1. Report of Faculty Senate Benefits Subcommittee
Joanna L. grossman
Ellen K. Solender Endowed Chair in Women and Law

2. Committee Charges
Work with Provost’s Office to ensure implementation of parental leave policy.
Review prescription drug coverage across SMU medical plans and evaluate on average faculty are spending out of pocket on prescription drugs as well as implications of prior authorizations and lack of coverage for non-preferred mediations on faculty costs and health.
Work with Sheri Starkey and SMU Benefits to find ways to encourage SMU employees to be more conscious of available benefits and more conscious consumers of healthcare services.
Review full-time faculty benefit coverage to verify that benefits are equivalent for TT and NTT faculty.

3. New Parental Leave Policy (Draft)
All full-time faculty are covered
Childbirth leave – ½ semester
Parenting leave -- ½ semester
Newborn, newly adopted, or newly placed foster child (ages 0-4)
Leave completed w/in 12 months of birth, adoption, or placement
Medical leave – 90 days
Tenure clock stops at option of faculty member

4. Health Care in a Nutshell
Current SMU Fiscal Year: June 2018-May 2019
Current SMU Plan Year: January 2019-December 2019
Gross Cost: Includes medical/Rx claims paid by SMU, in addition to administrative fees paid to BCBS for claims administration and stop loss insurance for claims exceeding $500,000
Employee Contribution: Reflects premiums paid by employees based on plan and tier election
Plan is designed around 65/35 cost allocation between SMU/employees
Net Cost: Reflects total paid by SMU after employee premiums are deducted

5. Prescription Drug Costs
Place of Service
91.9% of total scripts retail; 8.1% mail order
Drug Type
Generic (82%); Brand Preferred/Formulary (8%); Brand Non-Preferred (10%)
Member OOP
Member OOP as a % of total drug cost = 24.8% at Retail, 10.6% at Mail
Total Member Costs
Total Generic member OOP per script = $13.33
Total Brand Preferred member OOP per script = $125.67
Total Brand Non-Preferred member OOP per script = $151.94

6. Prescription Drug Benefits
We currently have the best of three plans offered by Prime Therapeutics
SMU cannot customize plan
Prescription costs are part of 65/35 allocation
Cost are allocated unevenly across insured pool based on structure of health plan
Do we want to survey faculty on usage, problems, concerns?

7. Better Consumers of Healthcare
Common mistakes/practices
Underuse of preventative services and on-campus preventive health screenings
Use of local pharmacies rather than mail order
Use of non-preferred medications when preferred or generics are available
Use of out-of-network providers
Using freestanding ER rather than urgent care
Low usage of telemedicine (MD Live)
Low usage of free healthcare consulting (Compass)
HSA mistakes (lots)
PROPOSAL: Presentation at faculty meetings on ways to reduce faculty spending on healthcare