Health Insurance for Students at the University of Chicago

1
Health Insurance for Students at the University
of Chicago

• University Student Health Insurance Plan (U-SHIP)
• 2008-2009

2
Presentation Overview

• Student Health Insurance Review Committee
• Overview of Finances and Health Services
• Potential Recommendations for Next Year
• Your Feedback

3
Overview of the Student Health Insurance Review
Committee

• Meets bi-weekly to review the University Student
  Health Insurance Plan.
• Committee members are appointed by SG and VPDOS.

4
Members of the Student Health Insurance Review
Committee

• Faculty and Staff
• Terri Owens (chair)
• Dean of Students, Divinity School
• Celia Bergman
• Associate Dean of Students for Student Health and
  Administrative Affairs
• Georgia Bonner
• Manager for Payroll Insurance, Primary Care
  Group and Student Care Center
• Kristine Bordenave, M.D.
• Director, Student Care Center
• Ellen Cohen
• Dean of Students, Harris School of Public Policy
• Belinda Cortez Vazquez
• Interim Associate Dean of Students for Student
  Affairs
• Deb Pratt
• Administrative Director, Student Counseling and
  Resource Services
• Osman Webb
• University Risk Manager

• Students
• Neal Corson
• Doctoral Student, Medical Physics
• Zoe Hruban
• College Student, Psychology
• Frederick Ketchum
• Doctoral Student, Anthropology
• Yelena Koldobskaya
• Doctoral Student, Chemistry
• Victor Leung College Student, Political Science
• Ned Resch
• Masters Student, SSA/Graduate Program in Health
  Administration Policy
• David Marc Small
• Masters Student, Harris School of Public Policy
• Syed Shahnawaz Zaheer
• College Student -- Biochemistry

5
The initial cost of health care

• Student Health and Wellness Fee
• 531 per year (177/quarter)
• All students pay this
• Funds the Student Care Center (SCC) and Student
  Counseling and Resource Service (SCRS)

• University Student Health Insurance Plan (U-SHIP)
• 1,845/year for Basic Plan
• Some students enroll in Rx Advantage Plan for
  2,811/year
• Dependents of students also eligible to enroll in
  Basic Plan

6
The Components of a Health Insurance Plan

• Number of members
• The health needs of the members
• Plan cost/premium
• Limits of coverage
• Benefits
• Out-of-pocket cost
• Provider choice/network
• Plan Choice (tiered Basic Rx Advantage)

7
The changes we have made Looking at our
Chickering/Aetna 07-08 and StudentResources 08-09
plans
8
Health Care Review Autumn 2008

• Conducted an extensive review of student health
  services at UChicago
• Surveyed students about insurance
  needs/satisfaction
• Results indicated the following student
  priorities for additional insurance coverage
• dental, immunizations and vaccinations, lower
  out-of-pocket expenses, some support for a co-pay
  plan
• The consultants recommended
• Continue to increase mental health benefit
• Continue to increase pharmacy benefit
• Put the plan out to bid regularly

9
Question Why is our student insurance plan so
expensive?

• Fact Compared to our peer institutions, our
  insurance premiums are comparable
• U Chicago 1,845/year
• Peers 1,404/year - 3,024/year
• Consider the following features of our current
  plan
• 200 deductible
• 1 million lifetime max
• 90 of covered services are paid for by insurance
  at in-network facilities
• No caps on medical services such as day surgery
  or MRI/CT Scans
• No pre-existing condition limitation
• Option to purchase unlimited Rx coverage

10
What can we do to decrease cost of insurance?

• There are some things we cannot control
• How many students enroll in the plan
• Who enrolls in the plan (students with few health
  problems/need for care or students with chronic
  health conditions)
• The bills from illnesses and accidents determine
  how high/low our claims are which impact premiums
  for the next year
• The rising cost of health care across the country!

• And there are some things we can
• We can work with the SCC and SCRS to make
  adjustments to what they provide
• Plan Design
• Put the plan out to bid every 3 years

11
Assumptions for 2009-10U-SHIP

• Enrollment will be similar (6,500)
• Premiums will increase 7-10 without making any
  plan enhancements (due to rising national cost of
  health care)
• We will continue to use United Healthcare/Student
  Resources as our carrier (7 months of data is not
  enough to warrant putting the plan out to bid)
• We will continue to have two on-campus insurance
  representatives to assist students

12
Anticipated Premium for 2009-10 with no plan
changes ? 7-10 increase

• Current Premiums
• Basic1,845 year
• Rx Advantage 2,811 year
• 2009-10 Premiums
• Basic 2,030 year
• Rx Advantage 3,092 year

13
Potential Plan Enhancements

• Increasing out-patient mental health benefits
• Adding sex reassignment surgery
• Changing the referral requirement for the SCC
• Increasing prescription benefit on the Basic plan
• Including some routine immunizations and
  vaccinations
• Decreasing the annual out-of-pocket maximum

14
Mental Health Parity

• NOW
• Outpatient benefit
• Up to 70 reimbursement
• 25 visits max

• ACHIEVE PARITY between mental health other
  benefits
• 0.4 increase in premium

15
Sex reassignment surgery

• NOW
• Surgery is not covered.
• Hormone replacement and pre-surgery counseling
  are covered.
• PROPOSED BENEFIT
• cover sex-reassignment surgery up to 100,000
• 1.8 increase in premium

16
Change SCC referral process

• NOW
• students required to obtain referrals for each
  specialist
• PROPOSED CHANGE
• to require only one referral per condition for
  the lifetime of the student
• 0.5 increase in premium

17
Increase prescription benefit

• NOW
• Basic Plan has pharmacy benefit up to 1500.
  After this, there is no benefit.
• Issue Some students receive diagnoses during the
  year that require expensive medications.
• Such conditions include asthma (e.g. Advair 500
  240/mo), cancer, depression.
• PROPOSED CHANGE
• Maintain 1500 maximum while adding coverage at
  60 level for further prescriptions.
• 2.5 increase in premium
• Other options
• unlimited prescription 8.5 increase

18
Routine immunizations, including Gardasil

• NOW
• immunizations/vaccines and Gardasil are not
  covered by insurance
• PROPOSED CHANGE
• include routine immunizations and vaccinations to
  prevent the spread of disease in our campus
• In particular, this would cover tetanus, MMR,
  PPD, and Gardasil
• 1.6 increase in premium

19
Reduce out-of-pocket maximum Currently 1,700

• NOW
• Students pay the annual premium
• out-of-pocket costs up to 1,700
• Example 1,845 1,700 3,545
• PROPOSED CHANGE
• reduce the out-of-pocket cost from 1,700 to
  1,000.
• Example 1,845 1,000 2,845
• (this example uses this years premium)
• Result 2 increase in premium for next year

20
Some other things we have been thinking about

• Improving Dental
• Including routine physicals outside of SCC
• Going to a co-pay plan for some or all covered
  expenses
• For example co-pay of 100 for high cost
  procedures (e.g., CT scan, MRI) instead of
  90/10 co-insurance
• Extent of co-pay structure determines additional
  premium increase for next year (possibly 5-10
  increase)

21
What do you recommend?

• We expect an as is increase in premium of 7-10
  for 2009-10 based on our current plan enrollment,
  design, and utilization/claims experience.
• Given these conditions, what enhancements should
  we consider adding?
• Increasing out-patient mental health
  benefits 0.4
• Adding sex reassignment surgery 1.8
• Changing the referral requirement for the
  SCC 0.5
• Increasing prescription benefit on the Basic
  plan 2.5
• Include some routine immunizations/vaccinations 1.
  6
• Decreasing the annual out-of-pocket maximum 2