Trustees' committee hears several options for 2012 medical plans
WEST LAFAYETTE, Ind. - Merging of the Purdue Copay and Purdue Incentive medical plans was among several potential changes for 2012 discussed Monday (May 16) with the Purdue Board of Trustees' Audit and Insurance Committee.
The combined medical plan would have a deductible and coinsurance arrangement for most health care and a copay benefit on a few select services, such as primary care office visits.
Premiums for all 2012 medical plan options will be set in September when a better estimate of the full claims cost for 2011 can be made.
John Beelke, director of benefits, reported that Purdue's current medical plan budget is $140 million a year and growing at the rate of 8 percent annually. In an effort to manage the growth, Purdue is considering a number of changes for 2012, in addition to combining the Copay and Incentive plans:
* Establish a preferred network for outpatient lab testing. Currently, not all network labs provide the same level of discount on their services. All labs that wish to participate in the preferred network would need to agree to the same high level of discount.
* Change the coordination of benefits. Under the proposed arrangement, when Purdue is the secondary insurer of a patient, the Purdue plan would pay only the difference between the primary plan's benefit and Purdue's benefit, if any. For example, if the primary plan pays an 80 percent benefit for a service and Purdue's plan pays an 85 percent benefit for the same service, the university's plan would pay a 5 percent benefit after the primary plan had paid. Currently in this situation, the Purdue plan would pay a 20 percent benefit, bringing the patient to 100 percent coverage.
* Include coverage of bariatric surgery for weight loss. More evidence now supports the effectiveness of bariatric surgery when the patient has been deemed an appropriate candidate through a protocol program and undergoes the surgery at a bariatric center of excellence.
* Add a premium surcharge if a Purdue employee covers a spouse or same-sex domestic partner who is eligible for medical coverage through his or her own employer. Typically, under other plans, the surcharge is $50 per month, but the surcharge amount would be determined in the fall when other premiums are set.
* Add a premium surcharge for covered employees, spouses and same-sex domestic partners who smoke. The surcharge discussed with the board was $500 per year for each smoker, however, the surcharge amount would be determined in the fall.
Planning for 2013
Beelke reported on studies and evaluations under way in preparation for 2013:
* A study is in progress to determine the feasibility of opening on-site clinics for pharmacy and medical care at all four campuses. Purdue Benefits also will evaluate further the possibility of on-site services for medical imaging and other health-care components.
* A second consumer-driven health plan (CDHP) may be offered with a higher deductible than that of the Purdue Choice Fund with HSA plan, which is the current CDHP offering.
* To give employees and their families the tools they need to become better health-care consumers, Purdue Benefits will continue to look for ways to improve the information available to employees about the quality and cost of health care.