The University changed students’ health insurance policies for the upcoming academic year, decreasing minimum out-of-network requirements.

Vasudha Mathur / Sun Staff Photographer

The University changed students’ health insurance policies for the upcoming academic year, decreasing minimum out-of-network requirements.

November 8, 2018

University Updates Requirements to Waive Student Health Plan

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The University changed students’ health insurance policies for the upcoming academic year, decreasing minimum out-of-network requirements and altering waiver requirements, Vice President Ryan Lombardi announced in an email to some members of the Cornell community on Thursday afternoon.

Students who wish to waive the University-mandated Student Health Plan insurance for the 2019-2020 academic year must have a minimum out-of-network coverage of 60 percent, according to the new requirements, a 10 percent decrease from last year’s waiver requirements.

“Reducing the requirement to match the Affordable Care Act minimum standard means that students and their families have more choice for their insurance options,” Craig McAllister, director of Cornell’s Office of Risk Management and Insurance, wrote in an email to The Sun.

“It also means that they will have to carefully consider whether their insurance’s network coverage and out of pocket costs will work for them in the Ithaca area. There is risk that some students might not make a fully informed choice,” McAllister continued, saying that Student Health Benefits staff would be available to help inform students’ decisions.

Other changes outlined on the website also focus on revising who is eligible to waive the SHP. Health Maintenance Organization plans without an “away from home” rider, out of state Medicaid plans and “young invincible” plans will not be valid substitutes for the University plan next year. These plans, according to the University’s website, limit coverage in various ways. HMOs may charge additional premiums for riders or not provide riders, and out-of-state Medicaid plans only provide emergency coverage for students away from home.

The changes were made by administrators following recommendations of the Student Health Benefits Advisory Committee, Cornell Health and the Office of Risk Management. The SHBAC is composed of student, Cornell Health and University representatives, and advises on the SHP and the student health fee, according to its website.

“Feedback from students and parents about their experience this summer/fall with the waiver process was very helpful in guiding our discussions,” McAllister wrote.

The changes follow a tumultuous summer in which approximately 2000 students’ applications to waive the University-mandated health plan were initially rejected. The 2018-2019 Student Health Plan cost a full-time student $2,832 for the academic year, while students who successfully waived the plan paid a $370 health fee instead.

“The requirements for waiving the Student Health Plan became part of a community dialogue this year when we began to more carefully audit compliance,” Lombardi wrote.

After the audit, the University faced a large influx of initial waiver rejections over the summer. As a result, Cornell instituted a temporary measure to approve a greater quantity of waivers. Students who were both approved the year before and met a minimum out-of-network standard of 50 percent coverage were allowed to opt out of the plan, and pay the smaller health fee. However, these revised requirements were temporary measures.

Now, the new 60 percent value was chosen because it is the standard minimum coverage level for a “bronze” insurance plan under the Affordable Care Act. A bronze plan, according to the federal health insurance website, “can be a good choice if you usually use few medical services and mostly want protection from very high costs if you get seriously sick or injured.”

“That audit found that many students were waiving with insurance that did not meet a key requirement — coverage for health care where the student is attending school (Ithaca or elsewhere) at a reimbursement rate of at least 70%,” Lombardi continued.

The audit also revealed that meeting the minimum coverage percentage was a common issue for students. It also initially rejected the waivers of students who had been previously been approved to waive the University’s plan in past years, The Sun previously reported.

Cayuga Medical Center — the only hospital accessible by public transport for Cornell students — is not an in-network provider under UnitedHealthcare insurance. According to the SHP webpage, over 20% of students who did waive the SHP were covered by an insurance plan provided by UnitedHealthcare.

According to the student health benefits webpage, CMC has offered to work with the University to “find creative solutions to make services more accessible and affordable for Ithaca students with UHC products.”

The University has begun conversations with CMC, according to McAllister, and “will continue to explore options, both with CMC and other area providers.”

Administrators, along with the SHBAC, will review CMC proposals and determine the next steps.