Points discussed included:
MSU contributes approximately $447.00 per person towards health insurance.
On the 2006 plan, the co-pay counts toward out-of-pocket maximum but Roger Barker is checking to see if the co-pay counts toward the deductible.
There is no interest collected on HRA funds. The HRA is a non-interest bearing instrument. Money is paid out of those accounts as a reimbursement as claims occur.
One recommendation through a committee was to do a full detailed study on adding vision care to our health insurance. That has been done about every two years and is usually not a very good deal. They haven't found a plan that will help a large number of employees, but MSU is looking at trying to expand the number of optometrists in the Delta Vision Network.
Recommendation number one includes prescriptions.
Recommendation number two asks for lower deductibles for all plans. $1000 would be a realistic number for the CDHP plan. $500 would be great, but would probably not be possible and keep the $870 HRA. There would be an extra cost if the deductibles were lowered, but the PP&B committee hoped that the university would pick that up.
By law, premiums cannot be paid out of an HRA account, but the university could pay the premiums up front and reduce the amount of HRA money given to each employee. That way, the base plan would be paid for each employee in the CDHP plan. There are 480 participants in the single CDHP plan, 121 MSU husband and wife participants, and 158 family participants. We would need to know how the mass number of participants feel about giving up a portion of their HRA money to pay premiums before a vote occurs. By the performance of the plan, the CDHP is fairly well liked. Sixty percent of the balance of the HRA account was carried over after the first year.
An explanation of the prescription plan for next year is as follows:
Level 1-generics, $10 co-pay
Level 2-brand name drugs that have a generic equivalent or a drug that has equal therapeutic value, $30 co-pay
Level 3-has no generic, maybe is a new drug or non-preferred drug, 50% co-insurance with a $50 minimum or $100 maximum on the POS plan. Between those two numbers the participant owes 50% of the cost. If the drug is less than $50 it becomes $50 and if the drug is more than $100 if becomes $100. The new plan will be different for everyone depending on what drugs they purchase, but there will be no separate deductible this year for drugs and there will only be one maximum out-of-pocket instead of two like last year. Drugs will count toward the maximum out-of-pocket for the whole plan. 90% of people should find this will give them a cost savings.
On most plans and the way it is now, employees pay the lesser amount for drugs. If a prescription on a Level 2 drug costs $16, then that amount would be paid instead of the $30 co-pay. Roger Barker will check into this. That would only make sense. It would not be fair for the employee to pay more than the actual cost of the drug.
Has our health insurance plan for next year already been decided? If we solicited bids through an RFP process, why do we not have the other information in front of us to compare the CHA plan with? Anyone can look at the RFP's if they want. They can be placed in the Conference Room next to Human Resources for interested persons to view. The result of the RFP process was that CHA had the best plan.
The cost of health insurance was projected to increase by $485,000. If we had stayed self-insured, the cost would have been 6.5 million, but by going with CHA, the cost will be between 5.7 and 5.8 million. In reality, there would have been an $800,000 increase if we had remained self-insured.
What would be the possibility of giving employees a set amount of money and letting them decide what they want, such as dental insurance, health insurance, etc.? Without a group there would be no buying power and it would be difficult to get rates without knowing how many participants there would be.
CHA will get 12.3% to administer our health care plan.
To stay self-insured, MSU had to put a large amount of money in reserve. If we are no longer self-insured, the reserve funds will be used to pay run-out claims and the rest will be held in reserve to use if the university goes over projected claims. If we are lucky it will be a wash.
If we go with CHA, we will have a one year contract with four additional years by agreement of both parties. Either party can get out with written notice.
In the past the state has wanted us to join their plan and we have fought to stay self-insured. Will changing from self-insured to the CHA plan hurt our defense against going with the state plan? Have we looked at joining the state plan? We won't be self-insured anymore, but the state is looking at being self-insured this year. We definitely wouldn't want to go with them on the first year of them being self-insured. There are a lot of reasons why we wouldn't want to get on the state plan at this time. Maybe sometime in the future we would want to check on that. If we join the CHA plan we are not thrown into the CHA pool of experience, our premiums will be based on our experience and our experience alone. That is an important aspect of this plan.
Access to Nurse 411 will be covered in full.
It would be nice to know how many people had HRA funds to carry over. We know that 60% of the funds carried over but we don't know how many people that involved.
There is a $20 co-pay for the first doctor visit for maternity care on the CHA POS plan, the rest of the visits are covered in full. Inpatient services are separate.
When choosing health insurance plans, it might be useful in the future if we got to look at the information submitted by each company so that we could see for ourselves that the plan chosen was the best deal.
Any provider that accepts Master Card will accept the new debit card.
Human Resources is looking at ways to prevent all employees from having to fill out a new application. They are working on an electronic download from CA to get everyone's information. Employees might only have to fill out a new form if they are making a change. If employees submit their application online, HR gets a notification electronically and they print it off. A copy goes to payroll, they fax the original to the provider, and file a copy in the employee's personnel file. Instances of error are very small. Employees should also print off a copy for themselves when they do the registration online.
Human Resources asked for references from each company that responded to the RFP to see if they had long-term relationships with their customers and if the customers were satisfied.
Our claims drive price, so it is important to maintain wellness on campus.
The claims problems we have had in the past were CA's problems not CHA's problems. Overall though the error rate by CA has been very small.
Eight percent of faculty and staff are not participating in our health insurance plan. These people have either taken out insurance through their spouses plan or have opted out all together, in other words they do not have any health insurance. Human Resources counsels employees against opting out all together. It is very risky not to have health insurance.
When Dr. Eaglin was here, he felt that all employees should pay a portion of their health insurance. Now that he is gone maybe we could get the single plan paid again. Some single plan participants feel they are subsidizing the family plan. Unfortunately, costs are going up for everything. It is not probable that MSU can pay the amount of a single plan for each employee forever.
Process Works is not a part of CHA. MSU will pay Process Works a separate fee to administer our section 125 cafeteria plan. It has always been a separate fee. Process Works is replacing CA, but CA will still be paying the run-out claims for the FSA/HRA for this year.
The debit card will be used when employees go to the doctor or the pharmacy. No money will change hands. There will be five sessions to outline the differences between FSA and medical. The sessions will be two-hour blocks in the morning and afternoon on November 8 & 9. The schedule will be announced. There will also be a distance learning session. People can sit in on that one also. There will be a CHA representative here during open enrollment.
Maybe there should be a number six added to the recommendation about reducing the HRA money and adding it to the premium to make the single plan free to the employee, but it is already the middle of October and open enrollment starts in November. Is there time to make these decisions? This is not a done deal, but how can we know that everyone in the CDHP plan would be interested in doing this? It might help everyone more if the deductible amount was reduced. The money that people rollover from their HRA account is not going to have the same value in 10 years as it does now. It might be more beneficial to have the premiums paid instead of rolling over the funds.
Some people in the CDHP plan would rather pay their premium and carry over their funds if they don't need them so they can have a safety net if they would need an expensive procedure or test in the future. Maybe HR should do an in-depth study of how employees feel about this. Unfortunately, we don't have time to do an in depth study, our time is always limited on health insurance matters.
Some employees don't take health insurance because they don't feel they can afford the $37.00 premium. They know they're losing the $870.00 HRA money and it is risky not to have health insurance, but they are willing to take the risk. Right now employees pay $37 for the CDHP plan, but five years from now it could be $137. We cannot expect MSU to pay the base plan for employees forever.
It would be interesting to know how many benchmark institutions in Kentucky offer free health insurance.
In the past year and a half the physical plant has lost three employees to municipal organizations because they pay their full family plan health insurance.
Husbands and wives who both work at MSU do not have to pay anything for a two-person plan. They do have to pay if they have the family plan. The reason they don't have to pay for the two-person plan is that MSU makes two single contributions for them and that covers the cost of the plan.