Student Health Insurance

1
Student Health Insurance

• Representatives Meeting
• November 21, 2005

2
Problems

• Duke Plan health insurance premiums have
  increased at annual rates of 18,23, and 21 for
  the last 3 years
• These rates exceed all other components of the
  cost of education and cost of living at Duke
• A 20 increase for 2006-2007 would mean a premium
  of 1907, not including the Student Health
  Services annual fee (524 plus summer).
• Family Plan requires premium subsidy by single
  students, and does not accommodate all sizes of
  families

3
Result

• Burdensome costs for students on Dukes Plan are
  becoming overwhelming
• Some healthy students seek lower cost insurance
  in private market, driving up average utilization
  per student on Duke Plan
• Frequency of underinsurance increasing
• Duke is less attractive to prospective students
  compared to peer institutions with better health
  insurance support

4
GPSCs Actions Internal

• Develop internal structure within GPSC to address
  health insurance annually with continuity
• Create standing subcommittee featuring leadership
  cultivation and strong presence on Student Health
  Services Student Health Insurance Advisory
  Committee (SHIAC)
• Improve information exchange with students
• Leverage Young Trustee to coordinate BOT
  subcommittee representatives to address issue at
  Feb meeting in unified manner

5
GPSCs Actions External

• Work closely with Deans, Student Affairs and
  Student Health Services to communicate our
  values, objectives and proposals and provide
  feedback on their ideas
• Memorandum to Board of Trustees to elevate
  awareness of health insurance as critically
  important to students
• Statement of Our Values Regarding Health
  Insurance
• These values will guide our decision-making
  around proposals for achieving our objectives
• Statement of Our Immediate and Long Term
  Objectives
• Approval of GSAS plan to subsidize health
  insurance for all doctoral students
• Incorporate discussion of health insurance costs
  into ongoing strategic planning for Financial Aid
  Campaign
• Plan for institutional coverage of health
  insurance for all graduate and professional
  students
• Offer Proposals for Achieving Our Objectives

6
Timeline

• November 21 Meeting with GPSC Representatives
• November XX Obtain feedback on issues from GPSC
  Representatives
• December XX Update to GPSC Representatives on
  Values, Objectives and Proposals
• January XX GPSC representative approval of
  memorandum to BOT
• February 10 Submit memorandum to Deans, Student
  Affairs and Student Health Services
• February 24 BOT Meeting with presentation to
  Student Affairs Subcommittee

7
Four Principle Issues

• We need feedback from Representatives on these
  issues to help shape our statement of values on
  health insurance
• 1) Optimizing Utilization
• 2) Family Subsidy
• 3) Participation
• 4) Institutional Support

8
Issue 1 Optimizing Utilization

• Question what are most effective and tolerable
  methods for controlling rate of health insurance
  premium increases through utilization and keep
  our campuss healthiest members in the Duke plan?
• Increase brand name drug co-pays? Reduce drug
  formulary?
• Add emergency room visit co-pay?
• Increase annual deductible?
• Cover all family utilization at specific clinic?
• Closely case-manage historically high users?

9
Issue 2 Family Subsidy
Single Family
Utilization 757 4773
Premium 1063 2282
Subsidy 62
Assuming that claims equal 80 of "true"
premium, this means that the premium for families
should have been 5966.25 for families in
2003-2004, but their premium was only 2282,
meaning that 62 of their premium was paid by
single students
10
Issue 2 Family Subsidy

• Question What is the appropriate level of
  subsidy of Family Plan premiums by Single Person
  Plan premiums? Who should pay subsidy?
• 59 (current)? 25? 0?
• Single students? University?

11
Issue 3 Participation

• Question Should we mandate participation in the
  student health insurance plan by all students?
  Some students?
• Address underinsurance issue?
• Lower premiums by improving average utilization
  per student?
• Affect autonomy?

12
Issue 4 Institutional Support

• Question How can Duke move toward covering
  health insurance costs for all students?
• Endowed funds?
• Other models? Self-insurance?
• What should be covered first, e.g., doctoral
  students, family subsidy?

13
Feedback

• Email comments?
• Send out email reminder?
• Online survey?
• By what date? (See Timeline)
• Need time for them to collect opinions

14
Contact Information

• For additional comments or questions, please
  contact
• Justin Klein
• [phone]
• Justin.klein_at_duke.edu
• Megan McCrudden
• (XXX) XXX-XXXX
• Megan.mccrudden_at_duke.edu
• Eric Vance
• (XXX) XXX-XXXX
• Eric.vance_at_duke.edu