396.86

37,116.79 6,777.00

43,893.79

23,923.10 6,678.00

30,601.10

271,521.27 81,909.00

353,430.27

TOTAL 40,202.64 34,286.02 30,866.97 17,260.00 7,869.62 18,895.61 8,704.91 19,387.91 13,969.88 (1,488.50) 2,378.12 14,876.41 207,209.59

JULY 2019 AUG 2019 SEP 2019 OCT 2019 NOV 2019 DEC 2019 HMA, LLC

JAN 2020 FEB 2020 MAR 2020 APR 2020 MAY 2020 JUNE 2020 FYE 6/30/2020

Revenue Actives 49,841.41

Actives 48,395.74

Actives 48,660.63

Actives 51,539.56

Actives 49,393.04

Actives 49,856.60

Actives 48,961.62

Actives 48,452.30

Actives 48,469.60

Actives 48,864.94

Actives Actives TOTAL 492,435.44


TOTAL

32,363.74 6,966.00

39,329.74

10,511.67

61,823.92 6,867.00

68,690.92

(20,295.18)

42,167.93 6,921.00

49,088.93

(428.30)

53,991.44 7,002.00

60,993.44

(9,453.88)

27,830.90 6,993.00

34,823.90

14,569.14

38,535.48 6,993.00

45,528.48

4,328.12

28,541.51 6,930.00

35,471.51

13,490.11

26,534.33 6,921.00

33,455.33

14,996.97

25,182.66 6,912.00

32,094.66

16,374.94

29,469.37 6,912.00

36,381.37

12,483.57 0.00 0.00

366,441.28 69,417.00

435,858.28

56,577.16

Page 10 6/12/2020

Monthly Carrier Report

Date: June 5, 2020

Carrier: CVS Health

Period Report Covers: May 2020

Customer Service Utilization and Performance Data:

Call Center Statistics:

Number of calls answered by a live representative: 488

Percentage of calls answered in 10 seconds: 87.1% (425 calls)

Percentage of calls answered in 30 seconds: 88.11% (430 calls)

Average speed of answer (number of seconds before live person answers calls): 20 seconds

Average call duration: 491 seconds

Breakdown of calls by subject matter (one call can be logged in more than one category)

Rx Verification - Rx Verify Directions 781

Miscellaneous – View Account 1842

Retail Assistance 159

Plan Design Education 213

Plan Benefit Override 213

Retail Test Claim 316

Plan Design – Prior Authorization 146

Order Placement 252

Order Inquiry 293

Program Education 167

Others 1109

Requests by EUTF to Account Mgmt/Customer Care:

Number of Requests: 17

The average turnaround time for requests was responded to in 1 business day.

All rush enrollments were processed within 1 business day.

Breakdown of escalations by subject matter:

Account Maintenance - 1

Enroll Verify – 0

Outreach – 4

Reinstatements – 6

Research – 2

Rush Enrollments – 4

Appeals: There is a lag in appeals activity. The following appeals information is for the month of April 2020. 12 Total appeals for non-specialty drugs – 5 approved, 7 denied 9 Total appeals for specialty drugs – 6 approved, 3 denied

CVS Health Walk-In Servicing There were 0 CVS Health members that visited the customer service office on Bishop Street during the month of May 2020. Walk-in service is currently closed due to COVID-19 precautions.

Operational Issues Pertaining to EUTF Members:We performed an internal review of the EUTF’s plan design mid-2019 and discovered that:

1. Non-preferred insulin and diabetic supplies was being processed at a $15 copay instead of a $25 copay,2. Claims processed for 31-60 day supply was not adjudicating with two copays, but one copay, and3. The 90 day supply requirement for maintenance drugs was not rejecting properly after the third 30-day fill.

Impacted members were notified in writing on 2/13/2020. All coding has been corrected as of 1/30/2020 and a service warranty is in progress to reprocess impacted claims and to determine any reimbursement to the EUTF for amounts that were overpaid due to these coding issues.

UPDATE 6/5/20 – CVS Health is performing the 2nd phase of the service warranty for non-Medicare retiree plans. This is a manual evaluation to review pricing accuracy. The targeted completion date was 5/21/20, but has been extended. The account team is working with the SW team to get an updated completion date.

The initial validation for the active claims for the period of 2016 – 2020 were completed as of 5/14/20. The account team identified a few system updates that are currently in progress. Once those updates are complete, we will perform a 2nd validation of these claims in preparation for the 2nd phase to manually evaluate the pricing accuracy.

Issues Raised By or With the Vendor and Correspondence to or Referred to the Vendor:No information to report.

Any Legal Actions or Proceedings Involving EUTF Members:No information to report.

Pending or Approved Insurance Regulations or State Legislation Affecting Benefits:No information to report.

New Issues with Respect to New Programs or Benefits of Interest to Board:No information to report.

EUTF Client Service Team Contact and Pending Changes to Team, If Any:No information to report.

Community Activities Relating to Vendor’s That May Be Of Interest to EUTF:CVS Health opened 2 drive-thru self-test sites for COVID-19 on 5/29/20. The sites are located at Longs Drugs in Mililani andPearl City. Please see the attached announcement.

Other:There were 4 Class 1 recall notices received by CVS Caremark for the month of May 2020. CVS Caremark carried 3 of the 4products and will produce patient notifications for consumers impacted at CVS retail or mail pharmacies nationwide. This is notspecific to EUTF.

o Cetazidime for Injection 2g and Dextrose for Injection 50 mL in Duplex Container manufactured by B Braun Medical Inc.o True Metrix Air Blood Glucose Meter manufactured by Trividia Health, Inc.o NP Thyroid (Thyroid tablets, USP) 30mg, 60mg, and 90mg tablets manufactured by Acella Pharmaceuticals, LLCo Lactated Ringer’s Injection, 1000 mL Flexible Container manufactured by ICU Medical, Inc.

Attached is the Pipeline Review dated April 2020. This report provides information about new drugs that have recently been launched or will be launched in the near future. New indications may also be listed as well as biosimilar submissions and granted breakthrough designated drugs.

CVS Health released our 2019 Drug Trend Report and we are pleased to share that we announced our lowest overall trend in 5-years at 1.4%, and that 41% of our clients experienced a negative trend. EUTF’s active plan was one of the plans ending 2019 with a negative trend. There is a lot of information about CVS Health’s overall plan performance with details in specialty and programs which provide a good segue to our June presentation in providing our PBM Plan Overview.

If you have questions, please contact me at 808-282-0724, or by email at [email protected]. Mahalo,

Sandra Benevides Strategic Account Executive


CVS Health Opens 2 New Drive-Thru Test Sites in Hawaii as Part of Nationwide COVID-19 Response

Completes the company’s commitment to establish 1,000 test sites by end of May

WOONSOCKET, R.I., Thursday, May 28, 2020 — Building on the company’s comprehensive efforts to help slow the spread of the virus, on Friday, May 29 CVS Health (NYSE: CVS) will open two new COVID-19 test sites at select Longs Pharmacy drive-thru locations in Hawaii.

These new sites will utilize self-swab tests and deliver on the company’s commitment to establish 1,000 locations across the country by the end of May as originally announced on April 27. These new test sites help enable a goal of processing up to 1.5 million tests per month,subject to availability of supplies and lab capacity.

“CVS Health has been at the forefront of helping our nation scale-up COVID-19 testing capabilities, and we’re proud to meet our goal of establishing 1,000 testing sites in communities across the country,” Larry J. Merlo, President and CEO, CVS Health. “Opening access to testing in more locations using our drive-thru window represents an important milestone in our response to the pandemic. We remain grateful for the daily efforts and sacrifices of our front-line colleagues who make the continued expansion of our testing possible.”

More than half of the company’s 1,000 test sites will serve communities with the greatest need for support, as measured by the CDC’s Social Vulnerability Index. The index tracks a variety of census variables including poverty, lack of access to transportation, and crowded housing that may weaken a community’s ability to prepare for and recover from hazardous events like natural disasters and disease outbreaks.

Self-swab tests will be available to individuals meeting Centers for Disease Control and Prevention criteria, in addition to state and age guidelines. Patients must register in advance at CVS.com beginning Friday, May 29 to schedule an appointment. Patients will be required to stay in their cars and will be directed to the pharmacy drive-thru window, where they will be provided with a test kit and given instructions, and a CVS Pharmacy team member will observe the self-swab process to ensure it is done properly. Tests will be sent to an independent, third-party lab for processing and the results will be available in approximately three days.

Testing will not take place inside any retail locations, and CVS Pharmacy, HealthHUB and MinuteClinic will continue to serve customers and patients.

The new testing sites in Hawaii include:

Longs Pharmacy, 95 – 1077 Ainamakua Drive, Mililani, HI 96789

Longs Pharmacy, 1130 Kuala Street, Pearl City, HI 96782

Proprietary

https://cvshealth.com/newsroom/press-releases/cvs-health-significantly-expand-covid-19-testing-capabilities

https://cvshealth.com/newsroom/press-releases/cvs-health-significantly-expand-covid-19-testing-capabilities

https://svi.cdc.gov/

https://www.cvs.com/minuteclinic/covid-19-testing

https://www.cvs.com/minuteclinic/covid-19-testing

A complete list of CVS Pharmacy drive-thru test sites can be found here.

More information on steps CVS Health has taken to address the COVID-19 pandemic, including support for health care providers and clinicians facing financial and administrative strain, is available at the company's frequently updated COVID-19 resource center.

For downloadable COVID-19 testing media assets, including photos, video and interviews with CVS Health executives, please visit the Media Resource Center.

About CVS Health CVS Health employees are united around a common goal of becoming the most consumer-centric health company in the world. We're evolving based on changing consumer needs and meeting people where they are, whether that's in the community at one of our nearly 10,000 local touchpoints, in the home, or in the palm of their hand. Our newest offerings – from HealthHUB®

locations that are redefining what a pharmacy can be, to innovative programs that help manage chronic conditions – are designed to create a higher-quality, simpler and more affordable experience. Learn more about how we're transforming health at https://www.cvshealth.com.

Media Contact Monica Prinzing, (831) 241-8294 [email protected]

Proprietary

https://cvshealth.com/covid-19/testing-locations

https://cvshealth.com/covid-19

https://cvshealth.com/newsroom/media-gallery-and-corporate-logos/expanded-cvs-pharmacy-testing-media-assets

https://www.cvshealth.com/


Pipeline Month in Review April 2020

Brand Drug Approvals and Launches

Approval Product Name Manufacturer Indication Route Drug Class Actual/ Comments Date Projected

Launch Date

01/18/2019 Ontruzant (trastuzumab-dttb)

Merck/ Samsung Bioepis

The adjuvant treatment of HER2-overexpressing breast cancer, the treatment of HER2-overexpressing metastatic breast cancer, and the treatment of HER2-overexpressing metastatic gastric or gastroesophageal junction adenocarcinoma (biosimilar of Herceptin)

Injection-IV HER2 inhibitor/ Monoclonal antibody

04/15/2020 Biosimilar. Specialty Product.

12/20/2019 Dayvigo (lemborexant)

Eisai/ Purdue Pharma

The treatment of insomnia characterized by difficulties with sleep onset and/or sleep maintenance in adults

Oral-Tablet Orexin receptor antagonist (CIV Controlled Substance)

04/21/2020 New Molecular Entity.

03/06/2020 Isturisa (osilodrostat)

Recordati The treatment of adults with Cushing's disease for whom pituitary surgery is not an option or has not been curative

Oral-Tablet Aldosterone synthase inhibitor

03/31/2020 (Announced 04/16/2020)

New Molecular Entity. Specialty Product.

03/13/2020 romidepsin Teva Pharmaceuticals

The treatment of cutaneous T-cell lymphoma and peripheral T-cell lymphoma in adults who have received at least 1 prior therapy

Injection-IV Histone deacetylase (HDAC) inhibitor

04/14/2020 New Formulation. Specialty Product.

04/01/2020 Sevenfact (coagulation factor VIIa [recombinant]-jncw)

Hema Biologics/ LFB Biotechnologies/ rEVO Biologics

The treatment and control of bleeding episodes in patients aged 12 years and older with hemophilia A or B with inhibitors

Injection-IV Blood coagulation factor

4Q 2020 New Biologic. Specialty Product.

NOTE: SEE DISCLAIMER ON THE FINAL PAGE OF THIS DOCUMENT

Page 1 of 8


Brand Drug Approvals and Launches (continued)


Launch Date

04/03/2020 Reblozyl (luspatercept-aamt)

Acceleron Pharma/ Bristol-Myers Squibb/ Celgene

The treatment of anemia failing an erythropoiesis stimulating agent and requiring 2 or more red blood cell units over 8 weeks in adults with very low- to intermediate-risk myelodysplastic syndromes with ring sideroblasts or with myelodysplastic/ myeloproliferative neoplasm with ring sideroblasts and thrombocytosis

Injection-SC Erythroid maturation agent

04/03/2020 Supplemental Indication. Specialty Product.

04/08/2020 Braftovi (encorafenib)

Array Biopharma/ Pfizer

The treatment of adults with metastatic colorectal cancer with a BRAF V600E mutation after prior therapy, in combination with Erbitux (cetuximab)

Oral-Capsule Kinase inhibitor

04/08/2020 Supplemental Indication. Breakthrough Therapy Designation. Specialty Product.

04/10/2020 Koselugo (selumetinib)

Array Biopharma/ AstraZeneca/ Merck/ Pfizer

The treatment of pediatrics aged 2 years and older with neurofibromatosis type 1 who have symptomatic, inoperable plexiform neurofibromas

Oral-Capsule Kinase inhibitor

04/14/2020 New Molecular Entity. Breakthrough Therapy Designation. Specialty Product.


Page 2 of 8




Launch Date

04/15/2020 Jelmyto (mitomycin)

UroGen The treatment of low-grade, upper tract urothelial cancer in adults

Injection-Intravesical-Gel

Alkylating agent

2Q 2020 New Formulation. Breakthrough Therapy Designation. Specialty Product.

04/17/2020 Emerphed (ephedrine)

Nexus Pharmaceuticals

The treatment of clinically important hypotension occurring in the setting of anesthesia

Injection-IV Alpha receptor agonist/Beta agonist

04/23/2020 New Formulation.

04/17/2020 Pemazyre (pemigatinib)

Incyte The treatment of previously treated, unresectable locally advanced or metastatic cholangiocarcinoma with a FGFR2 fusion or other rearrangement in adults

Oral-Tablet Kinase inhibitor


04/17/2020 Tukysa (tucatinib) Array Biopharma/ Pfizer/Seattle Genetics

The treatment of adults with advanced unresectable or metastatic HER2-positive breast cancer, including patients with brain metastases, who have received 1 or more prior anti-HER2-based regimens in the metastatic setting, in combination with trastuzumab and capecitabine

Oral-Tablet HER2 inhibitor/ Kinase inhibitor



Page 3 of 8




Launch Date

04/20/2020 Cymbalta Eli Lilly The treatment of fibromyalgia in pediatrics Oral-Capsule Serotonin and 04/20/2020 Supplemental (duloxetine) aged 13 years and older norepinephrine Indication.

reuptake inhibitor

04/21/2020 Imbruvica (ibrutinib)

AbbVie/Janssen/ Johnson & Johnson

The treatment of adults with chronic lymphocytic leukemia or small lymphocytic lymphoma, in combination with rituximab

Oral-Capsule & Oral-Tablet

BCL-2 protein inhibitor/Kinase inhibitor


04/22/2020 Trodelvy (sacituzumab govitecan)

Immunomedics The treatment of adults with metastatic triple-negative breast cancer who have received at least 2 prior therapies for metastatic disease

Injection-IV Monoclonal antibody-drug conjugate/ Topoisomerase inhibitor

04/23/2020 New Biologic. Breakthrough Therapy Designation. Specialty Product.

04/23/2020 MenQuadfi (quadrivalent meningococcal vaccine)

Sanofi The prevention of invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, W, and Y in patients aged 2 years and older

Injection-IM Vaccine 2021 New Biologic.

04/24/2020 Ongentys (opicapone)

Neurocrine Biosciences

The adjunctive treatment to levodopa/carbidopa in patients with Parkinson's disease experiencing off episodes

Oral-Capsule Catechol-O-methyltransferase (COMT) inhibitor

3Q 2020 New Molecular Entity.

04/26/2020 Jublia (efinaconazole)

Ortho Dermatologics

The topical treatment of onychomycosis of the toenail(s) due to Trichophyton rubrum and Trichophyton mentagrophytes in patients aged 6 to 18 years

Topical-Solution

Azole antifungal 04/26/2020 Supplemental Indication.


Page 4 of 8




Launch Date

04/28/2020 Bafiertam (monomethyl fumarate)

Banner Life Sciences

The treatment of relapsing forms of multiple sclerosis, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults

Oral-Delayed release capsule

Immunomodulator 2Q 2020 New Formulation. Specialty Product.

04/29/2020 Milprosa (progesterone)

Ferring Pharmaceuticals

Use to support embryo implantation and early pregnancy (up to 10 weeks post-embryo transfer) by supplementation of corpus luteal function as part of an assisted reproductive technology treatment program for infertile women aged 34 years and younger

Intravaginal Progesterone 2020 New Formulation.

04/29/2020 Zejula (niraparib) GlaxoSmithKline/ Tesaro

The maintenance treatment of advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer in adults who are in a complete or partial response to first-line platinum-based chemotherapy

Oral-Capsule

Poly-adenyl-ribose polymerase (PARP) inhibitor



Page 5 of 8


Recent Submissions

Submission Date

Product Name Manufacturer Indication Route Drug Class PDUFA Date

Comments

12/16/2019 (Announced 04/07/2020)

Keytruda (pembrolizumab)

Merck The treatment of unresectable or metastatic solid tumors with tissue tumor mutational burden-high at least 10 mutations per megabase in adults and pediatrics who have progressed following prior treatment and who have no satisfactory alternative treatment options

Injection-IV Programmed death-1 (PD-1) inhibitor/ Monoclonal antibody

06/16/2020 Supplemental Indication. Priority Review Granted. Specialty Product.

02/08/2020 (Announced 04/08/2020)

Opdivo + Yervoy (nivolumab + ipilimumab)

Bristol-Myers Squibb

The first-line treatment of patients with metastatic or recurrent non-small cell lung cancer with no EGFR or ALK genomic tumor aberrations, administered concomitantly with a limited course of chemotherapy

Injection-IV Programmed death-1 (PD-1) inhibitor/ Cytotoxic T-lymphocyte antigen (CTLA) 4 inhibitor/ Monoclonal antibody

08/06/2020 Supplemental Indication-Combination Regimen. Specialty Product.

02/15/2020 (Announced 04/23/2020)

Plegridy (peginterferon beta-1a)

Biogen The treatment of relapsing forms of multiple sclerosis, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults

Injection-IM Interferon beta-1a 12/15/2020 Supplemental Indication. Specialty Product.

03/04/2020 Simponi Aria Janssen The treatment of polyarticular Injection-IV Tumor necrosis 01/04/2021 Supplemental (Announced (golimumab) Pharmaceuticals/ juvenile idiopathic arthritis and factor (TNF) Indication. 04/24/2020) Johnson & juvenile psoriatic arthritis in patients antagonist/ Specialty

Johnson aged 2 years and older, in Monoclonal antibody Product. combination with methotrexate


Page 6 of 8


Recent Submissions (continued)

Submission Date

Product Name

Manufacturer Indication Route Drug Class PDUFA Date

Comments

04/01/2020 pralsetinib Blueprint Medicines

The treatment of RET fusion-positive non-small cell lung cancer with progression following platinum-based chemotherapy

Oral Kinase inhibitor 12/01/2020 New Molecular Entity. Breakthrough Therapy Designation. Priority Review Granted. Anticipated Specialty Product.

04/07/2020 lumasiran Alnylam Pharmaceuticals

The treatment of primary hyperoxaluria type 1 in patients aged 6 years and older

Injection-SC

RNA interference (RNAi) agent

12/07/2020 New Molecular Entity. Breakthrough Therapy Designation. Anticipated Specialty Product.

04/09/2020 Bavencio (avelumab)

Merck Serono/ Pfizer

The maintenance treatment of locally advanced or metastatic urothelial cancer in patients whose disease did not progress after completion of first-line platinum-containing chemotherapy

Injection-IV Programmed death ligand-1 (PD-L1) inhibitor/ Monoclonal antibody

10/09/2020 Supplemental Indication. Breakthrough Therapy Designation. Specialty Product.

04/16/2020 Estelle Mithra The prevention of pregnancy Oral-Tablet Progestin- 04/16/2021 New Combination. (drospirenone/ Pharmaceuticals estrogen estetrol) combination

04/21/2020 relugolix Myovant/ Sumitomo Dainippon Pharmaceutical

The treatment of androgen-sensitive advanced prostate cancer

Oral-Tablet Gonadotropin-releasing hormone (GnRH) receptor antagonist

04/21/2021 New Molecular Entity. Anticipated Specialty Product.


Page 7 of 8


Granted Priority Review

Effective Date

Product Name

Manufacturer Indication Route Drug Class PDUFA Date

Comments

04/01/2020 Epidiolex GW The treatment of seizures associated Oral-Solution Cannabinoid 1 07/31/2020 Supplemental (cannabidiol) Pharmaceuticals with tuberous sclerosis complex (CB1) receptor Indication.

antagonist Specialty Product.

Refuse to File Letter Issued by the FDA

Effective Date

Product Name

Manufacturer Indication Route Drug Class Comments

04/30/2020 Cortrophin Gel (corticotropin)

ANI Pharmaceuticals

The treatment of infantile spasms, multiple sclerosis, rheumatic disorders, collagen disease, dermatologic diseases, allergic states, ophthalmic diseases, respiratory diseases, and edematous states

Injection-IM & Injection-SC

Adrenocorticotropin hormone (ACTH)

Anticipated Specialty Product. The FDA determined that certain portions of the Chemistry, Manufacturing, and Controls section in the application was not sufficiently completed to permit a substantive review.

*Medicare Part D formularies must include all or substantially all drugs within the anticonvulsant, antidepressant, antineoplastic, antipsychotic, antiretroviral, and immunosuppressant classes;Eligible (Drug is eligible for coverage under Part D); Not eligible (Drug may not be covered under Part D); TBD (Sufficient information not available to determine whether drug may be coveredunder Part D).The information contained herein is compiled from a variety of sources and is provided for informational purposes only. Due to circumstances beyond CVS Caremark control, information relatedto prospective drug launch dates and a drug’s eligibility for coverage under Medicare Part D is subject to change without notice. This information should not be solely relied upon for decision-making purposes. This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVSHealth. ©2020 CVS Health and/or one of its affiliates. All rights reserved. Information provided by Pipeline Services; [email protected]. 106-30991A 05016

Page 8 of 8


2019 TREND RESULTS

Partnering to Support You and Your Members Lowest trend in 5 years

Industry-leading trend performance

41% of clients had negative trend

In 2019, we helped our clients achieve the lowest overall trend in years —

1.4 percent — despite increasing utilization and ongoing price inflation.

Specialty pharmaceuticals remain the key management challenge, dominating

the pipeline and spurring utilization growth, yet we kept specialty trend in the

single digits through a number of focused strategies, including holding unit price

growth to 1.6 percent. In the 2019 Drug Trend Report, we highlight the results of

some of those strategies — including prioritization of generics and biosimilars,

and careful management of utilization — as well as share our perspective about

future marketplace trends.

We achieved these results in trend while helping payors reduce out-of-pocket

costs for their plan members. More than two out of three members spent less

than $100 out of pocket in 2019. The average member cost for a 30-day supply

actually declined by an average of $1.50.

The report that follows details these and other initiatives we have in place to

help our customers manage drug expenditures while supporting better health

outcomes for members.

We are living in an unprecedented health crisis and as part of the national health

care system, CVS Health has a key role to play. Our nearly 300,000 colleagues

are working hard to provide consistent access to needed medications and health

services while also helping our clients provide essential benefits and affordable

prescriptions to their employees and members.

These past difficult months have only reinforced our commitment to helping

you, our clients, meet your goals by working together and helping you and your

members improve outcomes and control costs. The need to work in partnership

has never been greater.

Alan Lotvin, M.D.

President, CVS Caremark

2019 Trend Results

CVS Health Drug Trend Report 2019

2

As soon as local and state governments began issuing shelter-at-home orders in response to the COVID-19 pandemic, we took several proactive steps to ensure that your members, especially those with chronic or complex conditions, had continued access to needed medications.

In response to the pandemic:

We helped members transition to 90-day supplies to ensure they had

needed supplies on-hand and could limit pharmacy visits.

Working with clients, we implemented both an early refill restriction override

and measures to ensure on-time refills.

To further support stay-at-home measures, CVS Pharmacy waived delivery charges.

Because members may have found it difficult to see their health care

providers during the pandemic — and until the country reopens more

fully — we extended previously-approved prior authorizations, enabling

members to refill most medications without having to renew the authorization.

This also serves to reduce the volume of phone calls and other administrative

burdens on physicians’ offices and pharmacies.

In order to ensure access to medications that could potentially be found effective in treating the virus, both for patients already using these

agents for their accepted indication and for potential COVID-19 patients, we

worked with clients to set appropriate limits on the dispensing quantity of

drugs under consideration. Members with existing prescriptions for these

drugs can bypass these quantity limits.

Now, as the country begins to reopen, we remain focused on supporting their health and pharmacy needs.

Ensuring ongoing member access to needed medications

COVID-19


3

Member average OOP cost per 30-day supply

The PBM lowered clients’ trend by mitigating the impact of price inflation and carefully managing utilization.

2019 Review

2019 Trend Highlights

Specialty Management Solutions

Delivering Results that Matter

Member Affordability

OOP: out-of-pocket

We helped keep drugs affordable for members

Lowest overall trend in 5 years:

1.4%

Specialty trend reduced to single digits:

9.3%

Price Growth

TToottaall TrTreenndd

Utilization Trend

-0.1%

1.5% 1.4%

of clients had negative trend

41%

Tightly-managed client specialty trend

8.9% Unmanaged client specialty trend

13.2%

Price Growth

Total Trend

Utilization Trend

1.6%

7.7% 9.3%

-5% to 0%

>10% <-10% 0% to 5%

-10% to -5%

5% to 10%

21.5%

13.9% 12.1%

20.1%

6.9%

25.5%

$1.50 >67%of members spent less than $100 OOP

OVERALL TREND CLIENT TREND DISTRIBUTION

SPECIALTY TREND

Tighter management reduced trend even more

$10.07 2018

2019

$9.72 since 2015


4

Our strategies helped clients stay ahead of evolving market trends Our job is to be the best manager of our clients’ pharmacy benefit by eliminating wasteful spend and reducing inefficient spend, while encouraging impactful spend to help reduce medical costs. In 2019, we stayed the course, delivering historically low trend despite an uptick in utilization.

Through smart formulary and utilization management strategies, we helped prioritize lower-cost and generic options when clinically appropriate. Our solutions helped deliver negative price growth for non-specialty drugs and very low price growth for specialty drugs, despite brand inflation remaining at twice the U.S. Consumer Price Index.

This enabled us to deliver low net trend and single-digit specialty trend for a broad cross-section of clients, covering more than 25 million commercially-insured lives.

Average wholesale price inflation has moderated, but remains >2x U.S. inflation1

9.2% 8.3%

2.1%

2017 2018

8.1% 7.6%

1.9%

6.5%

5%

2.3%

2019

Non-specialty brands Specialty brands U.S. Consumer Price Index

2019 TREND HIGHLIGHTS


5

See how digital tools and Accordant nurse care management helps support members using specialty medications.

LEARN MORE

Managing specialty, the fastest-growing area of pharmacy spend

For successful cost control now and into the future, specialty spend must be managed with laser-like focus and precision. In addition to formulary strategies, our management programs — including specialty guideline management (SGM) which helps ensure appropriate utilization, and new-to-market (NTM) strategy which carefully reviews all newly launched products for clinical and cost effectiveness prior to formulary inclusion — helped clients control costs while ensuring appropriate utilization and member access.

To help payors stay ahead of changing marketplace trends, as always, we continue to evolve our solutions including our SGM criteria.

Clients with two or more specialty management programs had significantly lower trend

13.2%

8.9%

0 PROGRAMS

2+ PROGRAMS

8%

In 2019, 32 of the 54 novel agents approved by the FDA, and 80 of the 135 expanded indications were for specialty treatments.

average client savings for managed categories from just two strategies

2019 SPECIALTY TREND


Specialty treatments now comprise nearly half of all pharmacy spend, and the total specialty spend for pharmacy and medical benefit combined is estimated to grow to $310 billion by 2023. Inflation on existing brands continues to play an important role, but utilization growth, at 7.7 percent, was the major trend contributor in 2019 — accounting for 80 percent of specialty trend. New treatments are being developed for more conditions, and specialty drugs already on the market continue to obtain approval for additional indications, leading to an ever-expanding patient population. These patients have higher overall costs and complex care needs.

6





Specialty management: tackling the highest-cost category New autoimmune treatments being approved and supplemental indications for existing ones led to increased utilization, with the category accounting for a third of specialty pharmacy spending. Drugs in the category are used to treat conditions like rheumatoid arthritis, psoriasis and Crohn’s disease and include some of the highest volume drugs — Humira, Enbrel, Rituxan, and Remicade. Currently, the category faces little generic or biosimilar competition. Without careful management of this category, payors risk sharp utilization and cost increases.

ACSF

10.3%

13.4%

-3.1%

NO ACSF

12.3% 12.3%

0.1%

CLIENTS THAT SWITCHED FROM NO ACSF TO ACSF

13.7%

-9.4%

4.3%

Autoimmune trend

Utilization trend

Price growth

Advanced Control Specialty Formulary (ACSF) helped clients control price growth and trend in the autoimmune category

autoimmune price growth for clients newly adopting ACSF

-9.4%

SPECIALTY MANAGEMENT SOLUTIONS


7

Clients aligned with our template formularies, and those who have opted for tight management, will be best positioned to manage specialty cost over time.

See how our financial protection solutions can help clients mitigate the cost impact of high cost gene therapies.

LEARN MORE

Pipeline overview 2020–2022

~7,000 medications in development

~75% of them potentially first-in-class

~64% are specialty drugs

~5 vs. 7–8 years for approval

2-week approval with Real-time Oncology Review pilot

Changes at FDA accelerate drug approval4

600 new drugs expected to gain approval between 2020 and 2022



-

The evolving specialty marketplace The trend of specialty treatments being the fastest growing spend category in the pharmacy benefit is likely to continue, as is that of higher launch prices. Price tags for currently approved gene therapies range from $475,000 for Kymriah to treat acute lymphoblastic leukemia, to approximately $2 million for Zolgensma, a treatment for spinal muscular atrophy among pediatric patients.2,3 While most of these treatments will be covered under the medical benefit, they will be a significant cost consideration for payors who will need innovative solutions to mitigate the impact.

Manufacturers also continue to seek supplemental indications to increase sales and gain longer patent exclusivity. Changes at the U.S. Food and Drug Administration (FDA) are likely to help expedite approvals, potentially bringing new drugs to market more quickly. Both of these factors will lead to a greater number of members using specialty medications. Payors will need nimble strategies that evolve with the marketplace to help them stay ahead of emerging trends.

8

https://payorsolutions.cvshealth.com/insights/gene-therapy-keeping-costs-from-negating-its-unprecedented-potential

https://payorsolutions.cvshealth.com/insights/gene-therapy-keeping-costs-from-negating-its-unprecedented-potential

https://payorsolutions.cvshealth.com/insights/supplemental-indications-add-uses-expand-market

The FDA has approved a total of 26 biosimilars, of which 17 products have launched.5 There are many more in the pipeline. As more biosimilars come to market increasing competition within the therapeutic category, there will be greater opportunity for significant savings for payors.

Biosimilars to play an increasingly important role in specialty marketplace

Top specialty biologics expected to see biosimilar launches by 2023



Reference Drug Therapeutic Area

Route of Administration Brand Biologic Manufacturer

Projected Launch

Remicade Autoimmune Injection-IV Avsola Amgen 1H 2020 [Janssen]

infliximab Aprogen/Nichi-Iko Pharmaceuticals 2021

Neulasta Hematology Injection-SC pegfilgrastim Pfizer 3Q 2020

[Amgen] pegfilgrastim Cadila Pharmaceuticals 2021

Neupogen Hematology Injection-IV Grastofil Apotex USA 2020

[Amgen] & SC filgrastim Kashiv Bioscience 2020

filgrastim Tanvex BioPharma 2020

Humira Autoimmune Injection-SC [AbbVie]

Amjevita Amgen Jan. 2023

Cyltezo Boehringer Ingelheim July 2023

Hyrimoz Novartis/Sandoz Sept. 2023

Hadlima Merck/Samsung Bioepis June 2023

Abrilada Pfizer Nov. 2023

adalimumab Fresenius Kabi 3Q 2023

adalimumab Coherus BioSciences 2023

Avastin Oncology Injection-IV bevacizumab Samsung Bioepis 3Q 2020

[Genentech/Roche] bevacizumab Mylan 4Q 2020

bevacizumab AstraZeneca/Centus Biotherapeutics 2021

bevacizumab Coherus BioSciences 4Q 2021

Rituxan [Biogen/ Oncology Injection-IV rituximab Allergan/Amgen 4Q 2020 Genentech/Roche]

Actemra [Genentech/Roche] Autoimmune Injection-IV

& SC tocilizumab Bio-Thera Solutions 2022

9

$270K

$6.4M

$2.2M

$4.5M

Cumulative Generic Substitution Savings

CVS Specialty maximized utilization of specialty generics

Brand/Generic

Xeloda/Capecitabine

Gleevec/Imatinib

Copaxone/Glatopa

Ampyra /Dalfampridine

Other Specialty Pharmacies

99.25%

80.67%

88.93%

64.54%

CVS Specialty Pharmacy

99.75%

88.70%

93.22%

77.16%

Difference

0.50%

8.03%

4.29%

12.62%

Data represents results for PBM commercial clients.

Generic Substitution Rate



Helping clients maximize generic savings in specialty Our strategies encourage the use of generics to lower costs by preferring the cost-effective equivalent on our formulary, thus maximizing what is known as the Generic Substitution Rate or GSR.

By focusing on clinically appropriate generics, CVS Specialty helps payors save money by taking advantage of competition within therapeutic categories and we will continue to maximize their value as more competing generics come to market.

10

An ongoing challenge — oncology New cancer therapies continue to drive utilization and price growth. More than 20 percent of new FDA approvals in 2019 were cancer medications — 12 of 54. In addition, treatment prices continue to increase, and the category has low interchangeability. Given that we estimate oncology represents 8.7 percent of total pharmacy spend and 18.3 percent of specialty pharmacy spend, innovative management strategies for this class are imperative. With more new drugs — including gene therapies — in development and an expedited review process at the FDA, this therapeutic category will continue to be a major challenge for clients.

Transform Oncology Care, launched in 2019, uses technology and the latest genomic science to solve some of the biggest challenges in oncology management today. Better cancer care management — tailored to patient needs and plan goals — can enhance quality of care and outcomes, while helping lower the overall cost of treating this complex condition. For example, helping patients who are on certain infused medications transition from a costly outpatient hospital setting to a more effective site of care can lower costs for payors while making it more convenient for members.

Transform Oncology Care strives to improve the oncology patient and physician experience by making it easier for providers to access the latest clinical guidelines, and empowering evidence-based decision making.

See how we are supporting a new personal best in cancer care with Transform Oncology Care.

LE ARN MORE

Oncology represents: of our clients’ total

pharmacy spend

8.7% of their overall specialty pharmacy spend

18.3%



11

Clinical trial recommendations to increase access

to innovative therapies

Reduce therapy spend

Real-time prior authorization (PA)

integrated with NCCN Guidelines

for tighter UM

Decrease medication errors

Value-based provider contracts aligning provider-

payor goals

Optimize provider performance

Optimize site of care to

enable reduced treatment cost at

time of PA

Transition to lower cost site of care

Proactive patient support to manage

risks and reduce emergency room

(ER) visits

Fewer ER visits and hospitalizations

Broad-panel gene sequencing

for more complete, precise patient

profile

Reduce wasteful spend

Transform Oncology Care strives to provide targeted strategies for every step of the cancer care journey

With Transform Oncology Care we are working to make appropriate cancer care simpler and more accessible. We are the first company working to make the latest in precision medicine accessible to more patients. We are empowering informed treatment decision-making based on a patient’s clinical and genetic profile to give them the best chance for successful treatment and improved quality of life.

Transform Oncology Care — supporting a new personal best in cancer care

Supporting the best therapy and treatment, faster

Supporting the best experience for the patient

Striving for the best quality at a lower cost

$24M NCCN: National Comprehensive Cancer Network

UM: Utilization management

potential client savings per 1M eligible lives from implementing Transform Oncology Care



12

We enabled clients to eliminate wasteful spend on high-cost drugs that did not demonstrate a clear clinical benefit by developing and implementing strategies to ensure the appropriate use of drugs through utilization management.

In addition to negotiating discounts from manufacturers on behalf of our clients, we use our industry-leading formulary strategies — including preferred placement and drug exclusions — to encourage use of lower-cost and generic options. Through utilization management (UM) options such as drug utilization review, new-to-market strategy, and specialty guideline management, we help ensure that members are getting the right drug at the right time.

Managed formularies key to reducing prescription costs for chronic conditions





STATINS

$28.93

$14.81

PROTON PUMP INHIBITORS

$33.44

$21.74

METFORMIN

$26.67

$14.22

ANTIDEPRESSANTS (SNRI)

$45.95

$33.30

$7.8B from prioritization of generics and biosimilars

$59.3B from template formulary and UM strategies*

Unmanaged** Managed** ALL DRUGS

$97.10 $83.60

2019 client savings

2019 cost per 30-day Rx

Savings by therapeutic class


13

In 2017, we were the first in the industry to introduce a hyperinflation management program that targeted drugs experiencing extremely high inflation year-over-year. Last year, based on the success of the initial program, we expanded the strategy to include drugs that were price outliers — sometimes exponentially more expensive — compared to clinically equivalent treatments in the same category. For instance, one brand of extended-release metformin cost more than $620 for a 30-day supply compared to just $3.43 for the preferred alternative. Clients opting in to the hyperinflation strategy could reduce their spend on that single product by more than 99 percent.

As part of this strategy, we monitor our template formularies on an ongoing basis and remove hyperinflated drugs to help clients stay ahead of marketplace trends. Our hyperinflation strategy gives clients ongoing, dynamic control of drug spend by targeting drugs that see high year-over-year inflation, or are outliers in terms of price compared to other available clinically equivalent alternatives, quickly excluding such therapies from the formulary on an ongoing basis.

Hyperinflation strategy helped clients save on price outlier drugs

PMPM: Per member per month

56 drugs removed forbeing price outliers $1.89 average PMPM

savings for clients utilization of87% removed drugs

Our hyperinflation strategy in 2019:

$390.8M in overall client savings for 2019

DELIVERING RESULTS THAT MATTER


14

RxZero, introduced in 2020, eliminates out of pocket costs for all categories of diabetes medications without raising costs for the plan sponsor, or increasing premiums or deductibles. Learn about this innovative approach to managing costs associated with diabetes.

LEARN MORE


- -

Management strategies key to negative diabetes trend despite ongoing inflation More than 34 million — about one in 10 — Americans have diabetes.6 For years, diabetes drug trend was a major contributor to overall trend, driven in large part by ongoing brand inflation for diabetes drugs. Effective formulary strategy is the cornerstone to managing costs. Our template managed formularies are designed to maximize cost savings for clients by using competition to drive to lowest net costs through discounts negotiated with manufacturers and careful formulary placement. This is especially important because so-called low-list price products that manufacturers tout as cost-effective alternatives, in reality, don’t lower cost for clients. Our strategies continued to help blunt the impact of price inflation as evidenced by the significant difference in trend and per-member-per-month costs for managed clients compared to unmanaged ones.

Our management strategies help mitigate antidiabetic price inflation

6.4%

1.4%

6.5%

-1.7%

5.0%

-1.6%

Management**

reduces PMPM costs

$15.00 Unmanaged

$6.98 Managed

2017 2018 2019

Antidiabetic brand inflation Antidiabetic PBM trend

15


A comprehensive strategy for controlled substances and prescription safety Our industry-first comprehensive controlled substances strategy helps encourage appropriate prescribing by giving clients the option to implement not just days’ supply limitations but also restrictions on the morphine milligram equivalent (MME), and step therapy requirements for extended-release opioids. The strategy was developed by CVS Health in alignment with guidelines issued by the Centers for Disease Control and Prevention.

These strategies are designed to help ensure members have access to the medications they need, while encouraging appropriate prescribing. The strong positive results from the opioid management strategy also helped shape our new Prescription Safety Management solution, which includes preventive measures such as alerts for therapy duplication and drug interactions, and is designed to enhance safe prescribing for all medications.

See how our Prescription Safety Management solution enhances safe prescribing for all medications.

LEARN MORE

Opioid management results for CVS Caremark clients

42% decline in total number of opioid Rxs

~50% drop in dispensing of opioid Rxs for longer than 7 days

15% decrease in MME per day per Rx

49% decline in extended-release opioid Rxs

~89% of acute Rxs are for 7 days or less†

~99% of acute Rxs are for 90 MME per day or less†

SINCE Q1 2017: SINCE 2019:



16

We also helped keep specialty drugs affordable for members

>61%of members using specialty drugs spent less than $500 annually***






Lowering prescription costs for members In addition to higher drug costs, increasing rates of chronic disease and the rising use of high deductible health plans (HDHP) have put additional financial stress on many consumers. In 2019, HDHPs covered 30 percent of consumers, compared to 24 percent in 2015.7 Cost can be a barrier to adherence and higher out-of-pocket costs can force individuals to make tough choices about whether or not to fill a prescription.

In order to help members afford their medications and to support better overall outcomes, we have developed a range of strategies to address out-of-pocket (OOP) costs. Members can access prescription cost and real-time benefit information wherever they are: at the doctor’s office, the pharmacy, at home, or on the go. We advocate for the inclusion of $0 copay preventive drug lists in high-deductible health plans, offer it to our own employees and recommend clients adopt it for their plans. We were also the first in the industry to begin offering point-of-sale rebates, so clients can pass on part or all of the discounts we negotiate from the manufacturer to their members at the point of dispensing helping lower costs during the deductible phase. Along with essential strategies such as formulary designs that promote the use of lower-cost drug options, these initiatives have helped lower OOP costs per 30-day prescription and reduced member cost share. Two out of three members spent less than $100 OOP in 2019.

Member average out-of-pocket cost declined year over year

In 2019, per 30-day supply:

2018

$10.07

2019

$9.72

$1.50 cost per 30-day supply since 2015

>67%of members spent less than $100

>85%spent less than $300

17

https://payorsolutions.cvshealth.com/insights/offsetting-member-cost-in-high-deductible-health-plans

Tailored solutions helped improve adherence Research shows that 24 percent of Americans find it hard to afford prescriptions and 29 percent skipped doses because of costs.8 By holding down member costs, we helped ensure that more members were able to afford their medications, thus reducing a key barrier to adherence.

Aligned with our goal of helping clients control their overall benefit costs, we have also tailored programs to better support members in staying adherent to prescribed regimens. Our Pharmacy Advisor program has been proven to help members improve adherence for key chronic conditions. The program has delivered 54 million interventions since 2011. We are further enhancing the program to even better identify members most at risk for non-adherence. Better adherence not only helps improve outcomes, it can also save money for payors from avoidable downstream costs. Because patients with complicated conditions face particular challenges, we also offer care programs such as Transform Diabetes Care. Each program provides ongoing, targeted intervention and outreach from pharmacists and clinicians. These programs help ensure each member receives support tailored to their unique needs.

Implementing such care management solutions helps ensure that members don’t fall off therapy because of side effects or drug interactions and leads to better adherence.

Increased Rx spend from improved adherence Medical savings

NET SAVINGS

DIABETES

$764

$1499

$2,263

HYPERTENSION

NET SAVINGS

$39

$1,361

$1,400

NET SAVINGS

HIGH CHOLESTEROL

$27

$1,091

$1,118

more members achieved optimal adherence over two years with Pharmacy Advisor

3.9%

Client savings from each optimally adherent member

MEMBER AFFORDABILITY


18

Trend methodology This report provides an overview of performance for CVS Health

commercial PBM clients — employers and health plans. Data was

calculated on a cohort of nearly 1,200 clients, covering 25 million

lives. The cohort is built only on clients under our management

throughout all of 2018 and 2019, excluding commercial clients

with eligibility shifts exceeding 20 percent as well as any clients

contractually prohibited from inclusion. Prescription drug trend is

the measure of growth in prescription spending per member per

month. Unless otherwise noted, reported data is net of negotiated

pricing, rebates, and manufacturer discounts.

CVS Health Drug Trend Report 2019 19

1. U.S. Consumer Price Index source: https://www.bls.gov/cpi/ as of January 2020.

2. https://www.fiercepharma.com/pharma/at-475-000-per-treatment-novartis-kymriah-a-bargain-or-just-another-example-skyrocketing.

3. https://www.npr.org/sections/health-shots/2019/05/24/725404168/at-2-125-million-new-gene-therapy-is-the-most-expensive-drug-ever.

4. https://www.phrma.org/en/Science/In-The-Pipeline. https://www.fda.gov/about-fda/oncology-center-excellence/real-time-oncology-review-pilot-program.

5. https://www.drugs.com/medical-answers/many-biosimilars-approved-united-states-3463281/.

6. https://www.cdc.gov/diabetes/data/statistics/statistics-report.html.

7. https://www.kff.org/health-costs/report/2019-employer-health-benefits-survey/.

8. https://www.kff.org/health-reform/poll-finding/kff-health-tracking-poll-february-2019-prescription-drugs/.

*Inclusive of rebates, and UM strategies such as preferred placement and drug removals. Inclusive of savings related to formulary drug removals since 2012.

**Managed clients have opted in to our standard formularies. Unmanaged clients opted out of our standard formularies and hyperinflation strategies.

***Inclusive of specialty copay cards.

†For paid claims.

Data source, unless noted otherwise, CVS Health Enterprise Analytics, 2020.

Pipeline Services projections, data 2020 through 2023, as of May 11, 2020.

Adherence results may vary based upon a variety of factors such as plan design, demographics and programs adopted by the plan. Client-specific modeling available upon request.

Savings will vary based upon a variety of factors including things such as plan design, demographics and programs implemented by the plan.

This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Health.

This page contains trademarks or registered trademarks of CVS Pharmacy, Inc. and/or one of its affiliates.

Image source: Licensed from Getty Images, 2020.

©2020 CVS Health. All rights reserved. 106-51866A 052120

https://www.kff.org/health-reform/poll-finding/kff-health-tracking-poll-february-2019-prescription-drugs

https://www.kff.org/health-costs/report/2019-employer-health-benefits-survey

https://www.cdc.gov/diabetes/data/statistics/statistics-report.html

https://www.drugs.com/medical-answers/many-biosimilars-approved-united-states-3463281

https://www.fda.gov/about-fda/oncology-center-excellence/real-time-oncology-review-pilot-program

https://www.phrma.org/en/Science/In-The-Pipeline

https://www.npr.org/sections/health-shots/2019/05/24/725404168/at-2-125-million-new-gene-therapy-is-the-most-expensive-drug-ever

https://www.fiercepharma.com/pharma/at-475-000-per-treatment-novartis-kymriah-a-bargain-or-just-another-example-skyrocketing

https://www.bls.gov/cpi


Date: June 5, 2020

Carrier: 9445



Call Center Statistics:

Number of calls – 1,214

Percentage of calls answered in 10 seconds – 94.5%(1,147 calls)

Percentage of calls answered in 30 seconds – 95.5%(1,159 calls)

Average speed of answer (number of seconds before live body answers calls) 7.2 seconds

Abandonment rate 0.5%

Average call duration 513 seconds

Breakdown of calls by subject matter (one call can be logged in more than one category):

Miscellaneous – View Member Account 1,842

Rx Verification - Rx Verify Directions 781

Plan Design – Prior Auth 146

Order Placement – CCR Refill 252

Retail – Retail Assist with Transmission 159

Order Status – Order Inquiry 293

Plan Design – Plan Benefit Override 213

Retail Test Claim 316

Plan Design – Plan Design Education 213

Retail- Retail Billing/Payment 166

Others 1,109

Requests by EUTF to Account Management/CustomerCare:

Number of Requests: 3

Average turnaround time complaints were responded to: 1 Day

1

Breakdown of escalations by subject matter:

Account Maintenance: 2

Reinstate: 0

Research: 1

Verify Enrollment: 0

Outreach: 2

Rush/Manual Enrollments: 0

CVS Health Walk-In Servicing

0 SilverScript members visited the customer service office on Bishop Street during the month of

February 2020.

Operational Issues Pertaining to EUTF Members:

There is a pending coding correction for a Multi-Vitamin that was missed under the EUTF

Wrap plan.

Claims impacted currently – 4/1 to 6/4 – 33 Total Claim, 29 Utilizers

Correction of the coding is set to be completed by 7/1/20, after the correction, claim

reimbursement will be submitted under a SW for EUTF.

Issues Raised By or With the Vendor and Correspondence to or Referred to the Vendor:

No information to report.

Any Legal Actions or Proceedings Involving EUTF Members:


Pending or Approved Insurance Regulations or State Legislation Affecting Benefits:

Please refer to the CVS Health report.

New Issues with Respect to New Programs or Benefits of Interest to Board:


EUTF Client Service Team Contact and Pending Changes to Team, If Any:


2

Community Activities Relating to Vendors That May Be Of Interest to EUTF:

Please refer to the CVS Health report.

Other:


If you would like to have further detail on any of these topics, please feel free to contact Ty Bowers at

480-402-1116 or via email at [email protected].

Mahalo,

Ty Bowers

Strategic Account Executive, Medicare Account Services

3



Date: June 8, 2020

Carrier: Hawaii Dental Service


▪ Customer Service Utilization and Performance Data:Number of in person interactions with HDS and EUTF participants (walk-ins) = 0

▪ Call Center Statistics:Total number of calls = 591

Percentage of calls answered in 10 seconds = 78.99%

Percentage of calls answered in 30 seconds = 99.65%

Average speed of answer (number of seconds before live body answers calls) = 8.0 seconds

Abandonment rate = 0.67%

Average call duration = 5:18 minutes

Breakdown of calls by subject matter Eligibility/Benefits: 29% Claim Status: 4% Request for ID card: 4% Refer to EUTF (address change): 1% Dentist search: 1%

Results may not total 100%. One call could have more than one subject matter.

▪ Complaints:Number of Complaints = 0

Average turnaround time complaints were responded to = n/a

Breakdown of complaints by subject matter Number Resolved/Number Pending Resolution – None

1

_______________________________________

▪ Operational Issues Pertaining to EUTF Members:

Network Addition: Dr. Brett Sterling – Oahu

Network Exits: None

▪ Issues Raised By or With the Vendor and Correspondence To or Referred to the Vendor:None

▪ Any Legal Actions or Proceedings Involving EUTF Members:None

▪ Pending or Approved Insurance Regulations or State Legislation Affecting Benefits:None

▪ New Issues with Respect to New Programs or Benefits of Interest to Board:None

▪ EUTF Client Service Team Contact and Pending Changes to Team, If Any:None

▪ Community Activities Relating to Vendor’s That May Be Of Interest to EUTF:None

▪ Other: N/A

Elaine O. Fujiwara, Director, Sales & Account Management

2


Date: June 8, 2020

Plan: EUTF Supplemental Medical and Prescription Drug Plan

Carrier: Hawaii-Mainland Administrators, LLC (HMA)

Period Report Covers: May 1, 2020 through May 31, 2020

Customer Service Utilization and Performance Data

Total number of employees enrolled: 805

Total number of members enrolled: 2,218

Total number of claims paid: 201

Average turnaround time: 5 Days

Call Center Statistics

Number of Calls: 30

Average Speed of Answer From a Live Body: 10 Seconds

Abandonment Rate: 0%

Breakdown of Calls (By Subject Matter)

Although we do not have an automated manner in which to track the breakdown of calls by subject matter,

our detailed assessment for this month is as follows:

• Approximately 50% of calls received are member’s following-up on claims status.

Claims status inquiries include:

o Confirm receipt of claims document

o Time frame to receive reimbursement

o Filing deadline for last fiscal year

• Approximately 50% of calls received are of other miscellaneous related inquiries.

Miscellaneous inquiries include:

o Requests for claim form

o Check not received

o Assistance with on-line submission

o Instruction/verify form completed correctly

o Inquiry to learn more about the plan

Phone: (808) 951-4643 | Toll-Free: (866) 437-1992 | Fax: (808) 951-4620 Carrier_Report_050119 Page 1 of 2

• Complaints :

Number of Complaints: 0

Average turnaround time complaints were responded to: N/A

Breakdown of complaints by subject matter: N/A

Resolution: N/A

• Operational issues pertaining to EUTF Members :

None to report.

• Issues raised by or with the vendor and correspondence to or referred to the vendor :

None to report.

• Any legal actions or proceedings involving EUTF Members :

None to report.

• Pending or approved insurance regulations or state legislation affecting benefits :

None to report.

• New issues with respect to new programs or benefits of interest to board :

None to report.

• EUTF client service team contact and pending changes to team, if any :

None to report.

• Community activities relating to vendor’s that may be of interest to EUTF :

None to report.

• Others: *

Due to COVID-19 HMA staff worked remotely from home including the Customer Service Department

as of March 23, 2020. Because the phone system needed to be reconfigured to allow phone calls

remotely, it impacted the reporting capabilities. HMA’s self reporting ended on May 7th. The

automated reporting capabilities were restored on May 8th .

Please feel free to contact me directly at (808) 441-6024 with any questions or clarification concerning this report.

Sincerely,

Vanelle Hirayasu

Director, Account Management

HMA

Page 2 of 2


Date: June 15, 2020

Carrier: Hawaii Medical Service Association (HMSA)



• Call Center Statistics:▪ Number of calls – 1,494▪ Percentage of calls answered in 30 seconds – 97.59%▪ Percentage of calls answered in 20 seconds – 92.70%▪ Percentage of calls answered in 10 seconds – 77.64%▪ Average speed of answer (number of seconds before live body answers calls) – 00:10▪ Abandonment rate – 0.4%▪ Average call duration – 07:24 (MM:SS)

• Complaints:HMSA’s organization is set up with an initiative known as First Call Resolution (FCR).FCR is the concept that members should only have to contact HMSA one time with theirconcern/inquiry for it to be resolved. Although members’ inquiries may not be resolvedduring the first call, the idea is that the member should not have to call HMSA again aftertheir initial contact.

If a member is not satisfied with a response by a customer service representative, the member is provided with HMSA’s Appeals Rights and Processes. If a member decides to submit a formal Appeal with HMSA, HMSA begins tracking the member complaint through our Appeals Department, which is the information that we have provided below.

• May 2020▪ Total number of appeals unresolved from the previous month: 15▪ Total number of complaints (Appeals) received: 19▪ Average turnaround time complaints (Appeals) were responded to: 24 days (excluding

appeals that were extended)▪ Total number of appeals resolved with extensions: 0

• In some instances, additional information is required to support the nature of anAppeal, such as additional medical records. Extensions are applied afterobtaining member approval.

▪ Total number of appeals resolved without an extension: 16▪ Breakdown of complaints by subject matter – Number Resolved/Number Pending

Resolution:

• 17 Appeals pending as of June 1, 2020.

• 16 Appeals resolved in May 2020.

• 1 Appeals withdrawn in May 2020.

• 0 Appeals voided in May 2020.

1

Appeal Description Count of Cases

Back Brace 1

Cervical Spine MRI 1

Chest CT 1

Decision Dx Melanoma Assay 1

Foundation One Genomic lab test 1

Heart MRI 1

Liquid Gammaglobin 1

Lumbar Decompression 1

Lumbar Sacral Transforaminal Epidural

1

NJX DX 1

Nonpar ER Physician Visit 1

Nonpar Laboratory Service 1

OOS Labs Processed Nonpar due to Referring MD

1

Parsabiv 1

PET Scan with CT for Attenuation 1

Physical Therapy 1

Synovectomy Knee Arthroscopy 1

Total 17

Operational Issues Pertaining to EUTF Members: None for May 2020.

Issues Raised By or With the Vendor and Correspondence to or Referred to the Vendor: None for May 2020.

Any Legal Actions or Proceedings Involving EUTF Members: None for May 2020.

Pending or Approved Insurance Regulations or State Legislation Affecting Benefits: None for May 2020.

New Issues with Respect to New Programs or Benefits of Interest to Board: None for May 2020.

2

EUTF Client Service Team Contact and Pending Changes to Team, if Any: None for May 2020.

Community Activities Relating to Vendor’s That May Be of Interest to EUTF: HMSA employees have continued to actively participate in volunteer efforts during the statewide shelter in place order. Employees have helped at various food distribution sites, assisted with mask making & distribution, and even hosted online classes for Hawaii students. The health of all of Hawaii is important to us. Listed below are the organizations at which HMSA employees have volunteered over the that last few months. These efforts have been ongoing. HMSA has also contributed to food banks/baskets across the state throughout our various islands including the Hawaii’s ‘Ohana Distributions at the Aloha Stadium. We will continue to support community organizations through volunteerism so that all of Hawaii’s residents enjoy ever healthier lives.

Blood Bank of Hawaii Chamber of Commerce & Nepris Online Learning

Hawaii Foodbank Inc State Department of Health & Hawaii Children’s Action Network

Waianae Coast Comprehensive Health Center Friends of Children’s Justice Center (Keaau)

Kokua Kalihi Valley (Hooulu Aina) Every1ne Hawaii

Key Project (Windward)

Other: None.

If you have any questions, please contact me at 952-7845.

Sincerely,

Christopher M. Letoto Manager, EUTF Program Account Management and Sales

3


Date: June 9, 2020

Carrier: Kaiser Permanente


Customer service utilization and performance data:

Call center statistics:

Number of calls: 318 Calls

Percentage of calls answered in 30 seconds: 99.00%



Average speed of answer: 3 seconds

Abandonment rate: 0.31%

Average call duration: average talk time 278 seconds

(24%) Access, (36%) Benefits, (3%) Billing Issues, (6%) Claims, (1%) Complaints

(23%) Eligibility, (3%) ID/Demographics, (4%) Materials Requested

Complaints:

Number of Complaints: 35

Average turnaround time complaints were responded to: 8 days to close concerns

Breakdown of complaints by subject matter – Number Resolved/Number Pending Resolution:

Resolution: 23 closed, 12 open

– Access – (2) Scheduling Appointment, (4) Appointment Availability

– Benefits & Enrollment – (3) Coverage/Copays

– Operational Process – (4) Billing, (4) Telephone System, (1) Appeals Proc., (1) Covid-19

– Physician – (2) Diagnosis Treatment/Care, (8) Courtesy & Communication, (1) Efficiency/Service

– Physician Extender – (1) Efficiency/Service

– Facility – (1) Signage, (1) Check-in/Out Proc.

– Other – (2) Prescription

Operational issues pertaining to EUTF members:Holiday Clinic Closures:July 3, 2020 – In observance of Independence DayER will remain open 24/7

Temporary Clinic Consolidation: The below clinics continue to be temporarily closed

• Hawaii Kai Clinic • Kahuku Clinic

• Kailua Clinic • Kapolei Clinic

• Nanaikeola Clinic • Kihei Clinic

• Waimea Clinic

Temporary Closure of Walk-In Member Services: Walk-In Member Services continue to be temporarily closed

Issues raised by or with the vendor and correspondence to or referred to the vendor:None

Any legal actions or proceedings involving EUTF members:None

Pending or approved insurance regulations or state legislation affecting benefits:None

New issues with respect to new programs or benefits of interest to board:None

EUTF client service team contact and pending changes to team, if any:None

Community activities relating to vendor’s that may be of interest to EUTF:Waipio food distribution feeds families in need - More than 1000 families received fresh produceand other food at Kaiser Permanente’s Waipio Medical Office on May 31st, and June 7th.The food distribution is part of the United States Department of Agriculture Farmers to FamiliesFood Box Program facilitated by Ham Produce and Seafood and coordinated by KaiserPermanente Hawaii to benefit UNITE HERE Local 5 workers struggling financially due to theclosure of Hawaii’s visitor industry.Ham Produce and Seafood received USDA funding to purchase and assemble produce and meatproducts into large boxes for family-sized donations. The company then works with local nonprofitorganizations and partners to distribute the food to struggling families. More than 140 KaiserPermanente employees volunteered at the Waipio distribution event.

Other:Kaiser Permanente extends COVID-19 cost waiver through 2020 – Kaiser Permanente hasannounced that it will extend its waiver for most member out-of-pocket costs for inpatient andoutpatient services related to the treatment of COVID-19 through December 31, 2020. Thiswaiver, put into effect on April 1 and originally set to expire on May 31, is intended to alleviate thecost burden and stress of paying for care, allowing members to focus on recovery.

Troy Tomita

Senior Account Manager Kaiser Permanente

Employee Benefits Solutions

Monthly Carrier Report – Hawaii EUTF

Date: June 10, 2020 Carrier: Securian Financial Report Period: May 2020

Customer Service, Utilization and Performance Data

• Group Term Life Claims Paid: 92

• Active Employee Claims: 1

• Retiree Claims: 84

• Average Processing Time: 5 business days

Appeals Summary

• Number of Active Appeals: 0

• Number of Resolved Appeals: 0

• Average Time to Resolve: N/A

• Resolution Summary: N/A

Walk-In Servicing

• Number of Walk-In Visits: 0

• Average Time per Walk-In: 0 minutes 0 seconds

Customer Service Statistics

• Number of Calls Received: 261

• Average Speed to Answer: 13 seconds

• Abandonment rate of all calls received: 0.77%

• Average Call Duration: 4 minutes 51 seconds

• Requests by Category:

• Claims: 15

• Member information changes or updates: 32

• Policy related requests: 64

• Other: 12

Narrative of Other Activities

• Complaints: None to report.

• Operational Issues Impacting EUTF Members: None to report.

• Issues Raised By or With the Vendor: None to report.

• Legal Actions/Proceedings Involving EUTF Members: None to report.

• Pending/Approved Insurance Regulations Impacting Benefits: None to report.

• New Programs and Benefits of Interest to Board: None to report.

• Changes to EUTF Service Team: None to report.

• Community Activities of Interest to the Board: None to report.

Submitted 6/10/2020 by: Denise Mercil, Field Service Representative, Securian Financial (808) 282-6783, [email protected]

1




Date: June 8, 2020

To: EUTF Board of Trustees

From: VSP Vision Care

Monica Kim, Market Director - Hawaii

Report Period: MAY 2020

• Customer Service Utilization Data:

o EUTF customer walk-ins to the VSP Hawaii Office in May 2020: 0

VSP’s office has been closed due to VSP’s company-wide work from home order

• Call Center Statistics:

VSP’s main 1-800 customer service line (1-800-877-7195) Monthly Data

Quarterly Performance Guarantee now applies to VSP’s main Customer Service Line

Q1 2020 Results included in VSP’s Performance Standards Report

o Number of Calls:

▪ Company-Wide: 554,709 calls

▪ EUTF Calls: 521 Active & 214 Retiree calls

− VSP Confidential EUTF Call Response Reports enclosed(Call breakdown by subject matter)

o Average speed of answer (# of seconds before live body answers calls): 22 seconds

o Call abandonment rate: 1.27%

o Average call duration: 3 minutes 52 seconds

EUTF-specific toll-free number (1-866-240-8420) Monthly Data

Performance Guarantee no longer applicable to EUTF-specific phone line – information only

o Number of calls: 30 Active & Retiree calls

• Complaints:

o Number of Complaints*: 2 (2 Active & 0 Retiree)

o Average turnaround time complaints were responded to:

▪ Call Resolution (same day) 100%

▪ Complaint Acknowledgement within 5 business days 100%

▪ Complaint Resolution within 30 calendar days 100%

o Breakdown of complaints by subject matter:

VSP Confidential Complaint & Grievance Summary Reports (Active & Retiree) enclosed

▪ Number Resolved 2

▪ Number Pending Resolution 0

*Individuals with complaints may state more than one issue

1 6/8/2020

VSP Vision Care

EUTF Monthly Carrier Report – May 2020

• Operational Issues Pertaining to EUTF Members:

VSP continues to operate as a predominantly remote workforce. All staff, who are working remotely have

the same access to VSP systems as they would have on campus or regional offices and services are not

impacted due to this change. This includes the VSP Hawaii Office.

TEMPORARY ESSENTIAL MEDICAL EYE CARE SERVICES – Extended through June 30, 2020

What’s happening?

At VSP® Vision Care, we’re committed to doing our part to “flatten the curve” and protect the health

and safety of our members. That’s why, through the month of May, VSP has expanded access to

medical eye care services for most VSP members and their covered dependents. It’s effective April 1 through May 31, 2020 for members who do not already have this benefit.*

Why?

VSP network doctors do so much more than help with vision correction. They diagnose and treat

conditions including conjunctivitis, eye trauma, and sudden changes in vision. Access to optometrists

during this pandemic allows our members to maintain health and visual acuity while easing the burden

on primary care physicians and emergency rooms. Visiting the ER may increase exposure to disease, as

well as take services away from critically ill patients. We understand the connection between eye care

and overall health, and this expanded access will allow our members to turn to their VSP network

doctor for essential medical eye care services when they need it most.

• Issues Raised By or With the Vendor and Correspondence To or Referred to the Vendor:

None

• Any Legal Actions or Proceedings Involving EUTF Members:

None

• Pending or Approved Insurance Regulations or State Legislation Affecting Benefits:

None

• New Programs or Benefits of Interest to the Board:

None

• EUTF Client Service Team Contact and Pending Changes to Team, If Any:

None

• Community Activities Relating to Vendor’s That May Be of Interest to EUTF:

None

• Other:

2 6/8/2020