Report of Faculty Senate Benefits Subcommittee Joanna L. grossman Ellen K. Solender Endowed Chair in Women and Law

Committee Charges 2018-19 Work with Provost’s Office to ensure implementation of parental leave policy. Review prescription drug coverage across SMU medical plans and evaluate on average faculty are spending out of pocket on prescription drugs as well as implications of prior authorizations and lack of coverage for non-preferred mediations on faculty costs and health. Work with Sheri Starkey and SMU Benefits to find ways to encourage SMU employees to be more conscious of available benefits and more conscious consumers of healthcare services. Review full-time faculty benefit coverage to verify that benefits are equivalent for TT and NTT faculty.

New Parental Leave Policy (Draft) All full-time faculty are covered Childbirth leave – ½ semester Parenting leave -- ½ semester Newborn, newly adopted, or newly placed foster child (ages 0-4) Leave completed w/in 12 months of birth, adoption, or placement Medical leave – 90 days Tenure clock stops at option of faculty member

Health Care in a Nutshell Current SMU Fiscal Year: June 2018-May 2019 Current SMU Plan Year: January 2019-December 2019 Gross Cost: Includes medical/Rx claims paid by SMU, in addition to administrative fees paid to BCBS for claims administration and stop loss insurance for claims exceeding $500,000 Employee Contribution: Reflects premiums paid by employees based on plan and tier election Plan is designed around 65/35 cost allocation between SMU/employees Net Cost: Reflects total paid by SMU after employee premiums are deducted

Prescription Drug Costs Place of Service 91.9% of total scripts retail; 8.1% mail order Drug Type Generic (82%); Brand Preferred/Formulary (8%); Brand Non-Preferred (10%) Member OOP Member OOP as a % of total drug cost = 24.8% at Retail, 10.6% at Mail Total Member Costs Total Generic member OOP per script = $13.33 Total Brand Preferred member OOP per script = $125.67 Total Brand Non-Preferred member OOP per script = $151.94

Prescription Drug Benefits We currently have the best of three plans offered by Prime Therapeutics SMU cannot customize plan Prescription costs are part of 65/35 allocation Cost are allocated unevenly across insured pool based on structure of health plan Do we want to survey faculty on usage, problems, concerns?

Better Consumers of Healthcare Common mistakes/practices Underuse of preventative services and on-campus preventive health screenings Use of local pharmacies rather than mail order Use of non-preferred medications when preferred or generics are available Use of out-of-network providers Using freestanding ER rather than urgent care Low usage of telemedicine (MD Live) Low usage of free healthcare consulting (Compass) HSA mistakes (lots) PROPOSAL: Presentation at faculty meetings on ways to reduce faculty spending on healthcare