Daily Egyptian

Student insurance rates rise, causing students to pay more out-of-pocket fees

By Francois Gatimu

Student insurance rates for the next fiscal year are expected to rise due to increased healthcare costs following the approval of a new university insurance plan.

Ted Grace, director of student health services said in an Undergraduate Student Council meeting March 28 that SIU’s insurance provider moved to pass a new insurance plan, which cut benefits and raised deductibles.

The new plan was discussed at a Graduate and Professional Student Council meeting on Feb. 8, when Sheena Hart, a Student Health Advisory Board member, said the university’s current health insurance provider informed the administration of fewer enrollees in the insurance plans because of declining enrollment.

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“It’s really unfortunate that they are cutting the coverage because I’ve had to rely on its benefits all throughout my freshman and sophomore year,” said Alicia Mayen, a senior studying history. She said she chose to opt out of the school insurance this year to find better coverage.

Mayen sees the rising insurance costs as “a big turn off” for prospective students.

“If you’re a student with a disability or some kind of chronic illness, it’s kind of like the university is saying, ‘screw you,’” Mayen said.

Gallagher Student Health, the contractor company that helps identify the cheapest insurance options, determined the best course of action would be to purchase a lower-quality plan.

Pharmacy copay tiers have seen an average increase of 64 percent with the new plan, now including an office visit copay of $20 that was previously free. There will also be a $100 rise in deductibles of the in-network fee.

Graduate and professional students are more affected by the changes, even though undergraduates make up the vast majority of those covered under the school’s insurance, Grace said.

“Graduate students have the option of either SIU’s or the state’s exchange insurance under Obamacare, which last year was three times more expensive,” Grace said.

The premium would have increased by 30 percent starting this year, but the school rejected this proposal, opting for a lower plan with a better price of $675 per semester, Grace said.

By downgrading the plan, the university was allowed a lower premium, but it was at the expense of many of the previous benefits.

Besides the $50 increase in semester premiums, other major changes include in-network maximums increasing by $6,050 and out-of-network maximums increasing by $13,000.

In-network maximums, which have seen the largest increase, work on a percentage basis with those covered liable to pay out-of-pocket for 20 percent of the $7,150 total.

”[The in-network fee] sounds like a lot of money, but you don’t get near that amount unless you have a really catastrophic event,” Grace said.

Additionally, the $150 emergency room copay — which was previously free — was added, but it could be waived if admitted to the hospital, Grace said.

“With rising medical costs the change in plans was a result of the insurance company receiving numerous high claims,” Grace said.

Grace said high claims were recorded at $3.7 million for 2016, with surgery being the biggest expenditure at $1.8 million.

The student medical benefit is composed of the student health fee, which had seen little change, and student insurance fee, which is to incur most changes.

The student insurance fee covers health care outside the student health center and is refundable to students with independent insurance.

Staff writer Francois Gatimu can be reached at [email protected] or on Twitter @frankDE28.

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