MINUTES OF THE UMKC FACULTY SENATE
November 4, 1996 (Approved 11/18/97)
3:00 PM Kathy Loncar called the meeting to order.
3:05 Minutes of October 21, 1997 were approved with minor corrections.Special Meeting on Health Care: Mike Paden was a guest presenter and Jill Reyes attended to answer questions.
The 1998 health plan. It was hoped that there would not be any changes this year, but Blue Care’s counter proposal made that impossible because of very significant rate increases and a decrease in benefits. Blue Care also indicated that if UMKC dropped its enrollment by 10% it reserved the right to increase fees by 10% in the next year. A survey was sent to 30 (out of 140) UMKC employees members to determine if employees would be willing to pay the increase in Blue Care fees. The consensus was that they would not want to pay for the increase. The decision was made to drop Blue Care and a letter was sent out Oct. 8th informing Blue Care customers that this option would no longer be available.
United Health Care came to UM representatives with a proposal for the health care network market that they have developed in this area. Several questions were addressed before considering United Health Care’s proposal: Is there any way we can improve the claims process? Can we increase the number of physicians’ hospitals available to customers? Can we improve on the cost to employees in such an arrangement? Mike remarked that that the answer to all of these questions was, yes. United Health Care’s network does not require referrals from primary care physicians and claims are processed directly instead of going through HealthNet. The United Care Select Plus currently offered will be changed over to United Health Care’s Choice Plus program. Select Plus customers will be automatically enrolled into the Choice Plus program. The one negative to the United Health Care Choice Plus program is the loss of Baptist and Menorah hospitals to the network.
The directories of all of the UM health plans will soon be available on the university's website.
Three are no changes to Humana health care plan other than a modest 1% in terms of gross premiums. This compares favorably to the POS plans which increased about 5%. Express Scripts will still be handling prescriptions. The POS and Catastrophic plans are self-insured. Mike explained that experience has shown the university that it is more beneficial to try to stay with standard models because there is less chance of errors in administering the health care programs.
Discussion turned to performance guarantees required of United Health Care. United Health Care was penalized $150,000 this past year for unsatisfactory performance in three areas of the claim process. Claims turn-around processing is still a problem. The goal is to have 85% of claims processed within 14 days. Mike is able to monitor this process through aged inventory reports. Many faculty members have to make personal visits after every doctor appointment in order to get claim problems straightened out. Robert O'Byrne & Associates continues to handle medical claim problems for UMKC and they have had quite a bit of success . Their number is 472-UMKC. This arrangement will continue and UMKC has a special phone line to Robert O’Byrne & Associates for this service.
There have been many complaints this past year concerning the denial of claims and the slow response time to fill claims. UM Central Administration is auditing United Health Care. There will be another employee survey sent out to determine how United Health Care is performing. Discussions are under way to determine where the university wants to go with health care in 1999. It is unclear if as to whether United Health Care is "over the hump" on its claims problems. If any employees have outstanding claims, or claims they’ve paid out-of-pocket, they can turn theses claims over to Robert O’Byrne & Associates so that employees can be reimbursed.
Currently, UMKC has 780 enrolled in the Select Plus program of United Health Care. Humana has an enrollment of 774 BlueCare has an enrollment of 145 and the Catastrophic program has 17 enrolled. The advantage of the Choice Plus program is that it has flexibility that allows a customer to go out of network. UM-wide, 88% of employees have chosen to use the university’s medical health plans. There is no way to predict whether the health industry will stabilize in the future. Central Administration is taking a hard look hard at other health care companies. The objective is to put into place an outcomes management tool and work on this process is just starting. Employees are still covered (out of network) if they travel outside of the country. Vision benefits are being targeted for January 1999.
Jill Reyes is scheduling open sessions next Monday and Tuesday to answer questions about health care. Sessions will take place in the School of Education and the Dental School. Enrollment forms have not been put into the packets for employees still under the BlueCare plan. There will be a follow up mailing to those enrolled in BlueCare with a form to change health care plans to either Humana or United Health Care. Enrollment forms are due in Jill’s office by November 21st.
Vision care may end up being a separate plan in the same manner as our dental care. There is also the possibility that vision care can be built into the medical plan as a basic benefit. It should be possible to get good discounts because of the large volume the university account would provide. There will be a twelve percent increase in the dental benefit premium this year. Dental coverage has traditionally been very inexpensive, but increasing premiums may be a trend in the future.
There will be no attendance recorded since this was a special meeting on health care.
Nancy D. Stancel
Secretary, UMKC Faculty Senate