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November newsletter

November 2021 Newsletter

Find out:Why Saint Joseph’s College is a good fit for the captive solutionWhat is Advanced Primary Care and why is it an important healthcare policy

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First Maine School Joins edHEALTH: Saint Joseph's College is a Good Fit for Captive Solution

edHEALTH welcomes its first Maine educational institution when Saint Joseph’s College of Maine joins effective January 1, 2022. The school’s needs for faculty and staff healthcare benefits were a good fit for edHEALTH’s captive model. “Our college was attracted to edHEALTH because you have captured a balance of characteristics that echo the way we view ourselves,” said Kristine Avery, Associate Vice President & Chief Human Resources Officer for Saint Joseph’s College of Maine.“edHEALTH is regionally focused but diverse,” said Kristine. “Its membership is higher education-focused but offers a range of sizes and types of colleges and universities. And the captive model is innovative but also lower risk. The ownership embedded in this model — that any savings goes back to the institutional owners, and that each member can make its own set of plan choices and stop-loss levels based on...

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How Does our Captive Solution Work?

edHEALTH’s Tracy Hassett explains how the edHEALTH captive provides a healthcare solution that benefits higher education and secondary school institutions, their faculty and staff, and tuition-paying students and families in this Vermont Captive Insurance-produced video.I Would Like to Learn More

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Point32Health Selects UnitedHealthcare as its National Network – What This Means to Tufts Health Plan and HPHC Members

Point32Health, the combined Tufts Health Plan and Harvard Pilgrim Health Care organization, selected UnitedHealthcare as its national network provider effective January 1, 2024. UnitedHealthcare is already the national provider for Harvard Pilgrim Health Care members, so there are no changes for Harvard Pilgrim Health Care members as the result of this announcement. Until 2024, Tufts Health Plan members will continue to use the nationwide Cigna network. Tufts Health Plan and HPHC members residing in New England access the plans’ networks of nearly 100K healthcare providers and all New England hospitals. For PPO members, the national carrier complements these networks outside of the service area. When visiting a doctor or hospital, the employee shows their edHEALTH health carrier ID card, which gives the provider the information they need for billing the plan administrator.

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Higher Ed HR Leaders Share 3 Benefits from edHEALTH Coalition That Helped Them Navigate the Pandemic

Three of our higher education institution HR leaders shared how the edHEALTH coalition helped them navigate the pandemic at the October Association for Collaborative Leadership (ACL) Conference. This interactive forum provided a roadmap for other higher education consortiums. Higher education was hit particularly hard during the pandemic, and edHEALTH pivoted from a growth and retention trajectory to collaboratively focus on the needs of our member institutions. edHEALTH’s Tracy Hassett led a discussion that focused on three strategies that helped member schools.1) Collaboration Forums for MembersRecognizing that collaboration between colleges and universities could help HR departments learn from one another, we implemented bi-weekly virtual meetings for member schools toward the end of March 2020. Average attendance ranged from 60-65 people, primarily HR and financial staff along wit...

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Move to Self-Insurance Improves Control and Cost Transparency for Holy Cross — Joins edHEALTH Effective January 1, 2022

The College of Holy Cross began its search for a new employee healthcare benefit provider last spring when Fallon Health, their longtime carrier, announced that it was leaving the commercial market. As part of the selection process, the school evaluated whether it made sense to remain fully insured or move to a self-insurance arrangement. “Given our size and claims experience, we felt it was the right time to become self-funded and gain more control and cost transparency for our healthcare benefit program,” said Marymichele Delaney, the college’s Chief Human Resources Officer.Over 950 faculty and staff work at the school. “Holy Cross is at a size where self-funding makes sense,” said Jessie Campbell, Holy Cross’s advisor and a principal at Strategic Benefit Advisors. The school selected Harvard Pilgrim Health Care as its plan administrator. As edHEALTH offers this carrier, the school ...

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What’s Next for Harvard Pilgrim Health Care and Tufts Health Plan Merger? Vice President Patrick Cahill Shares Update

This year’s member-owner meeting included a presentation from Point32Health’s Vice President of the Massachusetts Market, Patrick Cahill, on the Harvard Pilgrim Health Care and Tufts Health Plan merger. The two plan administrators cover the majority of edHEALTH’s member schools. The name Point32Health refers to the 32 points on a compass. “Our combined organization’s mission is to guide members to better health,” said Patrick Cahill. He likened Point32Health to a holding company with the Harvard Pilgrim and Tufts Health Plan brands continuing for the foreseeable future.Cain Hayes is Point32Health’s new Chief Executive Officer, succeeding Tom Croswell, who retired in July. Cain Hayes leads the company’s executive team; ensures a strong culture of quality, innovation, and customer service; and defines strategic vision and direction. Previously he held leadership positions at Gateway Hea...

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Member-Owner Meeting Helps Focus on Pain Points and Opportunities

Which strategic initiatives should edHEALTH and its member schools focus on? This year’s member-owner meeting helped to guide those discussions. Almost 100 members, business partners, and – for the first time – school advisors attended this year’s event to learn about edHEALTH’s initiatives, find out which trends are concerning, and discuss options for improving care and bending the cost curve.edHEALTH’s data vendor staff provided an in-depth analysis of edHEALTH’s medical and pharmacy trend and where it diverges from higher education benchmark trends. This led to a discussion about the initiatives we’ve pursued and where there are opportunities for tackling the pain points. These conversations provide a springboard for our strategic vision for 2023 and beyond.The meeting also included Board news, financial reports, and updates on communications, the Tufts Health Plan and Harvard Pilg...

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Tracy Hassett Selected to Chair Search Committee for President of Vermont Captive Insurance Association

Educators Health Exchange President, Tracy Hassett, is chairing the committee to identify the next president of the Vermont Captive Insurance Association (VCIA). The organization’s president, Richard Smith, announced that he was stepping down in January 2022. He had helmed the organization since 2009.VCIA is the largest trade association for the captive industry and provides educational opportunities and legislative advocacy. Tracy Hassett is a Board member of VCIA. She will chair the selection committee that will identify the organization’s priorities for a new president, interview prospective candidates, and make a recommendation to the full board.“Our committee’s top priority is to find a new president who can advance VCIA’s mission and serve its members,” said Tracy Hassett. “We also want to ensure a smooth transition so that we’re ready to hit the ground running in 2022.”

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Share-it Employee Engagement Communications

edHEALTH provides share-it employee engagement communications to help member school employees navigate and maximize their healthcare benefits. Check out these helpful communication tools:December 1 Stress-Free Holidays Lunch and Learn.pdf | Online VersionPPO Members Can Access In-Network Providers Nationwide: PPO Members Can Access In-Network Providers Nationwide.pdf | Online VersionHow to Save Money on Prescription Drug Costs: How to save money on Rx share-it communication.pdf | Online VersionHealthcare Terms You Need to Know to Understand Your Options: Healthcare Terms - Share-it Communications.pdf | Online versionTake advantage of telehealth convenience Tufts Health Plan and Trustmark Health Benefits: Telehealth Tufts Trustmark.pdf | Online version Harvard Pilgrim Healthcare: Telehealth Harvard.pdf | Online versionTips for saving money and time using online health plan portalsTufts...

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5 Reasons Clinical Intervention Program Works: No Costs for Member Schools

According to a recent report from PricewaterhouseCoopers' Health Research Institute, medical costs will increase on average 6.5% in 2022. The report cites pandemic-related drivers for the jump: deferred care, exacerbated opioid and mental health crises, and an increase in unhealthy habits. Rising provider prices and market clout, skyrocketing prescription drug costs, and new expensive gene therapies will also push up rates.Controlling healthcare and prescription drug costs are critical for sustaining effective, affordable healthcare benefits. In 2018, to support these goals edHEALTH introduced KnovaSolutions®, a comprehensive clinical decision support service that focuses on those who need the most help. The savings are compelling - the program saves $3.39 for every $1.00 spent. edHEALTH provides this resource to member schools at no cost.Nineteen of our 23 educational institutions ar...

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COVID Vaccine Informational Videos for Your Employees

Share with Faculty and Staff to Help Overcome Vaccine HesitancyDistribute these helpful videos from the National Alliance of Healthcare Purchasers Coalition to help address employee concerns about COVID vaccines.COVID-19 Vaccines: Informed Decision Making - Informed Decision Making VideoCOVID-19 Vaccines: Get the Facts - Get the facts videoCOVID-19 Vaccines: Get the Facts with Spanish Subtitles - Get the facts with Spanish subtitles videoThe History of Vaccines - The History of Vaccines videoThe History of Vaccines with Spanish subtitles - The History of Vaccines with Spanish subtitles videoTrusting Vaccines - Trusting Vaccines videoTrusting Vaccines with Spanish subtitles - Trusting Vaccines with Spanish subtitles video

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Advisors Collaborate With edHEALTH Team to Identify Solutions for Their Clients

Savings Drive Consultant Recommendations to edHEALTHThe primary reason a health insurance consultant recommends edHEALTH to their higher and secondary education clients is when the pricing estimates support the change. Healthcare puts a huge strain on college, university, and private secondary school budgets, which drives up tuition costs. “Higher education is struggling with drops in enrollment and controlling costs is critical,” said Ben Lewis, Partner, Strategic Healthcare Practice Leader, Consiliarium Group, LLC. “Employee compensation and benefit costs represent the lion’s share of college budgets.”Through our purchasing clout, edHEALTH can negotiate lower administrative fees with less healthcare cost volatility than schools can generally realize on their own. The seven-year average health insurance premium increase is 2.9%, well below the industry average of 7.9%. “Self-funding ...

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3 Steps to Find Out Whether the edHEALTH Employee Health Benefits Solution Will Save Your School Money

There’s new urgency in finding ways to cut spending at higher education institutions and secondary schools. Compensation and benefits generally comprise at least 60% of a school’s budget; finding ways to reduce employee health insurance costs is an effective strategy for containing costs without sacrificing the quality of your benefits package.edHEALTH’s group purchasing power can generate significant savings on three key components of your employee healthcare benefit costs:Stop-loss coverageAdministrative feesPrescription drug benefits“If schools want to evaluate the potential savings they will realize by joining edHEALTH on January 1, we encourage them to start the process in June,” said Nancy McConaghy, edHEALTH’s Business Development Executive. “This helps ensure a seamless experience for the school, its faculty, and staff.”If your school is not on a January 1 plan year, edHEALTH ...

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How to Unlock Additional Savings if You’re a Go-it-Alone Self-Insured Healthcare Purchaser

Wentworth Institute of Technology VP of Finance and Consultant Share Their AdviceSelf-insurance wasn’t a novel approach for Wentworth Institute of Technology’s employee health insurance program. They self-funded the program over twenty years ago, well before it became common practice. “Wentworth had been self-insured for many years before joining edHEALTH,” said Wentworth’s Vice President of Finance and CFO, Bob Totino. “This arrangement saves the school from paying profits on top of claims to the health insurance administrators."On average, compensation and benefits make up 60% of higher education budgets and fiscal departments are keen to find new solutions for reining in costs. "Wentworth Institute of Technology discovered edHEALTH through our participation in The New England Educators Insurance Association (NEEIA), a group of seven private higher educational institutions that coll...

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Reluctant to Join a Captive? Take the Jump - it's Worth it says Boston College Financial VP

You may hear the word “captive” and get nervous. What is it and what’s the risk? Not only are captives not scary, they also provide added value to a go-it-alone self-insured healthcare program according to John Burke, Boston College’s Financial Vice President and Treasurer. A captive is an insurance company that is owned and controlled by its members to insure the risks of its member owners. “As a captive owner, you have input in the direction of the captive including plan design, which is critically important during these challenging times,” says John Burke.Boston College implemented a self-insured employee health insurance program in June of 2009. “Making the transition to a self-insured program can be nerve-wracking for any large or small entity,” said John. “However, the benefits of moving to a self-insured program more than outweigh an entity’s concern.” Although the school was h...

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Salve Regina Realizes Strong Results and Valuable HR Support

With compensation and benefits comprising 60% of Salve Regina University’s budget, Vice President for Administration and Chief Financial Officer, William Hall is always evaluating ways to keep costs in check while continuing to attract and retain top-notch faculty and staff. In the late 1990s he  moved the health insurance benefits from an insured to a self-insured program where the university takes the responsibility for paying medical claims plus stop-loss to protect against high-cost claims. This approach creates the lowest possible administrative costs and means that the employer isn’t paying profits on top of claims. This was a bold move, especially at the time, as some small colleges and universities worry about the higher risk of a self-insured arrangement.“We were already self-insured and had been pleased with that decision,” said Mr. Hall. “However, healthcare costs were stil...

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