Health Insurance

Pennsylvania Municipal Authorities Association Health Insurance Program

Administered by Delaware Valley Health Insurance Trust

DVIT_logo

Public entity budgets throughout Pennsylvania have been plagued by rising health care costs leaving public employers with a host of unpleasant choices: reduce benefits, raise taxes / rates, shift costs to employees, assume more risk or switch to some new and unproven carrier looking to expand market share with reduced rates. The Pennsylvania Municipal Authorities Association (PMAA) and the Delaware Valley Health Insurance Trust (DVHT) have partnered in an attempt to better contain health insurance costs without significantly impacting plan designs.

In addition to PMAA, DVHT is the endorsed health program of the County Commissioners Association of Pennsylvania (CCAP) and the Pennsylvania Municipal League (PML). Relatively speaking, the Trust has been better able to counter market trend, charge rates below those of commercial carriers for comparable coverage, and still offer several plan enhancements.

The Trust is a non-profit risk-sharing pool formed in 1999 by municipalities in southeastern Pennsylvania and it now provides coverage to 100 public entities located in eleven counties and over 17,000 employees and dependents. In direct contrast to the annual 10-20% increases imposed by commercial carriers, DVHIT’s increases have averaged 6.5% per year over the past 8 years — without relying on plan design changes to lower the average, and prior to the use of any earned rate credits.

Benefit Plan Structure & Costs

The Trust is designed to offer the best of being fully insured with the best of being self-insured. In the broad sense, that equates to significantly lower administrative costs, a return of excess funds to the member, and an ability to offer guaranteed, firm rates for a 12 month coverage year. DVHT provides a complete range of medical plans (HMO, QPOS, PPO and Indemnity), designed to meet the needs and interests of the member. The Trust has never unilaterally discontinued a plan or imposed plan design changes that could create conflicts with in-force collective bargaining agreements. For most applicants, the Trust will meet or exceed current commercial coverage at lower costs.

The program also provides, for no additional premium, the following value added benefits:

  • Fitness club reimbursement for employee and spouse of up to $250

  • An Employee Assistance Program (EAP) through Human Management Services

  • Healthcare advocacy services, a care facilitator for employees, dependents and family members, designed to help navigate the health care delivery system

  • A voluntary, comprehensive Member Wellness Initiative, with cash incentives for participating employees and spouses, including:

  • $100 for the completion of a comprehensive physical

  • $150 for a colonoscopy exam

  • For Women’s Health, $50 for a mammogram and $50 for a cervical screening exam

  • For individuals with specific conditions, classes and incentives for smoking cessation, healthy heart and diabetes management

  • When class attendance minimums are met, reimbursement of the registration fee for the AT WORK PROGRAM® from Weight Watchers®

  • On-site biometric screenings

  • COBRA and PA Mini-COBRA Administration

  • On-line Benefit Portal for coverage changes and open enrollments

The Trust can also provide access to FSA, HRA, and HSA administrators and access to discounted Voluntary Employee Benefits.

Risk Financing

Through leveraging and economies-of-scale, the Trust will reduce your current rates by 3% to 5% for comparable coverage. As noted above, average rate increases after the first year have been less than those experienced by public entities purchasing commercial coverage.

DVHT is working towards a long-term solution to healthcare financing. The Trust’s risk sharing model offers a number of advantages, including:

  • Excess funds are returned to the membership. A rate stabilization fund (RSF) is a unique tool allowing each member the option of applying credits to monthly premium, thereby reducing payments.  Members also have the choice of rolling their credit balance over to future years. In effect, the RSF allows each member the discretion of choosing the most opportune time to apply its own rate relief.  The Trust adds interest to any rolled over balance. To date, $25 million has been allocated to member RSF credits. The average rate increases noted above are prior to applying any RSF credits.

  • An expense ratio of 8.5% (inclusive of all costs other than the cost-of-care, including reinsurance premiums) which is well below commercial fully insured or self-insured programs.

  • Investment income accruing only to the benefit of the membership.

  • Improved control of health insurance premium dollars, products, services and management.

Networks

DVHT contracts with Aetna and Delta Dental and Guardian for access to their provider networks and discounts.  Subscribers will receive the provider networks’ ID cards. The Trust will assist in an analysis of the overlap in provider participation between the Trust’s service providers and commercial insurers.

Ancillary Lines

The Trust has an exclusive fee-limited partnership with The Standard Insurance Company for providing Group Life and AD&D, Long-term Disability and Short-term Disability coverage. The Standard has a strong public sector profile, and by leveraging the buying power of the Trust, we can offer preferred pricing and coverage enhancements.  Premium savings will range between 10% and 20%, and the package includes multi-year rate guarantees.

Service

Customer service is provided through Trust staff with added technical support provided by dedicated teams at the contracted providers. When an employee calls the Trust office, they get immediate access to knowledgeable staff dedicated to the health program. For standard inquiries, we typically resolve the issue within 24 to 48 hours.

Governance and Legal

The Trust is owned, managed and controlled by its public entity members. Each member appoints a trustee to the Board of Trustees. The Board elects five officers who serve on an Executive Committee. The Executive Committee meets monthly with staff and technical advisors, and directs the operation of the Trust.

The Trust will accept partial group enrollments. DVHT requires a minimum two full years of participation. After two years, a participant may leave Trust membership by providing 120 days written notice prior to the participant’s renewal date. The Trust assumes the liability for claim run-out after a member withdraws. The Trust does not impose either an upfront capital contribution prior to joining or a termination premium upon withdrawal. The Trust Agreement is available for review upon request. DVHT’s membership retention rate exceeds 95%.

Next Steps

To answer specific concerns, or to set up an appointment, please call Rick Lee (267-803-5710) or Anna Linn (267-803-5719) at the Trust office or email questions to rlee@dvit.com or alinn@dvit.com. Our office is located at 719 Dresher Road, Horsham, PA 19044-2205 and the main office number is (215) 706-0101.

To obtain a quote, please provide the following information:

  • Confirmation of renewal date

  • Copies of current invoices from medical, prescription drug and dental providers

  • Copies of current plan summaries

  • A current employee census

Authority members only