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Health Benefits @ Rice

Health Benefits @ Rice. December 4, 2013. We Can Be Thankful…. We Can Be Thankful…. Ground Rules. Let’s have a constructive conversation! If you have a personal complaint, please table it for post-discussion, and we’re happy to discuss later

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Health Benefits @ Rice

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  1. Health Benefits @ Rice December 4, 2013

  2. We Can Be Thankful…

  3. We Can Be Thankful…

  4. Ground Rules • Let’s have a constructive conversation! • If you have a personal complaint, please table it for post-discussion, and we’re happy to discuss later • Rice is self-funded, meaning we pay for the claims directly out of our bank account, and only pay Aetna an administrative fee • This fee plus reinsurance premiums total only 6.3% of total premiums • Going with another insurance carrier will not necessarily save us money on these fees • Nor will changing carriers lead to less administrative hassles • We are constrained by budget issues, and cannot offer free coverage, etc. • Fringe rates are affected by Rice contributions toward premiums

  5. Health Care is Changing! • Medicaid (Texas opted-out of expansion) • Medicare uncertainty (2026?) • Aging population (Rice avg. age = 45.6) • Increasing overall health care costs • Access to latest medical tests (proximity to TMC) • Affordable Care Act (ACA), or “Obamacare” • 2014 = Individual mandate and automatic enrollment for new hires • 2018 = “Cadillac Tax” that will require richer plans to pay a 40% tax/penalty for amounts in excess of the upper limits set by ACA

  6. Health Benefits @ Rice • Rice moved to Aetna for self-funded coverage effective July 1, 2002 • We’ve now been with Aetna, with the same plan designs, for over 11 years! • Very minimal plan design changes • Increasing premium costs (but below market) • Really? Let’s see…

  7. Health Benefits @ Rice

  8. Health Benefits @ Rice

  9. Health Benefits @ Rice • Rice continues to pay for 84.4% to 62.9% of premiums:

  10. Health Benefits @ Rice

  11. Health Benefits @ Rice • What is our “secret sauce” for keeping the plans affordable? • Managing our health care expenses well • HMO model works • Keeping you healthy and productive • Wellness programs • Emergency rooms versus urgent care (know where to go) • More drugs moving to generic (but specialty drugs on the rise) • EnvisionRx Options (and Orchard) • Luck!

  12. Health Benefits @ Rice • We regularly benchmark our benefits against our peers • Private, peer universities • Texas Medical Center institutions • We remain very competitive • Fewer institutions focused on HMOs • High-deductible health plans are becoming more common in higher ed. (14% currently offer and 23% seriously considering in the future) • Narrow network option? • People are inherently inefficient when making health care choices (30%+)

  13. Rice’s Population • How would you describe our needs? • Lower paid faculty/staff (want lower premiums and OOP expenses) • Freedom of choice (fewer restrictions, and willing to pay for freedom) • High utilizers (ill, children, etc.) • The top 5% of our enrollment drives over 80% of our costs • Young invincible (low premiums, no use) • Network needs (MD Anderson, Kelsey-Seybold) • Retirees (both pre- and post-65) • Anyone else?

  14. Future Health Benefits @ Rice • What do we want for the next 5 to 10 years? • Insurance company? • Benefits Committee endorsed remaining with Aetna • Providers? • Plan designs? • Cadillac Tax impacts • What is most important to you? • Understand we have to follow the law • Understand we have a limited budget • Total compensation picture (benefits = 26-28% of your total pay package)

  15. Your Input Concern about changing carriers and approvals of services already authorized Happy with Aetna Concern about network? Premiums on a sliding income scale? We should make people more accountable for their care/costs?

  16. Health Benefits @ Rice Thank you!

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