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Background on SHIP for SHAC Meeting
Waiver, Appeals, and 2015-2016 Plan
ChangesOctober 21, 2015
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SHIP 101 SHIP Governance
SHIP Waiver Fall 2014 what happened, what did we do about it
Spring 2015 experience
Fall 2015
New Appeal Form for Spring 2016
2015-2016 SHIP Changes Benefit and premium changes
Discontinuation of dependent and continuation plans
Agenda
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ALL students have access to
University Health Services~60% of students
have SHIP
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Medical and mental health plan throughAetna Student Health (ASH)
Dental plan through MetLife
Vision plan through Vision Service Plan (VSP)
Plan Carriers
Student Health
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All UC Students are: Required to have major medical health insurance
Automatically enrolled in SHIP when registered
(current SHIP coverage August 15-August 14)
Able to enroll in SHIP any time within the semester if theircurrent coverage is lost (no prorated rate)
Able to maintain dual coverage
Able to waive out of the plan through an online waiver
Insurance at UC Berkeley
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ACA Essential Health Benefits: preventive and wellness services and chronic disease
management mental health and substance abuse disorder services,
including behavioral health treatment
rehabilitative and habilitative services and devices
ambulatory patient services emergency services
hospitalization
maternity and newborn care
prescription drugs laboratory services
Berkeley SHIP
already provided
all of these benefits plus
includes dental and vision
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Basedon in-network providers
SHIP BENEFIT HIGHLIGHTSPreventative 100% covered (you pay $0)
Primary Care $15 co-pay
Specialists $15 co-pay
Urgent Care $30 at UHS; $50 outside UHS
Counseling Outside UHS $15 co-pay (first five visits free at UHS for all students)
Emergency Room $100 co-pay
Hospitalization 90% co-insurance (you pay 10%)Labs/tests/x-rays 90% co-insurance (you pay 10%)
Prescription drugs $5 generic, $25 brand name
Dental 2 free cleanings/exams per year; 80% co-insurance minor dental, 70%
co-insurance coverage major dental (up to $1000/year)
Vision $10 eye exam, $25 co-pay frames & lenses, or contact lenses
(up to $120/year)
Deductible $300 for some services outside of Tang
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Glossary Premium The amount you pay to be enrolled in insurance plan
EXAMPLE: Berkeley SHIPs undergrad premium is $1290/semester
Co-insurance The percentage of the health care costs you have to pay. EXAMPLE: For some services, Berkeley SHIP pays 90%, and you pay 10%
Deductible The amount of medical costs you have to pay before yourinsurance kicks in per year. EXAMPLE: Berkeley SHIP has a $300 annual deductible for some services outside of Tang
Co-pay An upfront cost you pay when you have an office visit; Not counted aspart of deductibles.
EXAMPLE: Primary Care visits at Tang are $15
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Note: Waiver criteria set system-wide.
SHIP GovernanceADVISORY ROLES
CFO in
consultation
with campus
administration
makesfinal
decision
Campus
Leads and
UHS advise
on final
decisionSHIAC &
studentleadership
provide
feedback on
RFP and plan
UHS initiates
SHIP renewal
process and
Broker seeks
carrier bids
Campus
stakeholders
provide inputon RFP and
plan selection
GA CSF SHACASUC
UHS
manages
daily
operations for
SHIP
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Fall SHIP Aug 15-Jan 14
Spring SHIP Jan 15-Aug 14
July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June July
Fall (Annual) Waiver deadline July 15
(alt. coverage must begin by Aug 15)
Fall waiver covers full academic year; if you waive
for fall, you wont need to waive again in spring.
Spring Waiver deadline Jan 10
(alt. coverage must begin by Jan 15)
SHIP COVERAGE PERIOD
SHIP WAIVER PERIOD
Late waiver deadline $50 late fee:
Fall Sept.15, Spring Feb. 5
SHIP WAIVER APPEAL A waiver appeal form can be filed within 10 business days of waiver denial.
(Those on financial aid will be prioritized, a new feature added by
recommendation ASUC SAO) SHIP will notify of waiver appeal decision within 30 days.
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Three emails: April, July, September
Postcard to home address in June
Cal Parents
CalSO/MyBerkeleyApp
eBill notification, Cal Student Central
Be Well @ Cal Social Media (Facebook, Twitter,
monthly buzz eNews)
Tang website homepage ASUC Student Advocate Office (SAO) communications
SHIP Waiver Communication
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As a result of massive changes in the health insurance
marketplace, our student leaders along with other UCstudent leaders and Student Affairs Vice Chancellors
advocated for strengthening the waiver criteria to
block out some plans:
These are plans that have low up front costs (so they
seem affordable), but if you actually use them, would
cost hundreds, if not thousands, of dollars out of pocket
first posing a barrier to care and a financial burden.
SHIP Waiver Fall 2014
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Before waiving, our website instructs users to
complete a worksheet (PDF) with all the questions in
the waiver.
This mirrors the online application flow and questions to
get them ready to fill out the actual waiver. As long as the information entered matches the
criteria, you get an instant waiver confirmation.
About 10k families successfully waived.
SHIP Waiver Fall 2014
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Problem assessment
Over the summer, we noticed significant
numbers of students were failing the online
waiver process (AKA being denied a waiver).
Normally we process 1500 waiver appeals,
fall 2014 we had 7500 (400% increase).
Most problems were just user error, not reading
instruction or having all the information beforesubmitting form.
SHIP Waiver Fall 2014
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More than 75% of fall waiver appeals were approved,
indicating user error attributed to most all of theconfusion.
Students admitted they didnt complete worksheet or
bother to get the actual information just guessed. Social media (Reddit, Facebook groups, Daily Cal)
posted waiver hacks that spread misinformation.
Families were confused about some terminology
easily obtainable from your insurance company butstill can be confusing.
Why did this happen?
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The mass volume of appeals impacted the
timeliness of when we could process appeals.
Parents and students calling about status of appeal
created massive customer communication backlog
UHS responded with:
dedicating more staff and management time
work with key stakeholder to keep theminformed and make tweaks as possible
Impact
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In August, UCOP lightened the requirements for
two criteria (pharmacy deductible and out of
pocket maximums that didnt factor in Health
Savings Accounts) systemwide
Sent email to ALL students about the new waiverrequirements
Streamlined the waiver form and provided more
info to make it simpler
New! SHIP Waiver Cheat Sheet (ASUC SAO)
What did we do about it?
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In partnership
with ASUC SAO
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This Fall, about 17,200 waivers submitted
Of these about 3,900 denied
About 3100 appeals, of which 2,700 passed appeal
Over 15,900 successfully waived out
Word of caution: We audit 25% of waived accounts andthose who didnt complete correctly will be charged for
SHIP. Additional auditing and possible student conduct
action for those who post cheats
SHIP Waiver Fall 2015
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SHIP Office has developed a new online appeals form
SAO is testing the development site now
Will pilot for Spring 2016 Waiver season
Will replace the need to mail, fax, drop off or email
appeals form Should make appeals easier and more efficient
Systemwide changes to waiver criteria to further
simplify or clarify criteria to take effect Fall 2016.
New for waivers for 2016
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Premium increased:
Undergrad premium = $1,290/semester
Graduate premium = $1,877/semester
Deductible increased from $200 to $300
Discontinuation of voluntary plans:
Continuation plan
Dependent plan
SHIP Changes for 2015-2016
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Why the University made the decision:
ACA required parity rates (or equal rates for familymembers)
Meaning student price would go up to reduce
dependent price Less than 1% of students on SHIP had voluntary
dependents on the plan
Informed that 50 other campuses made similar
decision, including UCSB
Discontinuation of Dependent Plan
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Free insurance helpline to assist in finding new plans
Information sessions for dependents
Transition Assistance Fund for Dependents
Individualized help at the SHIP Office
Resources Voluntary Members
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Need for more transparency about SHIP Renewal
process and decision making
More avenues for student and campus stakeholder
feedback
Will look at options to offer dependent coverage More clarity about timeline
Lessons Learned
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http://uhs.berkeley.edu/ship
(510) 642-5700
Thank you!
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