Although some students have expressed discontent with the College health plan's lack of routine eye and dental care, the Dartmouth College Student Group Health Plan remains competitive in the health insurance market, according to College Health Services Director John Turco.
If the basic Dartmouth health insurance plan which began covering enrolled members of the Class of 2016 on Aug. 1 extended to cover dental and eye care, the majority of students would have to pay higher premiums for services they do not need or use, Turco said. Providing supplemental options to only those students needing additional services would increase the premiums significantly for those students.
"We anticipate that such a small number of students would purchase this supplement that the extra premium would be extremely high," Turco said.
Keri Wolfe, a third-year MALS student who recently switched from her parents' private insurance company to Dartmouth's plan, said that the student health plan will cost her more due to co-insurance and deductible payments.
"For basic prescription and basic care what most students will need it's not bad," Wolfe said. "I do think that it could be problematic if you are a student who needs to utilize more of the health care and have no other option than the student plan."
Having received eye care coverage under her parents' insurance plan, Wolfe said she would like the College's policy to include eye and dental.
Dental insurance, however, is a "misnomer," according to Turco, who said it does not function like other insurance plans. Typical insurance plans depend on insurance beneficiaries having low chances of needing coverage, and insurance plans that do cover dental care maintain relatively low caps.
"To a large degree, it's a pre-payment plan," he said. "They know you are going to need regular dental care, so it's not like real insurance because you pay a lot up front."
Medical dental issues resulting from accidents are covered by the plan, Turco said. Similarly, while routine eye care is not covered, insurance does cover accidents and eye diseases.
While discussions regarding the policy have included subsidizing of eyeglass purchases, such a change would require the entire student population to subsidize glasses for only a small number of students, Turco said.
The College's student health insurance offers more competitive benefits than plans offered at other colleges when premiums, benefits, deductibles and health plan rules are taken into account. With some exceptions, the Dartmouth insurance plan charges a $2,006 premium fee, $200 deductible for in-network providers, $50 deductible for prescription drug coverage and 20 percent co-insurance for in-network provider care. Excepting deductible payments and an out-of-pocket limit of $1,000 for in-network providers, the insurance plan covers all expenses, including prescription drugs and hospital care.
Medical centers become in-network providers after the College "buys into" a company called Multiplan to negotiate with medical centers to charge less for medical services in exchange for patient referrals, Turco said. Students who seek care from out-of-network providers pay $400 in deductibles and 30 percent co-insurance.
The Dartmouth Student Group Health Plan is less expensive than many plans available in the Ivy League and other institutions. Brown University, for example, offers students annual eye exams and discounted prices for eyeglasses and contact lenses, but requires students to pay an annual premium of $2,861 and up to $400 in deductibles. Similarly, while Harvard University has no co-insurance requirements, Harvard students are charged a $3,098 annual premium and co-payments for every provider visit.
The 10 universities in the University of California system merged their insurance plans two years ago into a single plan called University of California Health Insurance Plan, which is administered by Anthem Blue Cross, according to UC Berkeley public information officer Kim LaPean. The plan insures approximately 65 percent of undergraduates and more than 90 percent of graduate students at UC Berkeley alone. Students pay $1,782 in annual premiums on the undergraduate level and $2,306 on the graduate level.
The University of California insurance plan requires $15 co-pays for office visits, co-insurance payments between 10 and 20 percent and a $3,000 out-of-pocket maximum. While the plan provides some dental insurance, the maximum amount covered by insurance annually is $1,000.
"We never want health care cost or lack of access to health care or health care insurance to be reason that students can't pursue their academic career," LaPean said. "Look at it as an important part of being academically successful to be healthy and not worry about the impact of some catastrophic health incident."
After she tore a ligament, Heather Beatty '13, a member of the varsity ski team, received coverage for surgery through her Dartmouth plan in a co-insurance arrangement. Beatty said her college insurance plan provided better coverage than the universal health benefits in her native Canada.
"I had surgery within two weeks of when the accident happened, and I felt very fortunate to have coverage here," Beatty said. "I would have had to wait six months for surgery in Canada, and I wouldn't have been able to compete this year."
In the past few decades, an increasing number of students have sought coverage under the Dartmouth insurance plan as private insurance premiums have increased dramatically, Turco said. According to the Kaiser Family Foundation's Employer Health Benefits 2012 Annual Survey, average premiums for family coverage have increased by 97 percent since 2002. However, Dartmouth's premiums have been rising by 1 or 2 percent because the College utilizes reserve funds from previous years to prevent dramatic rises in premiums, Turco said.
Currently, around 50 percent of undergraduate students and more than 80 percent of graduate students are enrolled in Dartmouth's insurance plan.
"Over the last 10 to 15 years, our plan has become more and more popular," Turco said. "The reasons for increasing undergraduate enrollment include a very competitive premium that has not risen as fast as other plans, less favorable family plans offered by parents' employers and the fact that our plan can be used everywhere including out of the country."
Because Dartmouth's insurance plan is self-funded, the plan does not make a profit, and all excess premium payments are stored as reserves for future claims. Previously, the College purchased stop-loss insurance, a safety measure that covered claims exceeding available funds.
Since the passage of the Patient Protection and Affordable Care Act of 2010, students have been able to retain family health care coverage until the age of 26. Turco said that the College anticipates a slight decrease in undergraduate enrollment in the health insurance plan given the federal legislation, but this information is not yet available.
All students are required to have health insurance, either under Dartmouth's plan or private plans that meet the College's parameters, Turco said. Students unable to afford insurance receive the necessary support via financial aid.
