1. Measuring UNLV’s Health: Faculty and Staff Tell Us Their Story May 30, 2005 2005 Annual Forum Association for Institutional Research San Diego, California

2. Overview  Plan History  Committee Charges  Employee Utilization & Satisfaction Survey Objectives & implementation Results  Committee Recommendations  Current Events  What’s Next

3. Plan History  1983 Plan converts from fully insured to self-funded  1992 Projected reserve shortage Benefits eliminated, increased premiums and out-of-pocket costs Chancellor creates Ad Hoc Committee on Health Benefits

4. Plan History (continued)  1992-1999 Problems with self-funded plan Insufficient claims data Inadequate business processes Lack of health care expertise Mismanagement Lack of oversight Frequent changes in claims administrator

5. Plan History  1999 Creation of Public Employees’ Benefits Program  2003 Shortfall requires bailout by Legislature Governor increases state contribution Increased deductibles, co-payments, out-of-pocket costs

6. Affordability  In the past three years, State subsidy increased 56%  Accompanied by substantial increases in deductibles Medical Deductibles: $250 to $500 Pharmacy deductible: $0 to $50 Dental deductible: $0 to $50 (individual) $0 to $150 (family)

7. Affordability (continued)  Other additional costs PPO out-of-pocket maximums increased from $1,500 to $3,500 PPO specialist copay doubled from $15/visit to $30/visit Vision plan: $125 materials every two years benefit eliminated

8. Plan Premium Rates Self-Funded Plan, $500 Deductible

9. $591 $247 1998 2006 State Subsidy 140% increase in past 8 years

10. Committee Charges  Collect Data Impact of health plan changes on faculty and staff What faculty and staff want to see in their health plan Other state university systems with similar configurations

11. Committee Charges (continued)  Identify successful health plans  Make recommendations for health plan changes  Recommend methods of improving communication of changes in advance of implementation

12. Survey Implementation  Survey Instrument Online and paper  Funding Provided by President  Cannon Center for Survey Research Programming Beta testing Hosting

13. Survey Objectives  Survey Objectives Basic demographics Self-funded vs. HMO Satisfaction Out-of-pocket costs Personal strategies Tell us your story

14. Survey Results  Response Rate – 41% 778 online surveys 200 paper surveys  Demographics 45% academic & administrative faculty 55% classified staff 58% male; 42% female 66% were 41 or older 51% at UNLV 5 years or less; 31% 11 years or more

15. Survey Results (continued)  Self-funded vs. HMO 65% chose PPO 35% chose HMO  Deductible Levels 65% chose $500 10% chose $1,000 2% chose $2,500

16. Reasons for Choosing Plan  Choice of Doctors – 75%  Convenience – 61%  Customer Service – 53%  Cost – 62%

17. Satisfaction  Most Satisfied (6=excellent) Choice of doctors (4.54) Access to medical care (4.43) Choice of primary providers (4.09)  Least Satisfied (1=very poor) Vision coverage (2.42) Prescription drug coverage (2.79) Obtaining out-of-state care (3.10)

18. Benefit Planners  Ratings on a Scale of 1 to 6 (excellent) Claims processed in timely manner (3.74) Timely response to telephone inquiries (3.63) On-line claims history (3.41) Website navigation (3.33) Clarity of claims calculations/explanations (3.31)

19. Benefit Planners (continued)  Issues Incompetent handling of PPO list Misinterpretation of claims Physicians not paid in timely manner Dysfunctional claims review process Failure to record changes in coverage Claim representatives cannot answer specific questions about plan Do not respond to correspondence or provide “canned response” letters

20. Importance of Health Benefits  How important were your health benefits in your decision to come to UNLV? 41% - important/very important  How important are your health benefits in your decision to stay at UNLV? 47% important/very important

21. Loss of Medical Providers  Have any of your physicians dropped out of the plan? 41% said yes Goodbye.  Why? Claims not paid in timely manner Burden of providing additional treatment information to Benefit Planners

22. Communicating Health Benefits  Does the currently provided health benefit information explain your coverage well enough? 57% said no  How well do you understand your benefits? 61% - not at all 15% - somewhat 24% - very well

23. Out-of-Pocket Costs  Actual and Anticipated Doctors Visits Hospital Visits Dental & Vision Prescriptions  Flexible Spending Account Awareness Participation

24. Personal Strategies and Stories  Delay needed medical care Cannot afford deductible & copays Pay off one medical commitment before making next appointment

25. Personal Strategies and Stories  Prescription “management” Patient modifying prescribed dosages Purchase prescription drugs from Canada Preferred vs. non-preferred drugs

26. Personal Strategies and Stories  Inability to Obtain Follow-up Care  Delay Necessary Surgeries  Difficulty Obtaining Referrals  Collection Agencies

27. Recommendations  Accountability Greater oversight of Benefit Planners Legislative oversight of Public Employees Benefit Program  Ongoing assessment of employee satisfaction with Benefit Planners and PEBP  Health care advocates at university, system & state levels

28. Current Events  Pending Senate Bill 484 Ends health insurance subsidies for future state employees  PEBP shifts focus to preventative care and assessment New two-tiered deductible option Reduced deductible upon completion of Health Assessment Survey Improved vision & dental benefits Elimination of pre-certification requirement

29. Thank You

30. Contact information  Questions?  Want to tell me about a great health insurance plan? muntal@ccmail.nevada.edu (702) 895-3771