University Benefits Advisory Council TO: FROM: A. John Bramley, Interim President Jane E. Knodell, Provost Jan K. Carney, M.D., Chair University Benefits Advisory Council DATE: June 4, 2012 SUBJECT: Report of the University Benefits Advisory Council (UBAC) 2011-2012 This report, as requested in the charge to the University Benefits Advisory Council (UBAC), summarizes the work completed during the 2011-2012 academic year and ongoing work the UBAC will address in 2012-1013. Activities for the 2011-2012 Academic Year During the past year, the UBAC met three times. At its March meeting, the Council heard a report of criteria used to select a third-party vendor to administer the VEBA retiree health savings plan, as approved during the previous years discussions of implementing changes to the Post-Retirement Medical Benefit. In April, the UBAC co-sponsored a panel presentation, led by Dr. Anya Rader Wallack, Chair of the Green Mountain Care Board, to engage the campus community in discussion of the future of health insurance in Vermont. We continue to have the following working groups: a Health Insurance Working Group (HIWG), as detailed in our UBAC charge, a Parental Leave and Child Care Working Group (PLCCWG), and a Retiree s Access to Benefits Working Group (RWG). We have combined the work of the HIWG and Retiree s Access to Benefits Working Group (RWG), as priorities for these groups continue to intersect. This year, the HIWG established three subcommittees in order to focus attention on three specific areas of interest: (1) Social Marketing and Wellness; (2) Vision, Hearing and Dental Benefits; and (3) Developing a Planning Approach for Achieving a Smoke Free Campus. Each Subcommittee met three times during the year, and after discussion, formulated recommenda-tions for discussion by the full UBAC. The Parental Leave and Child Care Working Group agreed to monitor progress toward its previous recommendations rather than to pursue additional considerations at this time.
We have opportunities for public comment at Council meetings, and we continue to use our template for review of benefits and privileges, for consistency during our discussions: Template for UBAC Working Groups: Guiding Principles: o Why benefits are important o Changing demographics o Other relevant information Target populations(s): Delivery mechanism(s) are these working? Demographic and Utilization data - Trends Are there gaps? Cost(s) and Cost Issues Other institutions for comparison? Other approaches? Options/Suggestions/Recommendations Our Recommendations for Academic Year 2012-2013: HIWG Subcommittee Recommendations: 1. Social Marketing for Health & Wellness: Use social marketing approaches to change our culture at UVM to focus on awareness and strategies to manage your own health, as described in the Vermont Blueprint for Health: Coordinate efforts with BC-BS of Vermont to engage faculty and staff in a Know Your Numbers campaign, including (1) on-site biometric screening, (2) education regarding the meaning of biometric numbers, and (3) connect screening with primary care; encouraging engagement of employees with their Primary Care Providers (PCP s) to create personalized action plans. Integrate the Employee Health Assessment, on-campus activities and content of The Wellness Corporation monthly newsletter to support the social marketing campaign, based on an annual communication plan. Continue to identify and monitor outcomes to document effectiveness of these strategies. Such measures as numbers of employees screened, numbers completing health assessments (HA), population level claims data relating to screening and annual primary care visits, will be explored. The subcommittee strongly supports continuing efforts to increase participation in the BC-BS online Health Assessment, as a way to focus on disease prevention, bend the curve related to the development of chronic conditions, and help UVM faculty and staff become more health literate partners in their own health. The subcommittee monitors annual HA participation; however, after reviewing data regarding numbers of employees who fail to have an annual physical examination or to designate a Primary Care Physician, the committee recommends additional strategies to increase awareness of evidence-based health promotion and clinical prevention strategies and to promote healthy behaviors, using social marketing approaches that 2
reduce risks for chronic diseases. The more specific focus of the Know Your Numbers campaign will target individual self-awareness in a way that can be reviewed through available data in order to measure progress. Availability of personal health and wellness coaching through The Wellness Corporation provides additional opportunities for employees to engage in health awareness in a way that can be measured through utilization data. Volunteer Wellness Ambassadors remain active on campus to assist with distribution of social marketing campaign materials. 3
2. Smoke-Free Campus Initiative: The Subcommittee recommends the following approach for achieving a tobacco-free campus. Structure: o Steering Committee (Responsible University Officials) to review options and address issues related to implementation of tobacco-free campus; o Working Teams (to include smokers, former smokers and never smokers): Communication; Facilities, Grounds and City of Burlington/FAHC Interfaces; Faculty and Staff ; Student Life; Guests, Events and Athletics; o Post-Implementation Advisory Committee (UBAC) Project Milestones: Year one: research and education; prepare the business (and community action) case; identify team participants, make appointments and charge teams Year two: Teams meet; recommendations finalized; policy revisions proposed Year three: Implementation; evaluation; feedback to campus community and neighbors Project Budget: Intern, Years 1 & 2 0.5 FTE $22,500/ann. Coordination, research The subcommittee discussed relevant materials, including: (1) UVM s current Smoking Policy; (2) A listing from American Nonsmokers' Rights Foundations of Colleges and Universities with Smoke free Policies; (3) survey responses from a Hewitt higher education HR survey regarding smoking policies and practices, (4) slides from an August, 2011, webinar titled "Tobacco-Free Campus: Emerging Trends"; and (5) University of Michigan's Smoke-Free University Initiative Report, which is available on their web-site. After some discussion, there was agreement that there are several key factors to be considered in order to ensure the success of such an initiative: student participation and buy-in; ability to control activities that occur on UVM property); collaboration with FAHC; funding through the State for initiatives related to smoking cessation; collaboration with the City of Burlington s Church Street initiative; COM/UVMMG co-sponsorship or endorsement (including Medical students); resources to support smokers who want to quit The subcommittee reviewed formal research results submitted by Callan Janowiec, a nursing Master s degree candidate who was assisted in her survey of undergraduate and graduate students by UVM s Office of Institutional Research. We learned that 73% of the student respondents are non-smokers. Of the 20% who are occasional smokers, more than 26% of them began smoking while attending UVM. More than 70% of respondents indicated that they are bothered by tobacco use on campus, including more than half of the respondents who are smokers. More than two-thirds of all respondents indicated a preference to socialize, live and learn in a smoke-free environment, including 60% of respondents who are smokers. Perceived barriers to implementation of a tobacco-free campus measured in the survey include student resistance, administrative resistance, infringement on individuals rights to smoke, and 4
enforcement. The survey provides valuable insights into needed communication and awareness/education that must precede any change in current policy and practices. 3. Vision, Hearing and Dental Benefits: Based on the UBAC s 2011 recommendations to the President, a subcommittee of the Health Insurance Working Group (HIWG) was convened to review and assess UVM s Vision, Hearing and Dental benefits, which have not been updated significantly for more than a decade. UVM s current Vision, Hearing and Dental benefits appear to provide adequate coverage for its employees; however, based on data regarding utilization of these benefits, we recommend that Human Resource Services develop a communication plan to inform active and retired individuals of the extent of coverage available as well as how to access these benefits effectively. We do not recommend changes to the benefit design or cost structure at this time. Dental Benefit UVM is currently self-insured for dental insurance through Delta Dental, which means that actual claims costs and administration costs are paid directly by the University. The review of dental coverage focused on cost sharing (applicable deductible amounts) and maximum coverage limits for both dental care and orthodontics. Three proposals from Delta Dental were discussed in terms of the potential impact of changes to both of these plan design elements on employee behavior, such as increasing the number of employees who engage in basic dental care annually. In principal, the committee agreed that reasonable increases in deductible amounts would not deter participation by covered individuals. There was also consensus that coverage maxima should be increased, based on information from the Vermont Benefit survey. The subcommittee reviewed projected cost data from the three proposals in relation to current cost data. After learning that 86% of those enrolled in the base plan do not use their maximum benefit; 90% of those enrolled in the high-option plan do not use the maximum benefit, the subcommittee concluded that employees need to be better informed regarding availability of the benefit. Vision Benefit The current coverage offered within the BC-BS VHP Open Access is available for treatment of medical conditions of the eye, including disease and injury. BC-BS does have a network of optometrists that are covered by the plan. Discounted materials (eyeglasses) and optician examinations are covered by a rider on the current Delta Dental insurance plan. After reviewing utilization data as well as cost proposals for expanding coverage for examinations and materials, the subcommittee members agreed that additional communication to the campus community is necessary to popularize the existing benefit, and raise awareness that it is attached to the Delta Dental insurance plan. Hearing Benefit The UVM health insurance plan currently covers only medically necessary audiology (testing), and there is no coverage for the cost of hearing devices; Blue Cross and Blue Shield of Vermont reported that no employers in their Vermont Book of Business offer such coverage at this time. Nonetheless, the committee reviewed a sample corporate rider for audiology coverage and associated cost estimates. Due to the high cost of coverage and the lack of such coverage in 5
typical employer benefit plans, the subcommittee does not recommend adding the coverage at this time. Ongoing Work for the 2012-2013 Academic Year: Health Insurance Working Group and Retiree Working Group: a. Continue to review, develop, and endorse specific social marketing approaches from BCBSVT and The Wellness Corporation. These will be based on a specific campaign : Know Your Numbers. The focus will be on information for self, family, and community. b. Engage University Leaders to finalize a process and next steps to support the goal of a Tobacco-free UVM Campus, based on the 2011-2012 plan outline. c. Continue to discuss how national and Vermont health reform efforts impacts our work. Parental Leave and Child Care: Review progress on recommendations. The University Benefits Advisory Council s continuing themes of Communication and Awareness and Health, Wellness and Fitness crossed our working groups. During the 2012-2013 academic year, we will propose a schedule for regular review of University benefits, monitor progress towards recommendations, and continue to make additional recommendations, all according to our charge. Respectfully Submitted, Jan K. Carney, M.D., M.P.H. Chair, University Benefits Advisory Council Professor of Medicine Associate Dean for Public Health 6