wednesday, february 11 5:30 pm 111 forum building sponsored by gpsa health insurance committee...

WEDNESDAY, FEBRUARY 115 :30 PM

111 FORUM BUILDING

SPONSORED BY

GPSA HEALTH INSURANCE COMMITTEE

CO -CHAIRS: ALISON FRANKLIN NATHANIEL PORTER

Special Health Insurance

Meeting

AGENDA

Welcome & Introduction (10 min) Alison Franklin, Graduate Student

Updates – ACA Guidelines & RFP (15 min) Dennis Shea, Associate Dean – Health & Human Development

Policy Decisions – Explanations & Exercise (60 min) Nathaniel Porter, Graduate Student

Closing Remarks (5 min) Danielle Rhubart, Graduate Student

Informal Q&A (25 min) Committee Co-Chairs and liaisons

TIMELINE

December – 2014 University allocates money for a consultant to put out a

Request for Proposals (RFP) for student health insurance plan 2015-2016

January – 2015 Consultant (Towers Watson) tasked with putting out RFI/RFP Jan. 15 – GPSA updated about consultant (RFI/RFP) Jan. 30 – GPSA updated about Premium Parity

February – 2015 Mid Feb. – Initial bids in. Student feedback needed for potential

insurers to craft proposals.March – 2015

Early March – Proposals reviewed End of March – Final deadline for final plan decisions, if insurer

is not Aetna

TIMELINE





insurers to craft proposalsMarch – 2015


is not Aetna

TIMELINE




February – 2015 Mid Feb. –Initial bids in. Student feedback needed for potential



is not Aetna

TIMELINE







is not Aetna

Explanation of Mandatory Changes

ACA Guidelines Family Rating (Premium Parity)

Individuals within same age bracket cannot have differing premium rates (i.e. students and spouses)

AV Calculator Updates Now includes prescription drugs for 2015

Request for Proposals (RFP) Process Consultant (Towers Watson) RFI/RFP put out for potential insurer bid/proposals

Student input on plan design very important when requesting proposals!

Proposals reviewed and voted on by Student Insurance Advisory Board/Council (SIAB/SIAC)

Feedback Format (each of 4 decisions in agenda)

Initial explanation of two contrasting options (Nathaniel)

Opportunity for brief clarification of optionsInitial vote- Hands raised high based on

information you have for each optionOral arguments- 1 minute comments (strictly

timed) Up to 2 students per position, raise hand to speak State preference up front then defend your position

Final vote – Same as before Both votes will be recorded and reported to Liaisons

Platinum Plan Gold Plan

Highest benefits and premiums

Current planLowest deductible,

per-visit costs and O-O-P max

Least risk of catastrophic costs

Moderately high benefits

5-15% lower premiumDeductible and O-O-P

maximum tend to be 2-2.5 times as high

Better value to rare users or UHS-only users

Decision 1- Metal Tier

Copay Coinsurance

Set fee (dollar amount) for each type of service

Predictable costs per visit

Higher average cost for routine visits

Do not always have a deductible

Higher O-O-P max

Set percentage pay for each type of service

Current planUnpredictable costs

for complex treatment (ER, etc.)

Typically much lower O-O-P max

Decision 2: Plan Structure

Higher Deductible Higher Coinsurance

Higher cost barrier to initial (non-UHS) treatment

Only limited flexibility (J-1 visa requires $500 or lower)

Higher costs for participants with ongoing or expensive medical needs

Decision 3: Balancing Ded./Coins.

Higher DeductibleHigher Out-of-Pocket Max

Deductibles affect higher portion of participants

Only limited flexibility (J-1 visa requires $500 or lower)

Major impact on those who reach maximum

Only affects small number of students

Decision 4: Balancing Ded./OOP Max

wednesday, february 11 5:30 pm 111 forum building sponsored by gpsa health insurance committee...

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