image of a person's hand filling out an insurance claim

Benefits survey responses to help guide 2018 programs

More than 1,800 faculty and staff completed Case Western Reserve’s benefits survey this month, and on two points in particular, their consensus is clear: When it comes to out-of-pocket costs, they prefer predictability, and they are willing to spend more to keep the same services covered.

Officials launched the survey after determining that a combination of factors meant that those who participate in university health insurance plans faced average monthly premium increases of between 15 and 18 percent next year. Working with outside experts, Human Resources (HR) staff identified a handful of options to reduce expenses—some of which could be implemented as soon as the next calendar year.

Before finalizing plans for 2018, they wanted to hear directly from those using university plans about their preferences among available choices.

“While our immediate ability to constrain increases is limited by developments beyond the university’s control,” Vice President for Human Resources Carolyn Gregory said, “we did want to have a better understanding of the aspects of coverage most important to our community.”

These developments included increased usage of health care services by those covered under the university’s plans, and accelerating costs nationally for both treatment and prescription drugs. Officials are exploring additional measures to reduce costs and improve employee health, but those could not be implemented before open enrollment next month. This initial survey, then, focused primarily on subjects relevant to proposals for the 2018 calendar year.

The first question involving out-of-pocket costs focused on whether people preferred predictable expenses (for example, fixed co-pay amounts) or variable ones (for example, deductible and co-insurance payments). Of those responding, 92.5 percent favored predictability.

The other question that saw an overwhelmingly one-sided response involved participants’ preference between keeping out-of-pocket costs stable but reducing available services and keeping existing covered services and increasing out-of-pocket expenses for when individuals accessed that care. Just under 89 percent preferred the latter option.

Those taking the survey were more evenly split regarding premium costs and out-of-pocket expenses. Specifically, they were asked whether they would want to pay higher monthly premiums and keep out-of-pocket expenses (for example, co-pays, deductibles and the like) the same, or higher out-of-pocket spending and lower premiums. Roughly 55 percent opted for higher premiums, and 45 percent chose higher out-of-pocket costs.

The one change outside of direct employee costs that could be made in time for open enrollment would involve transitioning from two plan administrators to one—a move that would save the university roughly $800,000 a year. To date, the university has given employees the option to choose between Anthem and Medical Mutual (MMO). This summer, however, Medical Mutual and University Hospitals (UH) announced that UH Cleveland Medical Center and UH Bedford Medical Center now would be covered under MMO plans. The change means that if the university shifted to one plan administrator, more than 90 percent of those covered under the university’s insurance still would find all of their physicians or hospitals are in network.

Asked about such consolidation, 45 percent of respondents supported a one-administrator model. About 27 percent said their preference would depend on whether they were among the few who might have to change physicians. Just under 15 percent said they did not know, and just over 12 percent opposed going from two plan administrators to one.

Gregory said that HR staff and their outside consultants are now developing models for 2018 that take into account the key survey results. HR staff members also are holding town hall meetings to allow members of the campus community to learn more about the need for changes and options under consideration. The first session is Thursday, Oct. 19, from 10 to 11 a.m. in the Biomedical Research Building, Room 105; details about subsequent sessions will be announced as soon as they are available.