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Determining Health Benefits"   The University purchases its health insurance through the State Employee Group Insurance Plan (SEGIP) Largest single group purchaser of health care in the state Covers over 150,000 lives Legislative, executive, and judicial branches of state, MnSCU, quasi governmental agencies Over 15,000 benefits-eligible employees of U of M Eligible dependents and retirees SEGIP also administers dental, life, and disability insurance, and long-term care insurancedf\fQ     1. Determining Health Benefits"   There are two plans in SEGIP: the State Plan and the Commissioner s Plan The State Plan is determined via collective bargaining during biennial contract negotiations The Commissioner s Plan covers unrepresented employees Bargained contracts and the Commissioner s Plan must be approved by the Legislative Coordinating Commission (LCC) and the legislature Benefits resulting from collective bargaining have served as precedent (model) for unrepresented employees\IkI  1. Determining Health Benefits"   The health care coverage: Covers comprehensive spectrum of medically necessary services Uses primary care clinic and network of providers Provides choice during open enrollment Has copay and OOP maximum for prescriptions Employer pays 100% of the employee cost for the low-cost carrier and 90% of dependent coverage Available plans differ primarily in provider networks and access to them z3f   1. Determining Health Benefits"   SEGIP issues RFP for both the State and Commissioner s Plans; purchases the coverage, and then sells it to the University Bargaining concludes after the RFP and the Legislative session. LCC approves the bargained contract; health benefit changes must be accommodated University bargaining is independent of the State; health benefits are generally modeled after the state-bargained outcome DOER charges the University an administrative service fee for the negotiations, actuarial services, COBRA, and satisfaction surveysdzZZZZ{ZZZ   62. Rising Cost of Health Plan Premiums: Percent Change77  7  &2. Rising Cost of Health Plan Premiums"'&  ' Reasons for premium increases: Increased use and consumer demand for service Aging population Provider consolidation Pharmacy costs Diagnostic and therapeutic technology Decrease in federal funding Government regulation, taxes, mandates, and paperwork4  33. Better Meeting the Needs of University Employees"43  4 <Health Plan Task Force Report was discussed at the December 2000 meeting of the Board of Regents Four benefit changes were identified: 1. Expanded mental health access 2. Improved out-of-network coverage 3. Improved out-of-area coverage 4. Complementary/alternative care (CAM) Eligibility for domestic partners "f3f3f f3f3ff3f3f%f# =  +4. Promoting Health of University Employees",+  , Promoting healthy workforce and workforce environment Programs that promote health, wellness, prevention, and appropriate utilization of health services Education, information, and services such as smoking cessation Use incentives such as copays and deductibles*mm     What is the University Doing?"   MTwo working groups created: Employee-based Interim Committee advisory to the President regarding health benefits Administrative Working Group advisory to the President regarding options for administering the health benefits Both groups agreed on guiding principles Continue to work with State DOER Analyze alternatives through an RFPLZZEZD N  What Does the RFP Do?"   +Gives the University a vehicle for thinking through what flexibility it wants Makes available to the University the options and prices for health benefits that the insurance companies and health plans are willing to commit to Does not exclude the University from continuing to purchase from SEGIP JNH+ , 0What is the Spectrum of Plan Designs in the RFP?"10  1 Limited HMO: access through defined clinics; small copay for office visit; no employee premium Traditional HMO: broader provider access; broader mental health coverage; moderate copays; little or no employee premium POS Plan: greater access to providers; out-of-area and out-of-network coverage; higher copays; more premium paid by employee New Option: major medical insurance with a very high deductible; and tax-free medical expense account provided by employer for employee to use to purchase health servicesd_ZZyZZ}ZZZ6  x   3What Coverage is Available in All Plans in the RFP?"43  4 ;Medically necessary benefits in the plans that University employees currently have Domestic partners would become eligible Emergency care worldwide, with a copay Urgent care worldwide, with a copay Pharmacy benefits with copay for each prescription and a cap that will probably be increased over the present onelS('$r< < What Happens Next?"   *RFP: responses received on March 16; analysis of responses over next several weeks; internal consultations Continue dialogue with DOER Report information and recommendations to the President by early May Make core decisions Complete the bargaining process Prepare for implementation in January 2002++ + What Are the Core Decisions?"   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Determining Health Benefits1. Determining Health Benefits1. Determining Health Benefits1. Determining Health Benefits72. Rising Cost of Health Plan Premiums: Percent Change'2. Rising Cost of Health Plan Premiums43. Better Meeting the Needs of University Employees,4. Promoting Health of University EmployeesWhat is the University Doing?What Does the RFP Do?1What is the Spectrum of Plan Designs in the RFP?4What Coverage is Available in All Plans in the RFP?What Happens Next?What Are the Core Decisions?  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