Friday, September 21, 2012

Lutecare: With federal mandates in a state of change, Pacific Lutheran University is forced to redefine health care for students

By Amelia Heath, Focus Editor

The hot-button issue of health care in the nation’s capital has now hit close to home.

Near the end of spring semester last year, the Office of the President announced that Pacific Lutheran University would no longer offer hard-waive health insurance to students. In its place, the university created the Wellness Access Plan, at a mandatory fee of $300 per student each year. The plan was created by Sheri Tonn, vice president of finance and operations, Laura Majovski, vice president of student life and dean of students, Matt Freeman, director of the health and counseling centers, as well as Chris Rice, fitness center coordinator, Erin McGinnis, director of dining and culinary services and Laurie Turner, director of athletics.

Tonn said PLU’s previous health insurance plan made no money for the university because almost everything was paid out in premiums. With the Wellness Access Plan, the insurance purchased by the university is self-funded. With claims that have a lower cost than the insurance premium, Tonn said, "we could actually get some of that money back" and build a reserve for claims that cost more than the premium. A little more than fifty percent of the student fee goes to the self-funded program and the rest goes to new wellness and nutrition programs.

The plan was created in a little more than one month. Tonn said the university had anticipated an extra year to create a health care plan to meet the requirements of the U.S. Affordable Care Act, but on March 16 learned that the U.S. Health and Human Services office had denied the waiver requested by the College Health Association. Students received an email from the Office of the President April 26 with a general description of the plan.

President Barack Obama signed the Affordable Care Act into law March 23, 2010. Under the act, companies offering health care plans must meet certain federal requirements in order to label the plan as "insurance." These requirements will continue to change, covering additional benefits until 2014 or 2015. If PLU were to amend its previous insurance program to meet these requirements, Tonn said, the program would cost students at least $1,600 for the 2012-2013 academic year and continue to increase as the federal mandates changed. Freeman said the hard-waiver program offered last year cost students around $400 and was "limited" in the sevices it covered.

The Wellness Access Plan provides students with free visits to the Health Center and removes charges for students for services provided at the Health Center, including physical examinations, tests, treatments and travel examinations. If a student must go elsewhere for a service, that student can use their primary insurance, bring the receipt to the Health Center and receive reimbursement for the copay or deductible charged. Freeman said taking away service fees will encourage students to get the tests and treatments they need.

In addition to supplementing a student’s health insurance, the plan provides students with other services not covered by traditional insurance. The university will now offer more nutritional and wellness education, workout classes, fitness consultations and new equipment in the Names Fitness Center. Equipment in the fitness center may now be replaced on a three-year cycle. Old equipment that is still in good shape will be moved to South Hall.

Emily Edison, owner and founder of Momentum Nutrition and Fitness in Seattle, will provide nutritional workshops and one-on-one consulting to students starting next week. Edison received her Master of Science in human nutrition with an emphasis in sport nutrition at Marywood University in Scranton, Pa. and is a member of the American Dietetic Association. She has consulted for the PLU athletic department in the past.

The Wellness Access Plan is intended to supplement a student’s primary insurance. However, some students on campus do not have primary coverage. Students without insurance will not be charged for services at the Health Center and may be reimbursed for out-of-pocket costs if they need to go off-campus for service. Still, Tonn encourages students without primary insurance to use the Health Center website as a resource to find an insurance program that works for them. The majority of these plans are age-based, meaning traditional students will be able to find programs with lower rates than people who are in their forties or older.

Freeman said the creators of the Wellness Access Plan "didn’t want to shock people," but students and their families expressed confusion and concern when the plan was first announced in April.

In hindsight, Majovski said, benefits of the plan could have been better emphasized.

"When we realized that people had more questions that we hadn’t addressed," Majovski said, "we went back and addressed them again and came out with a second communication back out to students and families."

Freeman said he sat down with families who came to him to explain the plan.

"It just takes time to understand all of that and to explain it," Freeman said. "As much as we’ve tried to get the word out in all of these different ways, health insurance is really confusing."

Now that more information is available, students are more willing to embrace the plan.

"I think the new health care plan is a great system," first-year Matt Cruz said. "It feels great to know that I don’t have to worry about any fees or copays whenever I wish to visit the health center."

The university will evaluate the plan at the end of the fall semester and decide on any changes before the end of spring semester. Due to the nature of the plan and the services provided, it will most likely remain a mandatory fee for students.

Guest writer Ashley Gill contributed to this article.