This morning the Division of Health Care Finance and Policy held a public hearing on proposed regulations which would increase reporting and disclosure requirements for student health insurance plans. The room was packed with students, advocates and other stakeholders who testified with concerns, questions and requests regarding the student health plans.
Theresa Koster from Gallagher Koster, a student health plan broker, spoke in opposition to the proposed regulations and her testimony contradicted some of what the students would later say about how the plans work. She stated that mandating schools to pro-rate premiums would add additional operational costs and intimated that this would lead to higher costs being passed on to the students. She also challenged the need for increased disclosure requirements, claiming plan information is already available to students, which was expressly contradicted in the students’ testimony. Koster explicitly asked what the purpose is in having all of this information reported since they adhere to quality standards and work very closely with their clients – the schools – to give the best benefit packages they can to the students.
The most compelling and truly sad testimony came from several students from the Student Health Organizing Coalition (SHOC). They represent a group of college students passionate about improving their health plans often because they had negative experiences with their student health plans. The students emphasized the inadequacy of the proposed regulations to address concerns with the structure of student health plans. The students shared horror stories of their struggles obtaining medical care and medications for diabetes, mental illness, tumors, endometriosis and other chronic conditions, forgoing necessary care and unknowingly racking up medical debt. The students called for increased accountability, higher standards, more transparency and a seat at the table during the insurance selection process. They emphasized that ‘affordability does not just mean lower premiums’ and that students should not have to choose between their education and maintaining health coverage.
Stephen Beckley, a student health insurance consultant, testified to express serious concerns with student health plans. Criticizing the plans as “horrifically inadequate,” he advocated for increased student education and more affordable, higher quality plans, which he says are possible. He asked that plans comply with the American College Health Association standards, which go a long way towards addressing the students’ concerns.
Andrew Cohen, from our ACT!! partner organization The Access Project, expressed appreciation for the reporting and disclosure requirements and raised several concerns about the structure and governance of student plans. He echoed the concerns raised by the students in their testimony and offered some solutions to the problems they raised. Cohen asked that students be provided with standardized, clear information about their coverage and the process for filing grievances. He requested that each campus designate a staff member to handle concerns that students will have with their coverage. Andrew also asked for information about the number of students who exceed per service and benefit caps, the number of students using Health Safety Net as wrap coverage and the costs, and details about brokers that contract with schools.
The ACT!! Coalition weighed in to express our support for the proposed regulations and briefly discussed our concerns with the inadequate coverage and unaffordable cost-sharing in many student plans. For more details check out our post on WBUR’s Commonhealth blog.
If you would like to learn more or get involved in student health plan issues please contact Catherine Hammons at chammons@hcfama.org.
Catherine Hammons
Great information on the QSHIP improvements. Student Health Insurance is a huge issue that may students don’t know or care about. Getting to word out on options is really the most important thing for students. They need to know what their options are when in school.
Gallagher Koster is, by far, the WORST health care plan I have ever had in my life. They did not live up to ANY of the promises outlined in their written contract.
After I had paid the entire balance in full, I was unable to obtain ANY contact with Gallagher Koster. I spent more time negotiating with their claims company, Klais & Co,than was necessary. Gallagher Koster did not reimburse, partially reimburse, or even acknowledge any of my routine doctors visits or required vaccinations for full-time graduate studies (as they had promised in their contract). Hence, I was stuck with the entire bill AFTER I had paid the entire (Gallagher Koster) prepaid balance.
What a waste of money! I really hope you improve your business strategy for Gallagher Koster’s sake.
A satisfied customer typically refers five new prospects on average. An unsatisfied customer dissuades nine.
Sincerely,
Anna C. Balch
Shown below is the email I shared with the members of the Lookout Mountain Group (www.lookoutmountaingroup.net) regarding the comments I made yesterday. Please contact me at Beckley@HBC-SLBA.com if you would like more information regarding my personal perspective on ACHA’s standards or the Looktout Mountain Group.
The testimony from students yesterday was straightforward, compelling, and well-reasoned. I am hopeful for a positive end-result for health care access for students in Massachusetts.
TO: Lookout Mountain Group:
Subject: A Good Day for Health Care Reform in Massachusetts — Sad Day for College Health/Student Affairs
Hello all,
Earlier today I attended a public hearing in Boston at the Division of Health Care Finance and Policy (see article below). The Commonwealth of Massachusetts has been working since last fall to reconsider the QSHIP regulations (first put in place in 1989) for mandating students have health insurance and specifying the benefit levels student insurance plans must provide. The Cuomo investigation and substantial protests from students seem to be the impetus for this review.
The usual litany of agents and insurance companies were represented. (Paraphrasing) They do not like the idea that colleges will have to report the financial results of their programs or that students should have comprehensive health insurance since it will be “unaffordable.” There were also a large group of students in the room and representatives from various health care advocacy organizations. The students did an amazing job of presenting the severe problems they have encountered from inadequate student health insurance coverage that meets the minimum QSHIP mandates.
After the students spoke (10 of them), I provided comment, not representing any clients or other entities — solely my personal opinion. I began by saying that it is arguable that the QSHIP regulations over the past 20 years, with deference to the good intentions of policymakers and others, probably did more harm than good because: (1) the limited benefits created a safe harbor, both legally and ethically, for college administrators to respond to complaints about limited coverage by saying their plans comply with state mandated coverage; and (2) there are undoubtedly numerous students/parents who enrolled in student insurance plans who would have otherwise purchased real insurance. In regard to this last point, many of the severe limits of student insurance plans in Massachusetts are not readily apparent to students/parents (e.g., a plan with a $75,000 maximum benefit is not likely to provide anywhere near this level of coverage if it has a $2,000 limit on total outpatient care).
After I spoke, a representative of a health care assistance fund reported that 25% of their applicants in the Boston area are students. He excoriated the colleges and universities for endorsing such woeful coverage and leaving students with limited ability to obtain necessary health care services. He rightfully asked many challenging questions of college administrators (e.g., what kind of agent commissions are involved with these programs?).
The overall day was high testimony to how bad things could be if we end up at the national level with health care reform that features a “low cost/low benefit” program for young adults. I know there are others who strongly disagree, but I would have loved for everyone who thinks “universal coverage first – quality second” to hear the students who spoke today in Massachusetts. The good news is that the public testimony was transcribed and will be available in early May.
What was most sad about today’s public hearing is that there were no speakers who were college health or student affairs professionals. Two risk managers were, as far as I could tell, the only direct representatives of colleges and universities in the room. The eloquent statements of the students not being acknowledged or supported by college health and student affairs professionals was profoundly disappointing. I cannot help but think that lack of attention by college health and student affairs professionals is the most important underlying cause for the widespread deficiencies for student health insurance plans and the large uninsured/under-insured student population.
There are a several colleges and universities in Massachusetts that have health plans that fully comply with ACHA’s standards. These institutions should rightfully take full credit for spending the time and resources to provide effective and appropriate health insurance plans for their students.
Please let me know if you have any questions. The Division of Health Care Finance and Policy is also accepting written comments following the public hearing earlier today.
Best regards,
Steve Beckley
My name is Dena Greenblum and I am a college student in MA and a member of the Student Health Organizing Coalition, known as SHOC. The Student Health Organizing Coalition is a community organizing initiative that seeks to improve student health insurance throughout the Commonwealth by unifying students who have experienced problems with their QSHIP plans and all those who sympathize with the cause. We testified at today’s hearing because the proposed changes to QSHIP regulations are inadequate. Our organization was founded in the summer of 2008 and has become effective in outreach to universities, state agencies, and students themselves.
Until this point, students have had little input in the rules and policies that govern student health insurance. Right now, there is also a bill addressing QSHIP in the legislative Committee on Higher Education. We feel it is very important that students had the opportunity to build power for the student voice in decision-making on student health insurance.
I am adamant that current QSHIP plans need to be more affordable, more comprehensive and demand higher standards from insurance companies. SHOC members certainly appreciate that the Division of Health Care Finance and Policy seeks to take steps to collect more information about the current state of student health insurance (as in section 3.07) and to enhance education of students in regard to the specificities of their plans (as in section 3.04.06). However, these metrics can not measure the many students who forgo medical care due to its high costs under their minimal plans. We feel that it is clear right now that QSHIP plans are not quality insurance products. We want to find out more about exactly how the DHCFP plans to respond to the new information they collect as well as what we already know.
At the hearing, we shared examples and personal stories, as well as their implications for changes in regulation and policy. Our first panel demonstrated the way that caps and exclusions make student health insurance unaffordable for those who need it most. Our second panel demonstrated the need for improvement in the education of students about their plans as well as enforcement of stricter standards of insurance company practices.
We appreciate the opportunity to be a part of the process to improve student health insurance, and we believe that the time is now for substantive action that goes beyond the current proposals.