August 9, 2007


Dear Colleagues:

Since my last communication in April, the University has been working to finalize the 2008 health care benefit programs. I am pleased to provide this update on our progress.

Our efforts started with communication—ensuring that we know what is most important to our employees. Aon Consulting hosted 13 focus groups on our three main campuses, and the Health Care Task Force prepared an online survey that was e-mailed to all faculty and staff during April/May. The survey was completed by 3,800 employees. Results mirrored the concerns we found in the focus group results.

Some of the prevalent themes were:

  • 84 percent of survey respondents rated medical health care as the most important benefit when compared to retirement, dental, life insurance, long-term disability, and tuition remission.
  • Respondents were almost evenly split between preferring higher premiums and lower out-of-pocket expenses or lower premiums and higher out-of-pocket expenses.

  • Most respondents said that co-pays (out-of-pocket expenses) and monthly premiums were most important when selecting a health care plan.
  • Many respondents felt that obtaining referrals was an administrative burden that did not add value. 

  • Most respondents were confused by the concept of co-insurance.

For complete results on the 2007 UM Health Care Survey, click here.

All of the information obtained from the focus groups and the online survey was reviewed by the Task Force and the Employee Benefits Advisory Council (EBAC), the newly formed employee group. 

The EBAC met three times over the summer to discuss health care plan options for 2008. Their input has been valuable, providing insight into employees’ specific circumstances, concerns, and needs. To view a full list of members, click here.

Survey and feedback information was taken into consideration when designing health care benefit plans for 2008. Some of the 2008 features include:

  • Health plan options have been reduced from five to four in an attempt to simplify the plans: HMO1, HMO2, PPO550, and Coverage First 1500.

  • The HMO1 and HMO2 plans will be open-access—that means you won’t need to elect a primary care physician (PCP) or obtain referrals for services. However, we encourage you to continue your relationship with your PCP. Some experts think the elimination of the referral/gatekeeper will result in an increase in usage and overall expense. Others believe it will eliminate waste and frustration without driving up cost. We’re going to try it for 2008 and evaluate results carefully.

  • The two HMOs will be distinct. HMO1 will have higher monthly premiums and lower out-of-pocket expenses. HMO2 will have lower monthly premiums and higher out-of-pocket expenses. That’s similar to car and home insurance. You can pay more in premiums and have lower deductibles or save on premiums in return for higher deductibles. 
  • Neither HMO plan will have co-insurance—where the employee pays a percentage of the total cost for particular procedures. The co-insurance feature caused some employees to steer away from HMO2 last year. Those employees may want to reconsider HMO2 and its lower monthly premiums this year.  
  • The HMO plans will have a new network called HMO Premier. This network is currently expanding throughout Humana's HMO national service areas. As areas begin to offer the HMO Premier network, you will be able to use providers in these areas. For employees with dependents living outside of South Florida, but within an HMO Premier area, this new network will enable you to elect an HMO plan for your family. Go to www.humana.com to locate participating physicians in your area. 
  • The PPO and Coverage First plans will also be a part of a new network known as the National POS Open Access Network. This network will provide employees increased discounts for procedures that involve co-insurance.
  • Co-pays/co-insurance will be less for all plans for services performed by UM physicians at UM facilities. Over time, as access improves, we will provide greater incentives to use UM physicians and facilities. 
  • UMatter Wellness programs will be enhanced. This will be a major initiative in 2008. The best way to save money on health insurance is to have healthy faculty, staff, and family members. Many preventive care services will continue to be offered at no cost to members. Our Wellness Centers are developing a variety of programs to better meet the needs of faculty and staff. We are working on implementing a weight management program that will include nutritional counseling. We will offer health fairs throughout the year that focus on health and wellness issues. You will hear more about these initiatives in the months ahead.
  • The UMatter mammography benefit has been enhanced. UMatter will provide one free "screening or diagnostic" mammogram per year—no longer will the results of the test determine whether or not there is a charge. In addition, the threshold for this benefit has been lowered from 40 to 35 years of age.
  • The Coverage First plan’s $500 up front allowance need not be used for UMatter Wellness preventive care offerings. That leaves the full amount to cover costs incurred, excluding co-pays. 

  • The out-of-pocket maximum for each plan will include co-pays and co-insurance to help protect you and your family even further.
  • Open Enrollment information will be distributed significantly earlier than in past years. Open enrollment packages will be distributed by mid-September. This will provide you with more time to evaluate plan offerings, ask questions, and make informed health care decisions. 
  • Humana will improve customer service by implementing a five-person dedicated UM customer service team that is well-informed about our plans. The new customer service team is in place and can be reached at 1-800-992-5780 Monday to Friday, 8 a.m. to 6 p.m. EST. Our contract with Humana provides financial incentives to improve service (and penalties if that’s not the case). We expect Humana to perform.  Benefits Administration needs to hear from you when that’s not the case.

We are trying to be responsive to the priorities you identified. Recognize that this is against the backdrop of another year of double-digit increases in health care that will take the total health care cost for University employees and their dependents to approximately $80 million, of which the University absorbs more than 75 percent. 

We are finalizing plans and employee premiums and will share all of this information with University trustees later in the month. We will begin communicating 2008 plan details in early September. You will have many opportunities to learn about the 2008 plans via group information sessions, departmental meetings, one-on-one sessions, benefits fairs, and many other communications. Open Enrollment is scheduled to begin October 15 and will run through November 2.

Health insurance is, of course, just one part of the University’s overall compensation plan. We recognize that the cost of living in South Florida has continued to increase markedly. In response, this year’s pay raise pool was increased and a new pension plan that is more costly to the University was introduced. We are committed to offering competitive salaries and benefits that are needed to attract and retain the best and brightest faculty and staff.  

I thank you in advance for your interest in this important matter. Your feedback is important. If you have comments or suggestions, please send them to me at umbenefits@miami.edu.

Sincerely,


Joe Natoli
Senior Vice President for Business and Finance
and Chief Financial Officer

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