University of Oregon Triple Option Organization and Responsibility Flowchart

1. University of OregonTriple Option Organization and Responsibility Flowchart • Internal Auditors • External Auditors Student Health Program Council/Trustees • Consultants • Actuaries • Legal Counsel Executive Director, University Health Center Provider Contracting Negotiator Program Communications Vendor Enrollment/Waiver Processes Vendor Eugene/Springfield Health Care Providers Supplemental Care Capitation and Self-Funding University Counseling Center University Health Center Student Health Insurance/Benefit Program* Fully-InsuredPartial Self-Funding • Insurance Company • Claims Administration • National Provider Network • Evacuation/ Repatriation Services Stop-Loss Insurance Hospital Hospital, Counseling/Psychiatry Providers, Ambulance, and other Providers • Funding for UHC and UCC is derived from: • $40 support fee paid by all students, regardless of insurance status. • Capitation for students enrolled in Supplemental Care. • Capitation for students enrolled in SHIBP. • Fee-for-Service Charges/Insurance reimbursement from students who are privately insured. Independent Third Party Claims Administrator Physician Network Counseling/Psychiatry Providers University Health Center And University Counseling Center National Provider Network Subsidiary Claims Administrator Rain Rock Evacuation/ Repatriation Services Ambulance Service • UHC and UCC develop insurance billing capability and/or contract with hospital for Management Services Only for insurance billing. • UHC and UCC enter into participating provider contracts with Oregon Health Plan and major insurance/health plan organizations for insurance billing for students with Platinum coverage. CONFIDENTIAL agreements between providers** and SHIBP and Supplemental Care Other Vendors (e.g., durable medical equipment, home health, and complementary medicine) * Showing two options for SHIBP, either fully with subsidiary TPA or insured with partial self-funding. ** Providers must approve Claims Administrator

2. University of OregonTriple Option Cost to Student Flowchart Based on Projected Costs for Partial Self-Funding KEEP UPGRADE WAIVE Comprehensive SHBP for International Students Graduate Teaching Fellows Comprehensive SHBP Supplemental Care Oregon Health Plan and Platinum Coverage Total UHC and UCC Funding Revenue derived from Pharmacy, Dental, Massage Therapy, Physical Therapy , and other services not covered by capitation may be derived, in part, from insurance reimbursements. Total Funding = $27,060,000 SHIBP and Supplemental Community Claims = $9,548,000 SHIBP Plan Administration = $2,246,000 University reported cost of attendance reduces from $11.8 ($154 x 22,600 x 3.38) to $3.1 million ($40 x 22,600 x 3.38). Savings = $8.7 (50% needed to fund reserves for SHIBP and Health and Counseling margin).

3. Triple Option ProgramSummary Explanation KEEP Under-Insured* Supplemental Care $154 (6.3m ÷ 12,200 ÷ 3.38) + $38 + $40 = $232 Per Quarter ($78 increase) Projected 12,200 students University reported cost of attendance reduces from $11.8 ($154 x 22,600 x 3.38) to $3.1 million ($40 x 22,600 x 3.38). Savings = $8.7 (50% needed to fund reserves for SHIBP and Health and Counseling margin). OR OR UPGRADE Ineffectively Insured *** Comprehensive Student Health Benefits Program Projected 7,200 students Based on partially self-funded plan, copayment benefit design, without COBRA, and no subsidy for dependent coverage. WAIVE Exceptionally Well-Insured** Student has Platinum Coverage or Oregon Health Plan Health Fee reduces to $40 Per Quarter ($114 reduction) Projected 1,200 Students with Platinum Coverage and 2,000 students with Oregon Health Plan (total = 3,200) • * Under-Insured: The health fee does not provide adequate benefits for students who have high deductibles with unfunded medical savings accounts and/or insurance plans that do not include health care providers in the Eugene/Springfield area. • ** Exceptionally Well-Insured: For a second group of students the health fee unnecessarily duplicates coverage provided by the Oregon Health Plan or other Platinum level coverage that has nominal copayments and participating providers in the Eugene/Springfield area. • *** Ineffectively Insured: Increasing cost shifting for employer-sponsored plans means a growing third cohort of students need cost-effective comprehensive insurance rather than current health fee benefits.

4. University of OregonTriple Option Enrollment/Waiver Flowchart KEEP: Student Opts to Keep Supplemental Care Student enrolls with sufficient credit hours to trigger TO Fees UPGRADE: Student Enrolls in Comprehensive SHIBP Student Is Presented with Key Factors for Supplemental Care Student Self-Attests to Having Health Insurance that Meets ACA Standards (provides Policy # and Billing Info) Or Student Declares He/She is not subject to ACA Insurance Mandate WAIVE: Student Opts to Prove Platinum Coverage -- Policy Provide Details Student Takes No Action Student Enters External Enrollment/Waiver System Student Is Presented with Key Factors for SHIBP Student is Automatically Enrolled in Comprehensive SHBP Student Is Allowed to Enrollment/Waiver System Student Protests SHIBP Cost Before End of Grace Period

5. University of OregonTriple Option Implementation Timeline • <IT implementation for support fee and variable TO fee> • <Board of Trustees?> • <UHC – UCC Implementation for insurance billing?>

6. University of OregonTriple Option Implementation Timeline

7. University of OregonTriple Option Implementation Timeline