Stateuniversity System Student Health Insurance Task Force

DRAFT

STATEUNIVERSITY SYSTEM STUDENT HEALTH INSURANCE TASK FORCE

CONCLUSIONS AND RECOMMENDATIONS

January 2010 Report

STATEUNIVERSITY SYSTEM STUDENT HEALTH INSURANCE TASK FORCE

2010

Student health insurance is a significant U.S. health care issue, is at the forefront of the national debate on health care reform, and has become a critical point of deliberation in the U.S. Congress during the task force’s period of activity. At the time of the writing of this report, federal legislation has yet to be passed and continues to be considered in both houses of Congress. However, the State University System Student Health Insurance Task Force has continued to monitor this national debate and to analyze proposed legislation as it relates to student health insurance issues.

The 2010 report represents an examination of the complex issues of student health insurance by a SUS task force with a broad representation of university constituencies. Conclusions were reached and recommendations were developed following a review of the current national health care reform deliberations, an update of other state and state system policies and purchasing plans, and an examination of existing SUS insurance policies and programs.

CONCLUSIONS

Health Insurance for University Students

Health insurance is now a critical factor in the delivery of student health care on university campuses as there is correlation between students’ health and well-being and their academic matriculation and persistence toward degree completion. The following factors apply:
Trend toward more complex health issues with an increased need for higher level of medical care: emergencies, acute illness, hospitalization, surgery, chronic/long term care.
Recognition of a direct financial impact of unexpected accidents or major illness.
Availability of more competitive insurance plans with improved affordability for students and enhanced benefits.
Growing demand for more comprehensive mental heath and counseling services, with increasingly critical issues affecting students.
Student health insurance plans offered by colleges and universities are customized to reflect the institution’s priorities in making insurance premiums affordable for their students while providing coverage that meets distinctive student and campus needs.
University students without adequate health insurance defer necessary preventive, medical, and mental health care, and assume extraordinary health and financial risks at a time when health care and finances are closely tied to their potential for academic success.
There is a significant financial impact on local Florida communities for non-reimbursed health care for uninsured and underinsured college students.

StateUniversity System Student Health Care

Each of the 11 institutions in the State University System has a unique student population, based on its history, size, geographic location, academic program offerings, complexity, and technological sophistication. Accordingly, each campus has unique health care needs that may extend beyond the basic, primary care services.
The distinctiveness of each state university dictates the health care services provided by that institution. These services range from student health centers with comprehensive and extended services at the large universities to clinics with limited services at the smaller institutions.
Each state university offers its own student health insurance plan to its enrolled students with distinctive coverage benefits and price points. Due to inconsistencies in coverage throughout the SUS, students have different financial responsibilities for medical care depending upon what university they attend.
In the three year, phased-in implementation of a mandatory student health insurance program, FloridaStateUniversity has:

Increased its student health plan participation by 416 percent;
Reduced its student premium by 14 percent for the comprehensive plan and 36 percent for the basic plan; and
Increased benefits by 833 percent for the comprehensive plan and 333 percent for the basic plan.

Student Health Insurance: Delivery Options

A number of states and higher education governing boards have implemented health insurance requirements for college students.
There are insurance cost efficiencies that can be gained by a system-wide plan for health insurance. State system plans are priced based on utilization and can provide targeted coverage and benefits.
As universities are increasingly requiring some form of health insurance for their students, many institutions are exploring ways to help students afford adequate health insurance coverage by broadening the institution’s definition of cost of attendance (COA).
From an analysis of existing state and state system policies, the following potential advantages have been identified for a mandatory policy of student health insurance coverage as a condition of enrollment:

Reduces the state’s uninsured and uncompensated health care costs by requiring that all students have health insurance to help pay for covered medical services;
Provides more affordable coverage by adding healthier individuals to the institution’s existing student health insurance pool, thereby spreading the risk and lowering premiums;
Increases student retention rates and reduce medical debt by creating a financial safety net for students in the event of major illness or injury;
Improves access to broader health services, by extending coverage to include more specialty services in both medical and behavioral health.

Healthy students are more successful in completion of theireducation pursuits than unhealthy students and quality health care is integral to general student health and well-being. The System of Care Life Cycle below shows the direct relationship between quality health care, health insurance and healthy students. At each step of the Life Cycle where a student needs health care services, health insurance coverage, billing, and reimbursement are part of the process. The SUS Task Force believes that the provision of comprehensive, cost effective health insurance coverage is integral to maintaining healthy, academically successful students in the SUS.

RECOMMENDATIONS

The Board of Governors should authorize the establishment of a StateUniversity System purchasing consortium for student health insurance to ensure that the System will be able to efficiently respond to pending federal legislation that addresses health care and insurance coverage.

The Board of Governors should direct the SUSHealthCenter Directors, in collaboration with the SUS Council for Student Affairs and student representation, to convene a Work Group to:

Develop an action plan for the provision of student health insurance in the State University System that will meet the insurance needs of all student constituents according to the guidelines set by the American College Health Association, and will provide for the efficient transition of all institutions into the consortium;
Recommend an Invitation to Negotiate (ITN) process for the procurement of a student health insurance program for the StateUniversity System that will be responsive to new federal law upon enactment and will comply with the state purchasing process.

Each state university should continue to individually determine its participation in a structured billing system for student health insurance claims pending the establishment of the SUS purchasing consortium and accompanying recommendations of the SUS Work Group.

The Board of Governors should include in its 2010-11 Legislative Budget Request support for full health insurance coverage for state university graduate assistants, teaching assistants, and research assistants.

Section 1009.24(11), Florida Statutes, should be amended to permit:

The student health fee to be utilized for student health education and outreach, wellness, behavioral health and medical care, health facility and equipment acquisition and maintenance.
Unexpended and undisbursed funds at the end of a fiscal year to be carried over in the student health fee fund and made available for allocation and expenditure during the next fiscal year.