Transcript Student Health Insurance

Sixteen Institutions with
One Hard Waiver Insurance Plan
The University of North Carolina
System-Wide Hard Waiver
Student Health Insurance Plan
David Rousmaniere, MBA
UNC - Charlotte, [email protected]
Katrin Wesner, MS
UNC - Wilmington, [email protected]
American College Health Association
June 4, 2010
The University of North Carolina
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UNC System Overview
• 16 four-year public institutions
• Total enrollment: 220,000
• UNC Board of Governors
• UNC President
• UNC General Administration
• Each of the 16 campuses has:
o
o
Chancellor
Board of Trustees
The University of North Carolina
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Student Health Insurance
Terminology
• Voluntary Model: There is no requirement for a
student to have health insurance through the
campus plan or a non-campus plan. A student
may choose to participate in the campus plan
or not.
• Hard Waiver Model: A student must have
either a creditable coverage non-campus
health insurance plan or purchase the campus
plan.
The University of North Carolina
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UNC Campus-Based
Student Health Insurance
Hard Waiver Campuses = 11
• Elizabeth City State University
• Fayetteville State University
• North Carolina A&T State Univ.
• North Carolina Central Univ.
• UNC Asheville
• UNC Charlotte
• UNC Greensboro
• UNC Pembroke
• UNC School of the Arts
• Western Carolina University
• Winston-Salem State University
The University of North Carolina
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Voluntary Campuses = 5
• Appalachian State University
• East Carolina University
• North Carolina State University
• UNC - Chapel Hill
• UNC Wilmington
UNC Campus-Based
Student Health Insurance
Wide Variation Across UNC Campuses
• There is a wide range of student health
insurance coverage, co-pays, and
benefits; base benefits vary from $6,000 to
$250,000 (2008-09).
• There is a wide range of premiums; from
$396 to $1,565 (2008-09).
* the SHI discussion began in Fall 2008
The University of North Carolina
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Who Designed the SHI Plan?
Designing a Quality Plan for All Students
• Extensive discussions with:
o
o
o
o
o
o
Student Health Center Directors
Vice Chancellors for Student Affairs
NC Department of Insurance
NC Association of Independent Agents
UNC General Administration
UNC Association of Student Governments
The University of North Carolina
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UNC Board of Governors Review
Spring 2009
• March 2009: decision made to ask UNC
Board of Governors for hard waiver policy
approval and not move forward in Fall 2009
• May 7, 2009: 3 Health Directors and
President/CEO of NCIOM spoke to the UNC
Board of Governors about SHI
The University of North Carolina
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UNC Board of Governors Review
Summer / Fall 2009
• Review feedback from BOG policy discussion
on May 7, 2009
• Summer 2009: answer BOG questions from
May presentations
• Plan for August 2009 BOG presentation and a
BOG vote on a hard waiver model with
implementation in Fall 2010
The University of North Carolina
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UNC System-Wide
Student Health Insurance
The Question Presented to the UNC BOG
• Can better rates and coverage be obtained
for all UNC students by using a hard waiver
model with a common base student health
insurance plan?
The University of North Carolina
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Current 2008 - 2009
Campus
Participation
ASU
voluntary purchase
did not purchase
ECU
voluntary purchase
did not purchase
Maximum
Basic
Benefit
Results From Fall 2008 RFP
Annual
Student
Premium
Participation
Maximum
Basic
Benefit
Annual
Student
Premium
$10,000
$1,008
hard waiver
$100,000
$549-$679
$0
$0
hard waiver
$100,000
$549-$679
$50,000
$1,294
hard waiver
$100,000
$549-$679
$0
$0
hard waiver
$100,000
$549-$679
ECSU
hard waiver
$6,000
$456
hard waiver
$100,000
$549-$679
FSU
hard waiver
$6,000
$396
hard waiver
$100,000
$549-$679
NCA&T
hard waiver
$10,000
$458
hard waiver
$100,000
$549-$679
NCCU
hard waiver
$5,000
$516
hard waiver
$100,000
$549-$679
NCSU
voluntary purchase
$100,000
$1,161
hard waiver
$100,000
$549-$679
$0
$0
hard waiver
$100,000
$549-$679
did not purchase
UNCA
hard waiver
$30,000
$611
hard waiver
$100,000
$549-$679
UNCC
hard waiver
$50,000
$688
hard waiver
$100,000
$549-$679
$250,000
$1,565
hard waiver
$100,000
$549-$679
$0
$0
hard waiver
$100,000
$549-$679
UNC-CH
voluntary purchase
did not purchase
UNCG
hard waiver
$100,000
$780
hard waiver
$100,000
$549-$679
UNCP
hard waiver
$6,000
$486
hard waiver
$100,000
$549-$679
UNCSA
hard waiver
$5,000
$380
hard waiver
$100,000
$549-$679
UNCW
voluntary purchase
$30,000
$1,452
hard waiver
$100,000
$549-$679
$0
$0
hard waiver
$100,000
$549-$679
$30,000
$596
hard waiver
$100,000
$549-$679
$448
hard waiver
$100,000
$549-$679
did not purchase
WCU
WSSU
hard waiver
The hard
University
waiver of North Carolina
$10,000
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UNC System-Wide
Student Health Insurance
The Answer =
• The November 2008 RFP results
demonstrated that better rates and
coverage can be obtained for all UNC
students through a hard waiver model with
a common base student health insurance
plan.
The University of North Carolina
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UNC Board of Governors Approval
Recommendation to the UNC Board of Governors
• Approve the use of a hard waiver model
in the creation of an RFP with a common
base student health insurance plan for
all UNC campuses with implementation
in Fall 2010.
** Approved unanimously by the UNC BOG
on August 14, 2009
The University of North Carolina
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UNC System-Wide
Student Health Insurance
RFP Design
•
•
•
•
Vendor capabilities & requirements
Base benefits + campus enhancement options
Continuation of coverage provision
Dependent coverage for spouse / domestic partner,
child(ren)
• Agreement period: three (3) annual agreements;
option for two (2) additional 1-year agreements
pursuant to all terms of the RFP and renewal rates
being acceptable to vendor and UNC GA
The University of North Carolina
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UNC System-Wide
Student Health Insurance
RFP Design - continued
• Bid pricing: All students vs. separate pricing for
undergraduate and graduate students
• Vendor administrative requirements
o Claims administration services
o Accounting & statistical reports
o Health insurance coverage verification
o On-line waiver system
o On-line activation of insurance
o Performance metrics for waiver requests
o Data transfers: vendor to/from Banner & PeopleSoft
The University of North Carolina
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UNC System-Wide
Student Health Insurance
Hard Waiver Participation Requirements
•
•
•
•
Degree-seeking students
Eligible to pay campus health services fee
Undergraduates = minimum 6 credit hours
Graduate students = minimum 6 credit hours except
minimum 1 hour at UNC-CH, NCSU, UNCC & UNCW
• Provision for special student populations
o International students
o Student internships
o Non-degree programs
The University of North Carolina
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UNC System-Wide
Student Health Insurance
RFP Process
• 2nd RFP released on September 9, 2009
• 5 bids received; opened on October 16, 2009
• 2 finalists selected for “finalists’ days” on December
7 - 8, 2009
• Campus Health Directors received the finalists’
RFP packets without prices prior to the finalists’
days; prices sent to Directors after finalists’ days
The University of North Carolina
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UNC System-Wide
Student Health Insurance
RFP Process - continued
• Each Director submitted via email to Dr. Mallette:
o
Their campus’ preferred vendor & why
o
Why they did not prefer the other vendor
• February 5, 2010: finalist day with UNC General
Administration leadership
• Vendor selection made by UNC GA
• Vendor announced on February 8, 2010
The University of North Carolina
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UNC System-Wide
Student Health Insurance
Basic Plan
• $610 per year ($305 per semester)
• Maximum benefit $100,000 per incident of injury or
sickness
• Prescription drug benefit = $1,000 per year
• Out of pocket maximum of $2,000 within the PPO /
$4,000 outside the PPO
• Immunizations (e.g., Meningitis, HPV, flu) = $500
per year
• Evacuation and repatriation
The University of North Carolina
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UNC System-Wide
Student Health Insurance
Optional Campus Selected Enhancements
•
•
•
•
•
Maximum benefit in base plan = $100,000 per incident of
injury or sickness
o $250,000 per incident of injury or sickness
o $1,000,000 or unlimited lifetime maximum
Deductible in base plan = $300
o $0 deductible or $150 deductible
Rx benefit in base = $10 co-pay; $1,000 maximum
o No co-pay or unlimited maximum
Wellness: maximum $500 per year or unlimited
Vision care and preventive dental
The University of North Carolina
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UNC System-Wide
Student Health Insurance
Implementation
• Weekly conference calls in February - March 2010
• Boilerplate announcement & FAQs for each campus to
use with their students, parents, and others
• Implementation web site of tools & tips
http://studenthealth.uncc.edu/UNC_SHI_Implementation.htm
• Each campus selected benefits enhancement options
• Visit to Pearce & Pearce, Inc. in Florence, SC by all
campuses on March 25 - 26, 2010
• Students begin requesting waivers on-line for Fall 2010
semester March 15th - April 1st
The University of North Carolina
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UNC System-Wide
Student Health Insurance
Implementation – continued
• Administrative fee (maximum $10 per semester)
• Coverage dates: waive once, verify twice
August 1st - December 31st
o January 1st - July 31st
Common waiver appeals process
Common affidavit for domestic partnership
Study abroad
International students
State employees
Age 26 and other Federal legislation impacts
o
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The University of North Carolina
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UNC System-Wide
Student Health Insurance
Why It Worked
•
Commitment from UNC President Erskine Bowles
•
Leadership by Dr. Bruce Mallette, Senior Associate Vice
President for Academic & Student Affairs at UNC GA
[email protected]
•
Active participation by representatives from NCDOI & NCAIA
•
All 16 Health Directors working together – “think system” and
wear the “big” hat perspective and not just “local”
•
Past hard waiver experiences on 11 UNC campuses
The University of North Carolina
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UNC System-Wide
Student Health Insurance
Why It Worked - continued
•
Involvement of campus student governments
•
Past hard waiver experiences on 11 UNC campuses
•
All 16 Health Directors working together – “think system”
•
Including vendor in conference calls once award was made
•
During implementation -- flexibility by vendor and campuses
in “getting to yes” on terms, definitions, and protocols; there
are always aspects of the RFP to which clarity, consistency,
and consensus must be reached
•
Many, many, many, many conference calls and emails !
The University of North Carolina
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UNC System-Wide
Student Health Insurance
Reminders
•
Voluntary insurance
o Sell insurance to fewer than 10% of students
• Hard waiver insurance
o Sell to all students (and parents)
o Waiver process as important as access to SHI
o Waivers will take up most of your time
o Importance of having health insurance as a life lesson
• UNC estimates
o
60,000 will buy SHI
o 140,000 will waive out or are ineligible
The University of North Carolina
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UNC System-Wide
Student Health Insurance
• Thank you
• Questions & Answers
Resource: UNC BOG materials are at www.northcarolina.edu
o Click on Leadership
o Click on Board of Governors
o Click on Pre-meeting Materials
o Click on 2009 and May 8th; see pdf files under Policy
Discussion
o Click on 2009 and August 14th; see pdf files under Policy
Discussion
The University of North Carolina
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