UHP Newsletter by xumiaomaio


									                             UHP Newsletter
     September 2011
     Volume 1, Issue 2

University Health        Mandated Contraceptive Coverage
Plans, Inc.              On August 1, 2011, the Department of          Currently, 28 states require contraceptives
(800) 437-6448           Health and Human Services (HSS) issued        to be included in a plan’s prescription
                         interim final regulations on preventive       coverage. Of those, over half allow
                         services to be covered under PPACA. The       contraceptives to be excluded from
                         new regulation adds several women’s           coverage for employers of religious
                         health services to the list of preventive     organizations.
                         services that will need to be covered
In This Issue:           without cost-sharing.                         The HHS regulation based its definition of a
                                                                       religious employer on legislation from those
 Contraceptives      1   The Institute of Medicine (IOM) conducted     states in an effort to “reasonably balance
 MA SHP Report       2
                         a study of preventive services for women      the extension of any coverage of
                         that have been proven to be effective for     contraceptive services under the HRSA
 State MLR Waivers 2     conditions that can affect a broad            guidelines to as many women as possible,
                         population of women and have a significant    while respecting the unique relationship
                         and potentially negative impact on a          between certain religious employers and
                         woman’s health and well-being. The study      their employees in certain religious
                         resulted in a list of eight recommended       positions.”
                                                                       It does not seem as though this definition
                           • Well-woman visits                         can be applied to student plans, as the
                           • Human Papillomavirus (HPV) testing        students are not employees of the school.
                           • Sexually Transmitted Infection (STI)
                             counseling                                The contraceptive methods and counseling
                           • Couseling and screening for human         to be covered without cost-sharing include
                             immune-deficiency virus (HIV)             “All Food and Drug Administration approved
                           • Gestational diabetes screening            contraceptive      methods,       sterilization
                           • Breastfeeding support, supplies, and      procedures, and patient education and
                             counseling                                counseling for all women with reproductive
                           • Contraceptive methods and                 capacity.” A common concern has been: If
                             counseling                                there is no cost-sharing for these services,
                                                                       who is going to pay for them? HHS,
ANNOUNCEMENT:              • Screening and counseling for
                                                                       however, “expect[s] that this amendment
                             domestic/interpersonal violence
UHP’s article, “How                                                    will not result in any additional significant
Health Care Reform                                                     burden or costs to the affected entities.”
Really Affects Student   These services make up the HRSA
Health Plans”, was       Women’s Preventive Services Guidelines.
printed last month in
                                                                       UHP analysis indicates otherwise. At one of
                                                                       our schools, for example, prescription co-
the URMIA Journal        Insurance plans (including student plans)
                                                                       pays for contraceptives through 10 months
2011.                    that begin on or after August 1, 2012, will
                                                                       of claims amounted to $42,000. This
                         be required to cover these recommended
                                                                       number is projected to reach $50,000 for
                         women’s health services with no cost-
                                                                       the 12 month policy year. Roughly 2,300
                         sharing. Opponents of the regulation are
                                                                       students at this school purchased the SHP.
                         concerned mainly with the contraceptive
                         requirement, due to both financial and
                         religious concerns.                                             Continued on Page 2

                                                                                                          Page 1 of 2
 UHP Newsletter                                                                                   September 2011

Mandated Contraceptive Coverage
Continued from Page 1
The elimination of contraceptive co-pays          When the insurance company includes its          University Health
would result in an additional claims cost per     retention (25%), the cost to eliminate
student of $22 ($50,000/2,300 = $22). The         contraceptive co-pays at that school will           Plans, Inc.
insurance companies will include a factor for     increase further to approximately $34 per
increased utilization (15%), inflating the        student.
claims cost to $25 per person.

Massachusetts SHP Annual Report 2009-2010
The Massachusetts Division of Health Care        More than 25% of full-time and ¾ full-time
Finance and Policy (DHCFP) published their       students in Massachusetts enrolled in a SHP            ADDRESS:
annual report this month on Student Health       for the 2009-2010 policy year. Of those            1 Batterymarch Park
                                                                                                     Quincy, MA 02169
Programs for the 2009-2010 policy year.          108,000 students enrolled in a SHP for the
                                                 2009-2010 policy year, only 7 exceeded their             PHONE:
Annual SHP premiums in MA ranged from            plan’s maximum benefit. None of the                   (800) 437-6448
$325 to $6,143 and averaged $1,294 per           students who exceeded their maximum
student.                                         benefit had a plan maximum of over                         FAX:
                                                                                                       (617) 472-6419

More States Requesting MLR Waivers

Since our last newsletter, five more states      meet the 80% MLR requirement.
and Guam have applied for an adjustment of
the 80% MLR requirement, bringing the total      To date, North Dakota is the only state
number of appeals to fifteen.                    whose MLR waiver application has been
In addition to Maine (whose MLR waiver we
discussed in the last newsletter), New           The MLR waiver applications submitted by
Hampshire, Nevada, Kentucky, and Iowa            the following states are still under review:
have been granted adjustments. Nevada            Florida, Georgia, Louisiana, Kansas,
and Kentucky are expected to meet the 80%        Delaware, Indiana, Michigan, and Texas.
MLR requirement beginning in 2012, while                                                           We’re on the Web!
New Hampshire and Iowa have until 2013 to                                                                See us at:
About Our Organization…
University Health Plans (UHP) is a leading       We specialize in managing student health
benefit brokerage/consulting firm specializing   insurance programs, in addition to offering
in the design, brokerage, and service of         ancillary programs such as sports and travel
College and University student health            assistance. Student health insurance is our
insurance programs.                              only line of business so we devote 100% of
                                                 our energies and resources to ensure cost
Using a team approach, UHP currently
                                                 effective student health insurance with
manages the student health insurance
                                                 superior customer service.
programs for over seventy-five colleges and

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