Alaska Division of Retirement & Benefits

The meeting included introductory business where new board members were welcomed. Key discussions centered on updates from the Department of Administration and Division of Retirement & Benefits, including extensions of temporary telemedicine coverage and flu shot coverage due to COVID-19, and future planning for COVID-19 vaccines. Updates were provided on the transition to automate IRMAA reimbursement via OptumRx starting in 2021. The Board reviewed updates regarding potential new benefits, such as a second opinion service for surgeries and the exploration of a Medicare Advantage Option via an RFI. Significant time was dedicated to Plan Year 2021 Open Enrollment for the Dental, Vision and Audio (DVA) plan, including proposed regulation changes concerning coverage adjustments, dependent eligibility, and handling dual coverage. The Board also reviewed and advised on premium rates for Plan Year 2021 for the Medical, DVA, and Long Term Care (LTC) plans, ultimately voting to adopt staff recommendations: a 5% premium reduction for paying medical plan members, no change for DVA rates, and no change for LTC rates. A clinical overview of COVID-19 vaccines and treatments was also presented.

The meeting agenda included a call to order, roll call, ethics disclosure, and public comment sessions. Key discussion topics for the department update centered on 2024 key activities and the Inflation Reduction Act concerning Medicare Part D changes. Modernization topics covered expansion of the Pacific Health Coalition for health fairs and primary care access, review of rehabilitative care including acupuncture, discussion of the Standard DVA Plan, behavioral health offerings, lifestyle and wellness programs, and enhancement of travel benefits. Discussions also included the status of the plan booklet update and adopted regulations. Regarding modernization priorities, the Board received updates on various proposals, noting high priorities such as Out-of-Network Reimbursement methodology change (R005), expansion of rehabilitative care like acupuncture (R009C), and chronic disease management. There was significant discussion regarding the DVA plan, specifically concerning vision, dental annual maximum, and audio benefits, as well as behavioral health provider access for Medicare recipients. The Division committed to preparing proposals for the top four prioritized items for the next subcommittee meeting.

The discussions focused primarily on the Retiree Dental, Vision and Audio (DVA) plan, specifically addressing the litigation resulting from 2014 changes and the implementation of the Superior Court's directive to offer members a choice between the 2013 Legacy Dental Plan and the current Standard Dental Plan, commencing January 1, 2020. Key topics included the procurement of a new Third Party Administrator (Delta Dental of Alaska), the operational tasks required to stand up the Legacy plan, and the extensive communication plan intended for retirees leading up to the open enrollment period, which was moved to start on October 16, 2019. There were detailed reviews and Q&A sessions regarding the benefit comparison table, premium setting methodology for 2020, network differences (PPO vs. Premier), recognized charge calculations for out-of-network care, and coverage classification for specific services like inlays and crowns. The meeting also featured a demonstration of the new online open enrollment portal and a review of the financial status of the DVA plan trust.

This document presents proposals for modernizing the AlaskaCare Retiree Health Plan. It addresses three key areas: adjusting the lifetime maximum insurance benefit to ensure comprehensive coverage for severe conditions, introducing a supplemental non-emergent surgery and travel program to facilitate access to specialized care, and implementing a virtual physical therapy and musculoskeletal care program for accessible and cost-effective treatment. These proposals aim to enhance member benefits, improve care accessibility, and optimize the plan's financial sustainability.

The working session focused on establishing the scope, process, and timing for reviewing specific provisions within the AlaskaCare Retiree Health Plan. Key areas of review included coverage for experimental and investigational services and supplies, the precertification process, and the travel penalty. Detailed documentation was provided outlining the criteria for determining if a service is experimental or investigational, including exceptions for ongoing clinical trials related to cancer or terminal illness. Furthermore, the precertification requirements were outlined, specifying mandatory notification timelines to Aetna for non-emergency admissions, emergency services, and various procedures such as hospital stays, transportation, and organ transplants. The consequences of failing to precertify, including benefit reductions and penalties, were also detailed.