College of Kentucky Health Benefits Task Force Preliminary RecommendationsSlide 2
Overview Core Recommendations 1. Increment University commitment to medical advantages in Fiscal Year 2003 (July 1, 2002-June 3, 2003) 2. Set a 5-year objective of financing 90% of individual, couple, representative child(ren), and family scope under an assigned wellbeing arrangementSlide 3
Overview Core Recommendations 3. Offer a lower advantage alternative at worker rate no less than 20% lower than UKHMO 4. Recognize elective advantage outlines that better address the issues of Medicare-qualified retirees.Slide 4
Overview Core Recommendations 5. Right UKPPO arrangement outline issues that cause sudden out-of-pocket costs 6. Extend geographic scope and improve systems of UKHMO Regional and UKPPO. 7. Address UKHMO get to and benefit issues.Slide 5
Overview Additional proposals 8. Make medical advantages more impartial for workers outside focal Kentucky. 9. Investigate the alternative of offering a high choice arrangement with a more compre-hensive statewide system than is as of now accessible.Slide 6
Overview Additional suggestions 10. Research expense and attainability of specific changes to wellbeing arrangement plan 11. Give relative budgetary backing to College of Pharmacy proposition to maintain a strategic distance from superfluous increments in professionally prescribed medication costSlide 7
Overview Additional suggestions 12. Bolster Wellness Program proposition for preventive administration investigation, health activities, and enhanced part training 13. Upgrade UK benefits office limit for client administration and administrationSlide 8
Overview Additional proposals 14. Qualification issues: Make qualified residential accomplices qualified for scope and investigate expense of some commitment for those working 20 or more hours/weekSlide 9
Core RecommendationsSlide 10
1. The University ought to expand its backing for medical advantages in Fiscal Year 2003 (July 1, 2002-June 30, 2003). Center RecommendationsSlide 11
Core Recommendations: Increased backing a. Notwithstanding typical financing increment for swelling, reserve $5 million in net general asset dollars and proportionate sum for representatives with wellbeing credit from different sources, assessed complete $9.6 million. Utilize a few assets to enhance current advantage structure, yet dominant part to expand University\'s commitment.Slide 12
Core Recommendations: Increased bolster Use a few assets to enhance current advantage structure as per taking after suggestions, yet greater part to build University\'s commitment.Slide 13
Core Recommendations: Increased bolster b. For FY 2003, No worker commitment increment for any UKHMO family arrangement level; Employee commitment to UKHMO representative child(ren) and family levels ought to diminish.Slide 14
Core Recommendations: Increased bolster c. Family sythesis level proportions: Employee in addition to child(ren): 1.5 times representative just rate Employee in addition to mate: 2 times worker just rate Employee in addition to companion and child(ren): 2.5 times worker just rate These proportions for the most part reflect standards among the University\'s benchmark foundations.Slide 15
Core Recommendations: Increased backing These proportions for the most part reflect standards among the University\'s benchmark foundations. Current family:single proportion is 1:2.79.Slide 16
Core Recommendations: Increased bolster d. In FY 2003, with the adjustment in family sythesis level proportions, keeping a uniform commitment will move the University towards the 90% commitment objective, yet in future years, subordinate scope will require a higher business commitment.Slide 17
Core Recommendations: Increased bolster e. Minority report: three team individuals bolster a pay diminishment of 0.5%-1% to give more needy premium backing in FY 2003. A pay diminishment of 1% is evaluated to raise the business commitment to family scope to more than 70%.Slide 18
Core Recommendations 2 . The University ought to set an objective of financing 90% of individual, couple, representative child(ren), and family scope under an assigned wellbeing arrangement inside 5 years. The present middle institutional backing of HMO family premiums in our benchmark organizations is 89.1%.Slide 19
Core Recommendations: 90% in 5 years a. Notwithstanding typical financing for medical advantages, one rate purpose of assets accessible for raises ought to be made accessible for this reason until it is accomplished. b. By no means ought to representative just scope be supported at under 90%.Slide 20
Core Recommendations: 90% in 5 years c. After FY 2003, accomplishment of the 90% objective will require University commitment to the expense of ward scope that is higher than the commitment for worker just scope.Slide 21
Core Recommendations: 90% in 5 years d. The University ought to screen benchmark medical advantages to keep up equality amid and after the accomplishment of 90% financing.Slide 22
RATIONALE *Inadequate subsidizing of ward scope has blocked enlistment and maintenance at all levels. *Inadequate financing has likewise brought on numerous representatives to drop scope of their wards, making the rest of the gathering more established and less solid.Slide 23
RATIONALE *The current budgetary circumstance of the University and the state makes quick accomplishment of this objective farfetched. *Reaching the 90% financing level is basic to the University\'s objective of turning into a top examination foundation.Slide 24
Core Recommendations 3. The University ought to offer a lower advantage alternative at a worker premium rate no less than 20% lower than UKHMO with a specific end goal to give more moderate ward scope before the 90% contribu-tion level is accomplished.Slide 25
Core Recommendations: Low Option a. Use oversaw care methodologies as opposed to fundamentally higher copayment levels to keep away from over-use. b. Potentially permit out-of-system usage at high out-of-pocket cost, for example, half coinsurance.Slide 26
Core Recommendations: Low Option c. Force yearly or lifetime advantage limit. d. Potentially bar a few advantages that are presently secured. e. Limit sway on expense of watch over youngstersSlide 27
Core Recommendations: Low Option f. Force copayment for grown-up outpatient essential consideration supplier visits other than yearly preventive consideration visit to dishearten superfluous doctor office visits, bring down the expense of the arrangement, and counterbalance the expense of different advantages that have been held.Slide 28
Core Recommendations: Low Option g. This offering would vanish when equality with benchmarks is accomplished at the 90% boss commitment level.Slide 29
Core Recommendations 4. The University ought to recognize elective advantage outlines that better address the issues of Medicare-qualified retirees. a. Keep on contributing the same dollar add up to retiree scope as to worker just scope.Slide 30
Core Recommendations: Retiree Coverage b. Investigate approaches to lower retirees\' presentation to high out-of-pocket expenses for professionally prescribed medications c. Hold security against catastro-phic budgetary misfortune. d. Hold scope for therapeutically fundamental and preventive administrations not secured by Medicare.Slide 31
Core Recommendations: Retiree Coverage e. Investigate impact of actuarially appraising Medicare-qualified retirees independently from the dynamic worker bunch. f. Bolster arrangement of a retiree to the University\'s Employee Benefits Committee.Slide 32
Core Recommendations: Retiree Coverage g. Bolster surviving life partners\' scope at the same rate as family scope for dynamic representatives, i.e., up to 90% backing when that level is accomplished for family scope.Slide 33
Core Recommendations 5. Redresses to UKPPO arrangement outline a. 100% scope of screening mammograms after $20 copayment b. Scope of research facility administrations with an outpatient visit at same level whether the administration is performed by a lab grouped healing center based or outpatientSlide 34
Core proposals 6. System extension and improvement a. CHA Health system (for UKHMO Regional Service Area), and Humana system (for UKPPO) ought to be urged to grow to new districts and add to systems in regions as of now served so that whatever number real clinics as could reasonably be expected are incorporated.Slide 35
Core suggestion: Network extension b. Particular guidelines ought to be set for system ampleness and it ought to be evaluated deliberately in future arrangements.Slide 36
Core suggestion: Network extension c. Favored taking an interest drug stores issue Need to give different workers measure up to doctor prescribed medication advantage Kroger, Kentucky Clinic, Appalachian Regional Healthcare accessible in just 45 areas and restricted in 3 moreSlide 37
Core suggestion: Network development Alternatives: make favored taking part drug stores accessible inside a sensible driving separation, or postpone the extra $5 copayment at partaking non-favored drug storesSlide 38
Core proposals 7. UKHMO issues Access to essential consideration doctors: decide proportion of essential consideration supplier arrangement hours to grown-up and tyke participation set objective and timetable for development, utilizing national gauges join as a part of ensuing UKHMO contracts with the UniversitySlide 39
Core suggestions: UKHMO issues b. Screen essential consideration and forte facilities for opportuneness of patient consideration both time to get an arrangement and holding up room time report issues and revision arranges quarterly to the Employee Benefits CommitteeSlide 40
Core suggestions: UKHMO issues c. Yearly nature of consideration self-appraisal report to University organization and the Employee Benefits Committee utilizing the National Committee for Quality Assurance\'s Health Plan Employer Data and Information Set (HEDIS) as a modelSlide 41
Core suggestions: UKHMO issues d. The Benefits Office ought to play out a yearly UKHMO part fulfillment review and answer to the Employ
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