The University of North Carolina 1 Sixteen Institutions with One Hard Waiver Insurance Plan The...

The University of North Carolina1

Sixteen Institutions with One Hard Waiver Insurance Plan

Sixteen Institutions with One Hard Waiver Insurance Plan

The University of North CarolinaSystem-Wide Hard Waiver

Student Health Insurance Plan

David Rousmaniere, MBAUNC - Charlotte, [email protected]

Katrin Wesner, MSUNC - Wilmington, [email protected]

American College Health AssociationJune 4, 2010

The University of North CarolinaSystem-Wide Hard Waiver

Student Health Insurance Plan

David Rousmaniere, MBAUNC - Charlotte, [email protected]

Katrin Wesner, MSUNC - Wilmington, [email protected]

American College Health AssociationJune 4, 2010


UNC System OverviewUNC 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 Chancelloro Board of Trustees

• 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 Chancelloro Board of Trustees


Student Health InsuranceStudent 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.

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


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

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

Voluntary Campuses = 5• Appalachian State University • East Carolina University • North Carolina State University • UNC - Chapel Hill • UNC Wilmington

Voluntary Campuses = 5• Appalachian State University • East Carolina University • North Carolina State University • UNC - Chapel Hill • UNC Wilmington




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

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?Who Designed the SHI Plan?

Designing a Quality Plan for All Students

• Extensive discussions with:o Student Health Center Directorso Vice Chancellors for Student Affairso NC Department of Insuranceo NC Association of Independent Agents o UNC General Administrationo UNC Association of Student Governments

Designing a Quality Plan for All Students

• Extensive discussions with:o Student Health Center Directorso Vice Chancellors for Student Affairso NC Department of Insuranceo NC Association of Independent Agents o UNC General Administrationo UNC Association of Student Governments


UNC Board of Governors ReviewUNC 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

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 ReviewUNC 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

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?

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?


ParticipationMaximum

Basic Benefit

Annual Student

PremiumParticipation

Maximum Basic

Benefit

Annual Student

Premium

ASU voluntary purchase $10,000 $1,008 hard waiver $100,000 $549-$679

did not purchase $0 $0 hard waiver $100,000 $549-$679

ECU voluntary purchase $50,000 $1,294 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


UNCA hard waiver $30,000 $611 hard waiver $100,000 $549-$679

UNCC hard waiver $50,000 $688 hard waiver $100,000 $549-$679

UNC-CH voluntary purchase $250,000 $1,565 hard waiver $100,000 $549-$679


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


WCU hard waiver $30,000 $596 hard waiver $100,000 $549-$679

WSSU hard waiver $10,000 $448 hard waiver $100,000 $549-$679

Current 2008 - 2009 Results From Fall 2008 RFP

Campus




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 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 ApprovalUNC 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

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




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

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




RFP Design - continued

• Bid pricing: All students vs. separate pricing for undergraduate and graduate students

• Vendor administrative requirementso Claims administration serviceso Accounting & statistical reportso Health insurance coverage verificationo On-line waiver systemo On-line activation of insuranceo Performance metrics for waiver requestso Data transfers: vendor to/from Banner & PeopleSoft

RFP Design - continued

• Bid pricing: All students vs. separate pricing for undergraduate and graduate students

• Vendor administrative requirementso Claims administration serviceso Accounting & statistical reportso Health insurance coverage verificationo On-line waiver systemo On-line activation of insuranceo Performance metrics for waiver requestso Data transfers: vendor to/from Banner & PeopleSoft




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 studentso Student internshipso Non-degree programs

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 studentso Student internshipso Non-degree programs




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

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




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

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




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

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




Optional Campus Selected Enhancements • Maximum benefit in base plan = $100,000 per incident of

injury or sicknesso $250,000 per incident of injury or sicknesso $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

Optional Campus Selected Enhancements • Maximum benefit in base plan = $100,000 per incident of

injury or sicknesso $250,000 per incident of injury or sicknesso $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




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

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




Implementation – continued

• Administrative fee (maximum $10 per semester) • Coverage dates: waive once, verify twice

o 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

Implementation – continued

• Administrative fee (maximum $10 per semester) • Coverage dates: waive once, verify twice

o 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




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

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”





Why It Worked - continued

• Involvement of campus student governments


• 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 !

Why It Worked - continued

• Involvement of campus student governments


• 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 !




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 timeo Importance of having health insurance as a life lesson• UNC estimateso 60,000 will buy SHIo 140,000 will waive out or are ineligible

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 timeo Importance of having health insurance as a life lesson• UNC estimateso 60,000 will buy SHIo 140,000 will waive out or are ineligible




• Thank you

• Questions & Answers

Resource: UNC BOG materials are at www.northcarolina.eduo Click on Leadershipo Click on Board of Governorso Click on Pre-meeting Materialso Click on 2009 and May 8th; see pdf files under Policy

Discussiono Click on 2009 and August 14th; see pdf files under Policy

Discussion

• Thank you

• Questions & Answers

Resource: UNC BOG materials are at www.northcarolina.eduo Click on Leadershipo Click on Board of Governorso Click on Pre-meeting Materialso Click on 2009 and May 8th; see pdf files under Policy

Discussiono Click on 2009 and August 14th; see pdf files under Policy

Discussion

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