The Bucks and Montgomery County Health Care Consortium is comprised of 22 school entities representing nearly 12,000 employees and 29,000 total members. These school entities have joined together in a unique self-funded arrangement as a large group purchaser of medical insurance, prescription drugs and other employee benefits. The purpose of the arrangement is for consortium members to group together to get the best price possible for health care and employee benefits while also focusing on collectively improving employee health and wellness, potentially leading to even greater cost savings.
Our mission is to manage and control the rising health care costs while maintaining quality health care.
Our guiding principles are:
Current school entities who have joined the consortium and who have representatives on the board of trustees include:
School entities that decide to join the consortium may join with the health plans they currently offer. Within 120 days, if not sooner, of joining the Consortium, the school entity must migrate to the three preferred medical plans. The three preferred medical plans are:
For the 2016-2017 plan year, approximately 89% of the members are covered under the preferred medical plans.
In future years, recognizing that significant changes to the health care industry are on the horizon, the trustees will collectively determine if new and/or different medical plans should be offered. The goal will be for the Consortium to consistently offer three or more medical plan options for its participants.
Through collaboration between Labor and Management, BMCS will achieve over $30 million in projected health care savings based on decisions made since BMCS's inception. While savings for individual school entities vary, all members have received some savings over their previous health insurance programs. Savings are achieved from: self-insurance funding; collective purchase of stop-loss insurance; reduced retention (carrier expenses), streamlined collection of premiums and reconciliation of accounts, as well as from our recent transition to Aetna for medical administration and CVS Health for prescription administration.
Continued future savings are expected to be achieved by Labor and Management working jointly together to educate employees and develop inventive health and wellness programs targeted at the specific needs of consortium members; developing new and innovative health plan designs that achieve greater cost savings while still meeting employee needs; and maintaining control over health plan reserves enabling maximization of investment income.
The Consortium is self-insured for stop loss retention on individual medical and pharmacy claims up to $1M. Recently, in an effort to move to a fully experienced pooled arrangement, effective 7/1/16, the individual stop loss (ISL) deductible was lowered to $25K for all school entities in the Consortium resulting in 40% of health care costs being shared. The claims experience above this deductible up to $1M is pooled across the Consortium (e.g., self-insured). Additionally, as a safeguard for the school entities, stop loss protection is purchased for individual health insurance claims above $1M.
Initially, monthly premium equivalent rates will be developed for each participating school entity based on their enrollments and risk and claims experience plus their shared portion of administrative fees and stop-loss insurance premiums.
Each school entity that participates in the consortium and has all consortium documents signed and approved by their Board by the deadline, will be guaranteed a management trustee seat. The school entity may appoint one management representative administrators or a school board member to the consortium trustee board.
Labor and management (union and employers) have equal voting strength at all trustee and committee meetings.
For the current plan year, the Chairman is Rebecca Roberts-Malamis of Bucks County Intermediate Unit #22 and Vice-Chairman is Linda Weaver of PSEA.