The University administration has revised its health care plans for University employees in an attempt to stop arbitrary hikes in insurance premiums and maintain general financial stability.
The new changes include additional cost sharing for both the high- and low-premium plans and increased premium levels for the high-premium plan only.
An influx of new University health insurance users prompted the switch, noted both Anne Broccoli, University director of faculty and staff benefits for the Human Resources department, and Human Resources Communications Manager Alexandra Rebhorn.
In an effort to increase cost sharing in both plans, brand-name prescription drugs are now part of an employee's co-insurance, not the co-pay, meaning that an employee will pay a percentage of the drug's costs with caps instead of a flat co-pay rate.
Additionally, co-pays for both plans increased from $15 to $20 for primary service and from $30 to $40 for specialists.
Though the University raised the premiums for the high-premium plan, the plan features less overall cost-sharing, through deductibles and co-insurance, at the point of service than the low-premium option.
More than 91 percent of University employees who take part in the University's health care plans are enrolled in the high-premium plan. While Susan Carkeek, vice president of University Human Resources, admitted that the high-premium plan is expensive, she added that the University's plans are a better deal than what the commonwealth offers for low- and high-premium care.
"We are the only group of state employees not covered under [the commonwealth's] plan," Carkeek said. "We feel pretty good at offering a comparable value plan for less money [or at a lower premium] and we've managed to do the same for the high premium."
In an address to the Faculty Senate last week, Carkeek attributed the plans' price increases mostly to an increase in "high dollar" claims, which are defined as those in excess of $100,000.
"In a typical year we have 30 high dollar claims ... last year we had 44," she said, noting that this translates to a $3 million increase in costs.
Both the low- and high-premium plans, Broccoli stressed, are health care plans and not health insurance plans.
"If it were [a] health insurance [change], [the health insurance company] would raise premiums for certain kinds of care and we wouldn't have any say in [those] decisions," Broccoli said.
Money the University collects from the plans - projected to total $130 million - will be used to pay for claims. "The money that we collect from our employees pays for our employees' care," Rebhorn said.
Human Resources will hold open enrollment from Nov. 2 to 20 and hold employee resource fairs Nov. 12 and Nov. 16, at which employees can find more information about the plans.
-Prateek Vasireddy contributed to this article
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