About MHECare | Requesting a Quote | Benefit Basics | Healthcare Reform & Student Health | MHECare Brochure 
 

A Midwest Student Health Collaborative

 About MHECare
The MHEC Student Health Benefits Advisory Committee (SHBAC), under a grant from Lumina Foundation for Education, has been working for the past three years on creating a mechanism to provide its colleges and universities health insurance for their students with cost-savings that could only be achieved by working collaboratively.

This mechanism, called MHECare, was created to offer unique advantages and benefits to participating institutions that cannot be readily achieved through institutions seeking coverage on an individual basis.  MHECare will offer campuses throughout MHEC member states medical insurance coverage for the approximately 4 million students across the region. 
 
In collaboration with the program administrator, Mercer, an independent consulting firm, MHEC and the SHBAC developed the plan design and selected UnitedHealthcare StudentResources (UHCSR), a national health care carrier, to underwrite the program through a competitive bid process.  UHCSR specializes in student health insurance plans, has a large national network of providers, offers web-based enrollment and support tools, and quotes competitive rates.
 
MHECare will be effective for plan years beginning fall 2012.  In the meantime, SHBAC is developing a marketing campaign that will give MHEC members an opportunity to learn about the program and its benefits.

Requesting a Quote
Now that MHECare’s standard high and low preferred provider organization (PPO) options have been finalized, MHEC is ready to accept requests from institutions for quotations for MHECare. Plan design options available to institutions and the process to obtain a quote are explained below.

The standard MHECare high or low PPO plans can be selected by institutions with less than 300 students enrolled in the plan and by institutions that do not currently offer a program. Rates for these plans will depend on whether the plan is voluntary or mandatory with waiver, but the rates will not be based on an institution’s claims experience. 

Institutions with more than 300 students enrolled have more options, including one of the standard MHECare high or low PPO plans, a quote for the institution's current plan, or a plan with design features tailored to the institution's student population. The cost for the plan will be underwritten based on the institution’s claim experience and utilization.

To receive a quote, the first step is to obtain the Request for Quote form via Jennifer Dahlquist, MHEC's assistant vice president for cost savings and chief financial officer, at jenniferd@mhec.org.  Additional information will be required if quotes are requested for more than the standard high and low plans. The additional information may include a copy of the current plan design, requested benefits, and claims experience. In addition, there is a MHECare confidentiality statement to complete. 

Once all of the information is received, UnitedHealthcare StudentResources will send the quotation within 10 working days.  

MHECare questions may be addressed to Jennifer at 612-626-1602. 
 
Benefit Basics
The second in a series of articles about the new Midwest Student Health Collaborative - MHECare
In this article, we present a high level summary of the key plan design provisions. One of the advantages of MHECare is the economy of scale that results from having standard plan provisions and exclusions. The Student Health Benefit Advisory Committee (SHBAC) reviewed several member-institution student health insurance policies currently in force with different carriers. They determined which plan design offered the most generous provisions and used that design as a template for MHECare. Given the wide variance in student health plans among MHEC member institutions, SHBAC decided to offer two MHECare plans – a low and a high option offered by UnitedHealthcare StudentResources.  While some details are still being finalized, this document presents some of the key provisions of the two options and shows the student’s out-of-pocket costs. 

Benefit

Low Option

 

High Option

 

In-network

Non-network

In-network

Non-network

Maximum benefit each policy year

$100,000

$500,000

Deductible

$300

$600

$100

$200

Out-of-pocket maximum

$5,000

$10,000

$2,500

$5,000

Student coinsurance for most services, after deductible

20%

40%

20%

40%

Hospitalization

20%

40%

20%

40%

Surgery

20%

40%

20%

40%

Emergency room

$150 copay per visit

$150 deductible per visit

$150 copay per visit

$150 deductible per visit

Physician office visits,

Including preventive care 

$25 copay per visit

Then pays 100%

40%

$20 copay per visit

Then pays 100%

40%

Lab and x-ray

20%

40%

20%

40%

Prescription drug copays, 31-day supply

UnitedHealthcare Network Pharmacy

$15 Tier 1

$30 Tier 2

$50 Tier 3

$5,000 annual maximum

No benefit

$10Tier 1

$30Tier 2

$50 Tier 3

 

No benefit

Mental health outpatient visits

20% up to 50 visit combined max in and out of network each policy year

40% up to 50 visit combined max in and out of network  each policy year

20% up to 50  visit combined max in and out of network each policy year

40% up to 50 visit combined max in and out of network each policy year

Student Health Center charges

Plan pays 100% of Covered Medical Expenses, deductible waived

Medical evacuation and repatriation

Benefits provided by Scholastic Emergency Services, Inc.

Accidental Death & Dismemberment

$1,250 - $5,000 maximum

Pre-existing Conditions, in excess of $1,000*

Condition that existed 6 months prior to the effective date will not be covered until the student has been insured for  6 months

 

*May not apply for individuals who have been continually insured under the institutions’ student insurance policy for at least six months
The chart above reflects only key plan elements. See the UHCSR Schedule of Benefits posted on MHEC for details.
 
 
Student health care plans may be subject to certain health care reform legislation. Given that the regulations change from year to year, MHEC will research and update the MHECare plans annually to ensure that they are compliant with the new regulations. By working with MHEC, campuses can be better prepared as the requirements come into effect, thus minimizing the inevitable difficulties that can occur during the transition.

In addition to these standard plans, member institutions with more than 300 covered students will have the option to continue their current plan design with respect to student deductibles, copays, out-of-pocket costs, and other plan provisions, but MHECare will encourage all schools to adopt the standard policies as much as possible. All benefits will be subject to insurance laws, which can vary by state.
 
MHECare: Health Care Reform and Student Health 
An important consideration in designing MHECare was to offer plans that meet the requirements of health care reform and to relieve MHEC member institutions from having to amend their plans and keep up with ongoing regulatory changes.  Many colleges and universities that sponsor student health insurance plans have been questioning what provisions of the Patient Protection and Affordable Care Act (PPACA) apply and when changes need to be made.
 
For the 2012/13 plan year the MHECare standard high and low PPO plan options meet the annual dollar limit requirement of $100,000.  As the U.S. Department of Health and Human Services (HHS) provides additional guidance, MHEC will modify the plans accordingly. For more information read this document (link to PDF) that answers frequently asked questions about the proposed regulations and their impact on fully insured health plans for college and university students.
If your campus or system is interested in learning more about the potential benefits of MHECare, please contact Jennifer Dahlquist, assistant vice president for cost savings and chief financial officer, at 612.626.1602 or jenniferd@mhec.org.  For more details, please view the MHECare brochure on our website here.