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Health Benefits @ Rice. December 4, 2013. We Can Be Thankful…. We Can Be Thankful…. Ground Rules. Let’s have a constructive conversation! If you have a personal complaint, please table it for post-discussion, and we’re happy to discuss later

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health benefits @ rice

Health Benefits @ Rice

December 4, 2013

ground rules
Ground Rules
  • Let’s have a constructive conversation!
    • If you have a personal complaint, please table it for post-discussion, and we’re happy to discuss later
  • Rice is self-funded, meaning we pay for the claims directly out of our bank account, and only pay Aetna an administrative fee
    • This fee plus reinsurance premiums total only 6.3% of total premiums
    • Going with another insurance carrier will not necessarily save us money on these fees
    • Nor will changing carriers lead to less administrative hassles
  • We are constrained by budget issues, and cannot offer free coverage, etc.
    • Fringe rates are affected by Rice contributions toward premiums
health care is changing
Health Care is Changing!
  • Medicaid (Texas opted-out of expansion)
  • Medicare uncertainty (2026?)
  • Aging population (Rice avg. age = 45.6)
  • Increasing overall health care costs
  • Access to latest medical tests (proximity to TMC)
  • Affordable Care Act (ACA), or “Obamacare”
    • 2014 = Individual mandate and automatic enrollment for new hires
    • 2018 = “Cadillac Tax” that will require richer plans to pay a 40% tax/penalty for amounts in excess of the upper limits set by ACA
health benefits @ rice1
Health Benefits @ Rice
  • Rice moved to Aetna for self-funded coverage effective July 1, 2002
    • We’ve now been with Aetna, with the same plan designs, for over 11 years!
    • Very minimal plan design changes
    • Increasing premium costs (but below market)
      • Really? Let’s see…
health benefits @ rice4
Health Benefits @ Rice
  • Rice continues to pay for 84.4% to 62.9% of premiums:
health benefits @ rice6
Health Benefits @ Rice
  • What is our “secret sauce” for keeping the plans affordable?
    • Managing our health care expenses well
      • HMO model works
      • Keeping you healthy and productive
        • Wellness programs
      • Emergency rooms versus urgent care (know where to go)
      • More drugs moving to generic (but specialty drugs on the rise)
      • EnvisionRx Options (and Orchard)
      • Luck!
health benefits @ rice7
Health Benefits @ Rice
  • We regularly benchmark our benefits against our peers
    • Private, peer universities
    • Texas Medical Center institutions
  • We remain very competitive
  • Fewer institutions focused on HMOs
  • High-deductible health plans are becoming more common in higher ed. (14% currently offer and 23% seriously considering in the future)
  • Narrow network option?
  • People are inherently inefficient when making health care choices (30%+)
rice s population
Rice’s Population
  • How would you describe our needs?
    • Lower paid faculty/staff (want lower premiums and OOP expenses)
    • Freedom of choice (fewer restrictions, and willing to pay for freedom)
    • High utilizers (ill, children, etc.)
      • The top 5% of our enrollment drives over 80% of our costs
    • Young invincible (low premiums, no use)
    • Network needs (MD Anderson, Kelsey-Seybold)
    • Retirees (both pre- and post-65)
    • Anyone else?
future health benefits @ rice
Future Health Benefits @ Rice
  • What do we want for the next 5 to 10 years?
    • Insurance company?
      • Benefits Committee endorsed remaining with Aetna
    • Providers?
    • Plan designs?
    • Cadillac Tax impacts
  • What is most important to you?
    • Understand we have to follow the law
    • Understand we have a limited budget
    • Total compensation picture (benefits = 26-28% of your total pay package)
your input
Your Input

Concern about changing carriers and approvals of services already authorized

Happy with Aetna

Concern about network?

Premiums on a sliding income scale?

We should make people more accountable for their care/costs?