Graduate Student Health Insurance Plan (GSHIP) Workgroup

1. Maria BlandizziDirector, Special Projects and Staff to the GSHIP Workgroup Office of the Vice Provost, Student Academic AffairsUC San Francisco Graduate Student Health Insurance Plan (GSHIP)Workgroup

2. Overview of the Issue • In the 1980s individual campuses passed graduate student referenda to require proof of health insurance; • Today, each campus individually bids and secures its own graduate student health insurance plan (GSHIP); • There is a high variation in cost and benefits among each campus.

3. Current costs

4. Current Arrangements

5. The Process • Vice Chancellors for Student Affairs and Graduate Deans called for study of GSHIP. • UC Office of the President-- Executive Vice President and Provost agreed to sponsor study. • Workgroup was appointed and conducted analysis (Phases 1-3) from October 2008 - December 2009.

6. The Process • The Workgroup was co-Chaired by Joe Castro, Vice Provost for Student Academic Affairs at UC San Francisco and Jeffery Gibeling, Dean of Graduate Studies at UC Davis; • Comprosed of campus leadership, graduate students, and UC Office of the President staff; • Hewitt Associates, a consulting firm that has a dedicated operational unit to higher education was retained to assist with the actuarial analysis; • The committee met from October 2008 through December 2009.

7. 3 Phased Approach • Phase I: Plan Design (Comparator Group Input and Standard Design Analysis) • Phase II: Cost Projections (Self Funded Cost Projections and Strategy Setting) • Phase III: Request for Proposal (Medical Self Funded Administrative Services

8. What we have heard from students: The UC Student Association shared the following priorities: • Affordable and quality coverage for dependents • Transparent and enhanced reciprocity across the system • Increased coverage for mental health care • COBRA for one year • Better coverage while researching abroad

9. Opportunities & Challenges Opportunities • Cost Effectiveness • Improved Long Term Rate Stability • Facilitates Implementation of Key Initiatives • Reduce Administrative Burden • Advantages of Consistency in Benefits Challenges • Commitment of campuses • Reduce Administrative Burden • Impact on USHIP • Timing of Implementation

10. Fundamental Concepts • Maintain the roles of the student health and counseling centers as the first points of contact for students seeking health care; • Provide affordable and quality coverage for dependents of graduate students; • Continue the practice that campus-based centers bill and receive funding from GSHIP plans where appropriate and beneficial to students and the plan; • Extend health insurance coverage for six months following completion of a graduate degree program, and/or during an approved leave of absence; • Offer transparent and enhanced reciprocity of health care among campuses; • Enhance University-Community relations by maintaining relationships with local network provider; • Continue quality coverage for mental health needs.

11. Request for Proposals • The primary intent was to secure competitive bids from qualified vendors who demonstrated an understanding of the Workgroup objectives as well as the unique capabilities and expectations of each local campus. • The bid process secured financial offers for both fully-insured plans as well as administrative services for self-insured plans

12. Observations • The four principal objectives justifying the bid project were achieved: • Substantial savings could accrue to the system and students with some of the GSHIP elements clustered systemwide; • Option to include dependents that is less costly than existing plans; • Option to extend coverage by 6 months beyond graduate degree program completion; • Maintain (or enhance) the role of student health and counseling centers in the delivery of health care to graduate students. • In addition, the vendors provided multi-year rate guarantee that will ensure price stability. • A systemwide purchase decision appears to provide the greatest market leverage and the lowest cost for graduate students in the aggregate.

13. Recommendations • Establish a University-wide policy that requires proof of health insurance coverage as a non-academic condition of enrollment for all University graduate students, consistent with its earlier action for undergraduates. (The Regents approved the proposed policy that requires proof of health insurance coverage as a non-academic condition of enrollment for all University graduate students at their November 19, 2009 meeting). • The Workgroup recommended that the Office of the President explore in more detail potential savings through systemwide purchasing methods to reduce GSHIP costs for the University and graduate students. • The University would be best served by purchasing “best in class” contracts for medical, dental and vision coverage from vendors with strong services and financial guarantees within each line of coverage rather than consolidating these services with one vendor. This approach is similar to the one used for UC faculty, staff and postdoctoral health insurance plans. • The University should assess its capacity and the risk to self-insure medical and dental benefits, and to contract for administrative and marketing support. Under this scenario, the University would create an internal pooling mechanism to “pool the risk” of claims from each campus in a University controlled and funded health care claims reserve. • A systemwide insurance plan to cover dependents should be implemented with the student paying the cost for spouse and children.

14. Recommendations • A systemwide insurance plan extension for 6 months following completion of the degree program or during an approved leave of absence should be offered to all graduate students and their dependents with the student paying the cost for the extended benefits coverage • The Workgroup places a priority on the health needs of graduate students who study/conduct research at a UC campus other than their home campus, and have named this priority as “reciprocity of health services”. • The Office of the President, with support from GSHIP Workgroup co-Chairs, should identify a GSHIP Cost Validation and Implementation Team to proceed into the next two phases of this work to implement a systemwide graduate student health insurance program. • An infrastructure to support the annual program must be established for the success of whichever plans are determined to be systemwide. • The timing of implementation should be further discussed with Academic Affairs, Strategic Sourcing, Risk Services, Health and Welfare, and campus student health and counseling centers.

15. The Process of Getting Buy-In • UCOP, Council of Chancellors, and Council of Executive Vice Chancellors/Provosts endorsement • Moving forward with the “coalition of the willing” • Campus Commitments • Continuing the dialogue • UAW Sunshine sessions • UCSA Townhall meetings • UCSA Student Lobby Conference • the USHIP question?

16. Let the work continue… • Phase 4: February – April 2010 • Update program costs and the financial analysis for the current contract; • Clarify campus-based expenses related to GSHIP; • Negotiate final prices and options with bidders; • Select semi-finalists from the GSHIP RFP, check references, coordinate semi-finalist presentations and site visits; • Select a finalist and negotiate final terms, conditions and contracts; • Develop GSHIP Program Infrastructure; • UAW negotiations.

17. Let the work continue… • Phase 5: April 2010 – July 2010 • Develop implementation work plan and transition plan from current contracts; vendor installation process, including developing communication materials about UC graduate student health insurance plans; • Hire 1-2 additional GSHIP staff to manage systemwide program; • Complete UAW negotiations. • Launch systemwide GSHIP plan: August 2010

18. Questions & Discussion

19. Thank you!