SHAC Ship Intro - Oct 2015

7/23/2019 SHAC Ship Intro - Oct 2015

1/25

Background on SHIP for SHAC Meeting

Waiver, Appeals, and 2015-2016 Plan

ChangesOctober 21, 2015


2/25

SHIP 101 SHIP Governance

SHIP Waiver Fall 2014 what happened, what did we do about it

Spring 2015 experience

Fall 2015

New Appeal Form for Spring 2016

2015-2016 SHIP Changes Benefit and premium changes

Discontinuation of dependent and continuation plans

Agenda


3/25

ALL students have access to

University Health Services~60% of students

have SHIP


4/25

Medical and mental health plan throughAetna Student Health (ASH)

Dental plan through MetLife

Vision plan through Vision Service Plan (VSP)

Plan Carriers

Student Health


5/25

All UC Students are: Required to have major medical health insurance

Automatically enrolled in SHIP when registered

(current SHIP coverage August 15-August 14)

Able to enroll in SHIP any time within the semester if theircurrent coverage is lost (no prorated rate)

Able to maintain dual coverage

Able to waive out of the plan through an online waiver

Insurance at UC Berkeley


6/25

ACA Essential Health Benefits: preventive and wellness services and chronic disease

management mental health and substance abuse disorder services,

including behavioral health treatment

rehabilitative and habilitative services and devices

ambulatory patient services emergency services

hospitalization

maternity and newborn care

prescription drugs laboratory services

Berkeley SHIP

already provided

all of these benefits plus

includes dental and vision


7/25

Basedon in-network providers

SHIP BENEFIT HIGHLIGHTSPreventative 100% covered (you pay $0)

Primary Care $15 co-pay

Specialists $15 co-pay

Urgent Care $30 at UHS; $50 outside UHS

Counseling Outside UHS $15 co-pay (first five visits free at UHS for all students)

Emergency Room $100 co-pay

Hospitalization 90% co-insurance (you pay 10%)Labs/tests/x-rays 90% co-insurance (you pay 10%)

Prescription drugs $5 generic, $25 brand name

Dental 2 free cleanings/exams per year; 80% co-insurance minor dental, 70%

co-insurance coverage major dental (up to $1000/year)

Vision $10 eye exam, $25 co-pay frames & lenses, or contact lenses

(up to $120/year)

Deductible $300 for some services outside of Tang


8/25

Glossary Premium The amount you pay to be enrolled in insurance plan

EXAMPLE: Berkeley SHIPs undergrad premium is $1290/semester

Co-insurance The percentage of the health care costs you have to pay. EXAMPLE: For some services, Berkeley SHIP pays 90%, and you pay 10%

Deductible The amount of medical costs you have to pay before yourinsurance kicks in per year. EXAMPLE: Berkeley SHIP has a $300 annual deductible for some services outside of Tang

Co-pay An upfront cost you pay when you have an office visit; Not counted aspart of deductibles.

EXAMPLE: Primary Care visits at Tang are $15


9/25

Note: Waiver criteria set system-wide.

SHIP GovernanceADVISORY ROLES

CFO in

consultation

with campus

administration

makesfinal

decision

Campus

Leads and

UHS advise

on final

decisionSHIAC &

studentleadership

provide

feedback on

RFP and plan

UHS initiates

SHIP renewal

process and

Broker seeks

carrier bids

Campus

stakeholders

provide inputon RFP and

plan selection

GA CSF SHACASUC

UHS

manages

daily

operations for

SHIP


10/25

Fall SHIP Aug 15-Jan 14

Spring SHIP Jan 15-Aug 14

July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June July

Fall (Annual) Waiver deadline July 15

(alt. coverage must begin by Aug 15)

Fall waiver covers full academic year; if you waive

for fall, you wont need to waive again in spring.

Spring Waiver deadline Jan 10

(alt. coverage must begin by Jan 15)

SHIP COVERAGE PERIOD

SHIP WAIVER PERIOD

Late waiver deadline $50 late fee:

Fall Sept.15, Spring Feb. 5

SHIP WAIVER APPEAL A waiver appeal form can be filed within 10 business days of waiver denial.

(Those on financial aid will be prioritized, a new feature added by

recommendation ASUC SAO) SHIP will notify of waiver appeal decision within 30 days.


11/25

Three emails: April, July, September

Postcard to home address in June

Cal Parents

CalSO/MyBerkeleyApp

eBill notification, Cal Student Central

Be Well @ Cal Social Media (Facebook, Twitter,

monthly buzz eNews)

Tang website homepage ASUC Student Advocate Office (SAO) communications

SHIP Waiver Communication


12/25

As a result of massive changes in the health insurance

marketplace, our student leaders along with other UCstudent leaders and Student Affairs Vice Chancellors

advocated for strengthening the waiver criteria to

block out some plans:

These are plans that have low up front costs (so they

seem affordable), but if you actually use them, would

cost hundreds, if not thousands, of dollars out of pocket

first posing a barrier to care and a financial burden.

SHIP Waiver Fall 2014


13/25

Before waiving, our website instructs users to

complete a worksheet (PDF) with all the questions in

the waiver.

This mirrors the online application flow and questions to

get them ready to fill out the actual waiver. As long as the information entered matches the

criteria, you get an instant waiver confirmation.

About 10k families successfully waived.



14/25

Problem assessment

Over the summer, we noticed significant

numbers of students were failing the online

waiver process (AKA being denied a waiver).

Normally we process 1500 waiver appeals,

fall 2014 we had 7500 (400% increase).

Most problems were just user error, not reading

instruction or having all the information beforesubmitting form.



15/25

More than 75% of fall waiver appeals were approved,

indicating user error attributed to most all of theconfusion.

Students admitted they didnt complete worksheet or

bother to get the actual information just guessed. Social media (Reddit, Facebook groups, Daily Cal)

posted waiver hacks that spread misinformation.

Families were confused about some terminology

easily obtainable from your insurance company butstill can be confusing.

Why did this happen?


16/25

The mass volume of appeals impacted the

timeliness of when we could process appeals.

Parents and students calling about status of appeal

created massive customer communication backlog

UHS responded with:

dedicating more staff and management time

work with key stakeholder to keep theminformed and make tweaks as possible

Impact


17/25

In August, UCOP lightened the requirements for

two criteria (pharmacy deductible and out of

pocket maximums that didnt factor in Health

Savings Accounts) systemwide

Sent email to ALL students about the new waiverrequirements

Streamlined the waiver form and provided more

info to make it simpler

New! SHIP Waiver Cheat Sheet (ASUC SAO)

What did we do about it?


18/25

In partnership

with ASUC SAO


19/25

This Fall, about 17,200 waivers submitted

Of these about 3,900 denied

About 3100 appeals, of which 2,700 passed appeal

Over 15,900 successfully waived out

Word of caution: We audit 25% of waived accounts andthose who didnt complete correctly will be charged for

SHIP. Additional auditing and possible student conduct

action for those who post cheats



20/25

SHIP Office has developed a new online appeals form

SAO is testing the development site now

Will pilot for Spring 2016 Waiver season

Will replace the need to mail, fax, drop off or email

appeals form Should make appeals easier and more efficient

Systemwide changes to waiver criteria to further

simplify or clarify criteria to take effect Fall 2016.

New for waivers for 2016


21/25

Premium increased:

Undergrad premium = $1,290/semester

Graduate premium = $1,877/semester

Deductible increased from $200 to $300

Discontinuation of voluntary plans:

Continuation plan

Dependent plan

SHIP Changes for 2015-2016


22/25

Why the University made the decision:

ACA required parity rates (or equal rates for familymembers)

Meaning student price would go up to reduce

dependent price Less than 1% of students on SHIP had voluntary

dependents on the plan

Informed that 50 other campuses made similar

decision, including UCSB

Discontinuation of Dependent Plan


23/25

Free insurance helpline to assist in finding new plans

Information sessions for dependents

Transition Assistance Fund for Dependents

Individualized help at the SHIP Office

Resources Voluntary Members


24/25

Need for more transparency about SHIP Renewal

process and decision making

More avenues for student and campus stakeholder

feedback

Will look at options to offer dependent coverage More clarity about timeline

Lessons Learned


25/25

http://uhs.berkeley.edu/ship

[email protected]

(510) 642-5700

Thank you!
mailto:[email protected]

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SHAC Ship Intro - Oct 2015

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