Duke Student Health Duke Student Health InsuranceInsurance

Eric VanceEric Vance

David KahlerDavid Kahler

GPSC RetreatGPSC Retreat

September 15, 2007September 15, 2007

How it works:How it works: Insurance company Insurance company (BCBS) predicts (BCBS) predicts total 2007-2008 total 2007-2008 claims $8milclaims $8mil

Duke students pay Duke students pay BCBS $10mil in BCBS $10mil in premiums plus premiums plus additional 2.4% for additional 2.4% for customer servicecustomer service

The extra 25% The extra 25% ($2mil) pays for ($2mil) pays for BCBS staff, billing, BCBS staff, billing, profit, etc.profit, etc.

This is in addition to the $546 (+$171 summer) fee each student pays for the Student Health Center.

History of PremiumsHistory of Premiums

2007-2008 Plan2007-2008 Plan BCBS Blue Options PlanBCBS Blue Options Plan $150 deductible$150 deductible Insurance pays 80% of Insurance pays 80% of bill, you pay 20%bill, you pay 20%

$1500 out-of-pocket $1500 out-of-pocket maxmax

$100 Rx deductible$100 Rx deductible $1000 Rx out-of-pocket $1000 Rx out-of-pocket max (new)max (new)

Dental savings program Dental savings program by Basix (new)by Basix (new)

Age group Premium

Under 26 $ 1,564

26-34 $ 1,690

35-44 $ 1,951

45 or over $ 2,198

Spouse $ 2,591

Child(ren) $ 1,491

Family $ 3,845

2007-2008 Plan2007-2008 Plan A $500 annual benefit for A $500 annual benefit for preventative vaccines (as preventative vaccines (as defined by the CDC) defined by the CDC) including the HPV vaccine. including the HPV vaccine.

Unlimited medical Unlimited medical evacuation and evacuation and repatriationrepatriation

No pre-existing condition No pre-existing condition exclusion (enjoy full exclusion (enjoy full benefits for the full benefits for the full policy term)policy term)

A new $1,000 annual out-A new $1,000 annual out-of-pocket maximum for of-pocket maximum for prescription drugsprescription drugs

In-network mental health In-network mental health benefits in the Durham benefits in the Durham areaarea

Age group Premium

Under 26 $ 1,564

26-34 $ 1,690

35-44 $ 1,951

45 or over $ 2,198

Spouse $ 2,591

Child(ren) $ 1,491

Family $ 3,845

GPSC HI Committee: GPSC HI Committee: 2007-20082007-2008

Vision Statement:Vision Statement:

The committee envisions all Duke The committee envisions all Duke students, their families, and students, their families, and their dependents with access to their dependents with access to the health care needed in a the health care needed in a timely fashion at the lowest timely fashion at the lowest possible cost.possible cost.

Mission StatementMission StatementIt is the goal of the committee to be transparent in its

efforts to ensure that:

No student is without quality health insurance;

Desired benefits are provided at the least possible cost*;

Students have access to a strong, effective network of providers;

The insurance plan takes advantage of Duke’s resources while also enabling students to be autonomous in their health care decisions;

As much of the premium or fund contributions as possible will be returned to the covered individuals in the form of benefits*;

* Taken from the American College Health Association, “Standards for Student Health Insurance/Benefits Programs,” available at: http://www.acha.org/info_resources/stu_health_ins.pdf.

Mission StatementMission StatementIt is the goal of the committee to be transparent in its

efforts to ensure that:

The total health of the student will be provided for, including mental health;

Resources available to assist students in making good health care decisions will be continually improved;

The administration of the student health insurance plan will be done in a culturally competent manner that is sensitive to students’ national, religious, and ethnic preferences with regards to health care and to respond to the unique health needs of students;

Both the student health insurance administration and the student health center will try whenever possible to offer preventative care before normal treatment would be required;

Those we work with to provide these services offer the same level of transparency to the student body (the student body is consulted in decisions where possible).

SHIACSHIAC Student Health Insurance Student Health Insurance Advisory Committee consists of Advisory Committee consists of GnP students and administratorsGnP students and administrators

Led by Dr. Bill Purdy and Led by Dr. Bill Purdy and advised by an independent advised by an independent consultant, Stephen Beckley consultant, Stephen Beckley (www.slba.com), SHIAC (www.slba.com), SHIAC determines the HI plandetermines the HI plan

Resports to Larry Moneta, Resports to Larry Moneta, Director of Students Affairs Director of Students Affairs

Issues for 2007-2008Issues for 2007-2008 Evaluating bids for 2008-2009Evaluating bids for 2008-2009 Restrictive waiver?Restrictive waiver? Partial self-insurance?Partial self-insurance? Better Mental Health networkBetter Mental Health network Family subsidyFamily subsidy Fair age-based pricingFair age-based pricing Copays?Copays?

Partial Self-fundingPartial Self-funding

Health Care

$7.5 mil

$6 mil

Discussion and Discussion and QuestionsQuestions