Over the past several weeks, faculty and staff have been digesting the proposed changes to the university’s medical plan design. We wrote about the proposed changes in Spotlight last month and opened the article up to comments. Thank you to those employees who used this option to share their thoughts.
In addition to the article and comments, HR and ERAC held four joint lunch and learn sessions which were attended by about 100 employees. During those sessions, Director of HR Services Toni Lee Febbo explained the goals of the Health Care Benefits Review and detailed the steps that were taken by Lehigh in conjunction with our consultant Mercer to reach the recommendations. These steps included:
- A survey of all faculty and staff in fall 2015
- A review of the university’s current plan’s performance
- Benchmarking of our plan design with a select group of higher education institutions selected by the Faculty Compensation Committee
- A comparison of our HMO and PPO plans to those of similar employers
Toni Lee reviewed the recommended plan design changes which included:
2016
- Implement a telemedicine option in July 2016
2017
- Introduce a new high deductible consumer driven health plan with a health savings account as one of the options in the 2017 plan year
- Introduce voluntary critical illness coverage
- Eliminate the Comprehensive Major Medical (CMM) plan
- Reprice the PPO-100 plan to more accurate reflect the true cost of the plan
- Continue to accept utilization management programs in the prescription drug plan as new options are recommended by the administrator (currently ExpressScripts)
- Provide educational programs and tools to assist faculty and staff in making decisions about the most appropriate plan for their individual needs
2018 and Beyond
- Modify or eliminate high cost preferred provider organization (PPO-100)
- Increase copayments for specialist visits
- Review/Revise deductibles, copayments, and coinsurance levels regularly to keep Lehigh plans in sync with those in the Higher Ed marketplace
- Add a third tier to the prescription benefit program to encourage use of drugs within the plan’s formulary
- Monitor and introduce new health care models that could be beneficial to Lehigh employees and their families
- Other incremental changes based on changes to the health care and medical insurance marketplace.
What We Heard From You
We received 20 comments on last month’s Spotlight article as well as a great deal of input from the 95 faculty and staff members who attending the lunch and learn sessions. There were several clear themes in the feedback.
First, those employees who currently subscribe to the PPO-100 plan feel strongly that they would like to continue this plan. They cited both the financial value of the coverage and the access to a national network of providers as reasons why they elected PPO-100 as their health care plan. Individuals enrolled in the plan indicated they are willing to pay more for the coverage that provides them with the greatest level of security.*
Similar concerns were expressed about the elimination of the CMM plan.
Another view a number of employees expressed was that the HMO plan does not include practitioners in a wide enough region, in particular the southeastern portion of the state, including Philadelphia suburbs. The chief reason for this is that Lehigh’s health plans are administered by Capital Blue Cross which is licensed to operate in the 21 county area covered by Keystone Health Plan Central. The HMO for southeastern Pennsylvania, Keystone Health Plan East, is administered by Independence Blue Cross. In the past, it has not been possible to offer both Keystone plans.
*It is important to note that the national network of providers for in-network and out-of-network care with PPO-100 are the same providers available in PPO-80.
Next Steps
The recommendations shared with faculty and staff, along with all of the feedback received by HR, will now be shared with the Provost and Vice President of Finance and Administration for their review. In turn, they will share this material with the senior officers who will make the final decision on which recommendations to adopt.
We will report to campus on the senior officers’ decision when their process is complete. Once those decisions have been made, HR will begin the process of implementation and we will keep you informed as details about our new plan design become available.
This fall, we will share information with you frequently and in multiple formats to prepare you for the new options and help you determine the best option for your own circumstances.
The Faculty Compensation Committee (FCC), Faculty Financial Planning and Operations Committee (FFPOC), and Employee Relations Advisory Council (ERAC) will continue to be consulted regarding changes considered for 2018 and beyond.