Duke Student Health Insurance Eric Vance David Kahler GPSC Retreat September 15, 2007

How it works: Insurance company (BCBS) predicts total claims $8mil Insurance company (BCBS) predicts total claims $8mil Duke students pay BCBS $10mil in premiums plus additional 2.4% for customer service Duke students pay BCBS $10mil in premiums plus additional 2.4% for customer service The extra 25% ($2mil) pays for BCBS staff, billing, profit, etc. The extra 25% ($2mil) pays for BCBS staff, billing, profit, etc. This is in addition to the $546 (+$171 summer) fee each student pays for the Student Health Center.

History of Premiums

Plan BCBS Blue Options Plan BCBS Blue Options Plan $150 deductible $150 deductible Insurance pays 80% of bill, you pay 20% Insurance pays 80% of bill, you pay 20% $1500 out-of-pocket max $1500 out-of-pocket max $100 Rx deductible $100 Rx deductible $1000 Rx out-of-pocket max (new) $1000 Rx out-of-pocket max (new) Dental savings program by Basix (new) Dental savings program by Basix (new) Age groupPremium Under 26 $ 1, $ 1, $ 1, or over $ 2,198 Spouse $ 2,591 Child(ren) $ 1,491 Family $ 3,845

Plan A $500 annual benefit for preventative vaccines (as defined by the CDC) including the HPV vaccine. A $500 annual benefit for preventative vaccines (as defined by the CDC) including the HPV vaccine. Unlimited medical evacuation and repatriation Unlimited medical evacuation and repatriation No pre-existing condition exclusion (enjoy full benefits for the full policy term) No pre-existing condition exclusion (enjoy full benefits for the full policy term) A new $1,000 annual out-of- pocket maximum for prescription drugs A new $1,000 annual out-of- pocket maximum for prescription drugs In-network mental health benefits in the Durham area In-network mental health benefits in the Durham area Age groupPremium Under 26 $ 1, $ 1, $ 1, or over $ 2,198 Spouse $ 2,591 Child(ren) $ 1,491 Family $ 3,845

GPSC HI Committee: Vision Statement: The committee envisions all Duke students, their families, and their dependents with access to the health care needed in a timely fashion at the lowest possible cost.

Mission Statement It is the goal of the committee to be transparent in its efforts to ensure that: No student is without quality health insurance; Desired benefits are provided at the least possible cost*; Students have access to a strong, effective network of providers; The insurance plan takes advantage of Duke’s resources while also enabling students to be autonomous in their health care decisions; As much of the premium or fund contributions as possible will be returned to the covered individuals in the form of benefits*; * Taken from the American College Health Association, “Standards for Student Health Insurance/Benefits Programs,” available at:

Mission Statement It is the goal of the committee to be transparent in its efforts to ensure that: The total health of the student will be provided for, including mental health; Resources available to assist students in making good health care decisions will be continually improved; The administration of the student health insurance plan will be done in a culturally competent manner that is sensitive to students’ national, religious, and ethnic preferences with regards to health care and to respond to the unique health needs of students; Both the student health insurance administration and the student health center will try whenever possible to offer preventative care before normal treatment would be required; Those we work with to provide these services offer the same level of transparency to the student body (the student body is consulted in decisions where possible).

SHIAC Student Health Insurance Advisory Committee consists of GnP students and administrators Student Health Insurance Advisory Committee consists of GnP students and administrators Led by Dr. Bill Purdy and advised by an independent consultant, Stephen Beckley ( SHIAC determines the HI plan Led by Dr. Bill Purdy and advised by an independent consultant, Stephen Beckley ( SHIAC determines the HI plan Resports to Larry Moneta, Director of Students Affairs Resports to Larry Moneta, Director of Students Affairs

Issues for Evaluating bids for Evaluating bids for Restrictive waiver? Restrictive waiver? Partial self-insurance? Partial self-insurance? Better Mental Health network Better Mental Health network Family subsidy Family subsidy Fair age-based pricing Fair age-based pricing Copays? Copays?

Partial Self-funding Health Care $7.5 mil $6 mil

Discussion and Questions