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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, drousman@uncc.edu Katrin Wesner, MS UNC - Wilmington, wesnerk@uncw.edu
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Sixteen Institutions with One Hard Waiver Insurance Plan The University of North CarolinaSystem-Wide Hard WaiverStudent Health Insurance Plan David Rousmaniere, MBA UNC - Charlotte, drousman@uncc.edu Katrin Wesner, MS UNC - Wilmington, wesnerk@uncw.edu American College Health Association June 4, 2010
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: • Chancellor • Board of Trustees
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.
UNC Campus-BasedStudent Health Insurance • Voluntary Campuses = 5 • Appalachian State University • East Carolina University • North Carolina State University • UNC - Chapel Hill • UNC Wilmington 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
UNC Campus-BasedStudent 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
Who Designed the SHI Plan? Designing a Quality Plan for All Students Extensive discussions with: • 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
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
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
UNC System-WideStudent 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?
UNC System-WideStudent 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.
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
UNC System-WideStudent 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
UNC System-WideStudent Health Insurance RFP Design - continued • Bid pricing: All students vs. separate pricing for undergraduate and graduate students • Vendor administrative requirements • Claims administration services • Accounting & statistical reports • Health insurance coverage verification • On-line waiver system • On-line activation of insurance • Performance metrics for waiver requests • Data transfers: vendor to/from Banner & PeopleSoft
UNC System-WideStudent 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 • International students • Student internships • Non-degree programs
UNC System-WideStudent 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
UNC System-WideStudent Health Insurance RFP Process - continued Each Director submitted via email to Dr. Mallette: • Their campus’ preferred vendor & why • 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
UNC System-WideStudent 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
UNC System-WideStudent Health Insurance Optional Campus Selected Enhancements Maximum benefit in base plan = $100,000 per incident of injury or sickness • $250,000 per incident of injury or sickness • $1,000,000 or unlimited lifetime maximum Deductible in base plan = $300 • $0 deductible or $150 deductible Rx benefit in base = $10 co-pay; $1,000 maximum • No co-pay or unlimited maximum Wellness: maximum $500 per year or unlimited Vision care and preventive dental
UNC System-WideStudent 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
UNC System-WideStudent Health Insurance Implementation– continued Administrative fee (maximum $10 per semester) Coverage dates: waive once, verify twice • August 1st - December 31st • 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
UNC System-WideStudent 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 bmallette@northcarolina.edu 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
UNC System-WideStudent 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 !
UNC System-WideStudent Health Insurance Reminders Voluntary insurance • Sell insurance to fewer than 10% of students Hard waiver insurance • Sell to all students (and parents) • Waiver process as important as access to SHI • Waivers will take up most of your time • Importance of having health insurance as a life lesson • UNC estimates • 60,000 will buy SHI • 140,000 will waive out or are ineligible
UNC System-WideStudent Health Insurance • Thank you • Questions & Answers Resource: UNC BOG materials are at www.northcarolina.edu • Click on Leadership • Click on Board of Governors • Click on Pre-meeting Materials • Click on 2009 and May 8th; see pdf files under Policy Discussion • Click on 2009 and August 14th; see pdf files under Policy Discussion