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
The University of North Carolina2
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
The University of North Carolina3
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.
The University of North Carolina4
UNC Campus-BasedStudent Health Insurance
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
The University of North Carolina5
UNC Campus-BasedStudent Health Insurance
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
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
The University of North Carolina6
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
The University of North Carolina7
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
The University of North Carolina8
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
The University of North Carolina9
UNC System-WideStudent Health Insurance
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?
The University of North Carolina10
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
did not purchase $0 $0 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
did not purchase $0 $0 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
did not purchase $0 $0 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
did not purchase $0 $0 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 University of North Carolina11
UNC System-WideStudent Health Insurance
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.
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 University of North Carolina12
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
The University of North Carolina13
UNC System-WideStudent Health Insurance
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
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
The University of North Carolina14
UNC System-WideStudent Health Insurance
UNC System-WideStudent Health Insurance
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
The University of North Carolina15
UNC System-WideStudent Health Insurance
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
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
The University of North Carolina16
UNC System-WideStudent Health Insurance
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
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
The University of North Carolina17
UNC System-WideStudent Health Insurance
UNC System-WideStudent Health Insurance
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
The University of North Carolina18
UNC System-WideStudent Health Insurance
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
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
The University of North Carolina19
UNC System-WideStudent Health Insurance
UNC System-WideStudent Health Insurance
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
The University of North Carolina20
UNC System-WideStudent Health Insurance
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
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
The University of North Carolina21
UNC System-WideStudent Health Insurance
UNC System-WideStudent Health Insurance
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
The University of North Carolina22
UNC System-WideStudent Health Insurance
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 [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”
• Past hard waiver experiences on 11 UNC campuses
The University of North Carolina23
UNC System-WideStudent Health Insurance
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 !
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 !
The University of North Carolina24
UNC System-WideStudent Health Insurance
UNC System-WideStudent Health Insurance
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
The University of North Carolina25
UNC System-WideStudent Health Insurance
UNC System-WideStudent Health Insurance
• 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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