Changes to the Dartmouth Student Group Health Plan for the 2014-15 academic year will include higher medical deductibles and out-of-pocket maximums for both in-network and out-of-network services, in addition to an increase in the co-payment students must pay for emergency room services.
The total cost of the student plan with no dependents grew to $2,435 for the 2014-15 year from $2,187 in 2013-14. This 11 percent increase comes on the heels of a 9 percent increase from $2,006 in 2012-13 — a 21 percent total increase in two years.
Cost for plans with one or multiple dependents also grew 11 percent, to $4,129 and $5,900 per year respectively.
Under the new plan, individuals must pay a $250 deductible for in-network claims, $50 more than under the previous year’s plan. The family deductible grew by $100 for in-network claims, while individual out-of-network claims increased by $100 and family out-of-network claims increased by $200.
The cost of the out-of-pocket maximum for both in-network and out-of-network claims doubled for individuals as well as families.
Even after the recent price increases, assistant vice president for finance Tricia Spellman said, the plan is still in the platinum-level category as defined by the Affordable Care Act, which means that the plan covers 90 percent of the actuarial value of health care expenses. From the consumer’s perspective, a platinum plan will have higher premiums but lower co-pays, co-insurances and deductibles.
An advisory committee convenes to discuss the state of the health plan four times a year and implements necessary changes once a year, Spellman said. The committee includes Spellman, health services co-directors Jack Turco and Mark Reed and representatives from various campus bodies, like the Deans Office and the risk and internal control services office.
The committee submitted recommendations to Dean of the College Charlotte Johnson earlier this year, who subsequently finalized the changes to the plan, Spellman said. One of these changes was the decision to increase cost-sharing for the upcoming plan year to keep the annual premium rate at an affordable level for students, she said. Cost-sharing includes expenses paid out-of-pocket, including deductibles and co-payments.
Over the 2013-14 plan year, she said, the committee witnessed increased spending on claims, which thus required a higher premium. The committee increased cost-sharing so that the premium rate would grow by 11 percent as opposed to 14 percent, which would have been the case in the absence of such a change, she said.
Due to an overall trend toward higher claims, Spellman said, the recent increase in cost-sharing does not constitute an unusual move.
Spellman noted that the changes for the new plan year have all been to pricing, not to benefits actual benefits, with the exception of the addition of pediatric, dental and vision coverage for individuals or dependents under the age of 18. This coverage is a requirement under the ACA.
In recounting other significant changes that have been made to the plan in previous years, Spellman said that around the time of the 2012-13 plan year, the committee decided to eliminate the lifetime maximum and enhanced the coverage of preventive care items like contraceptives, both in accordance with the ACA.
She added that the committee launched a dental program for the 2013-14 plan year, based on the feedback from undergraduate and graduate students. The program provides a discount to insured students when they visit the dentist.
The cheapest available annual student plans across the other Ivy League schools cost an average of $2,513, according to the latest information available, which puts the average about 3 percent higher than Dartmouth’s plan.
Spellman said that the committee analyzes the other Ivies’ plans each year to establish appropriate benchmarks and for similar or superior quality coverage for Dartmouth students. Many employers lean toward high-deductible plans, and the DSGHP continues to be a comprehensive, generous plan, Spellman said, even compared to other Ivy League schools.
Rita Tu ’16, who is not on Dartmouth’s insurance plan, said she had not heard of the changes, and that even if a student wanted to switch from the DSGHP because of price increases or other factors, he or she may not have better alternatives.
Lanphord Cao ‘16, who is on the plan, said that the price increases naturally make the plan less attractive to students. He said that even with the recent changes, the plan still lacks a crucial range of services that many students desire, such as vision care, and that the plan’s lack of vision coverage required him to visit an external facility and pay a large sum for an eye examination.
“I think most people are not educated about the plan,” he said. “It’s a huge investment and required for students, so they definitely should make sure that students understand what it covers and what it does not.”
Veri Di Suvero ’16, who is also on the plan, said she was not aware of the recent changes.
“I recognize that there is a reason for price increases, but at the same time, I don’t know exactly where my money is going,” she said.
Matt Brandon ’16, a DSCHP subscriber, said he rarely uses his coverage or Dartmouth health services, but whenever he does, the coverage has been sufficient. He said he had not known about the recent changes and that a higher deductible is something no customer wants to hear.
Roshan Dutta contributed reporting.
