Data Requirements for Further Analysis

This report represents the most basic analysis possible, providing the simplest forms of premium and coverage data obtainable without actuarial analysis. In order to reliably estimate the total premiums per month that the University faculty and staff would face, several types of data would be needed that were not available at the time of this report. These data requirements include the following:

• demographic profiles of University faculty and staff enrolled in each health plan currently offered,
• medical claims experience by age and gender cells for each health plan,
• estimates of costs for medical procedures covered in the projected health plan design, and
• cost-sharing parameters (e.g. coinsurance, deductibles, annual out-of- pocket maximums, copayments) in the health plan design.

The medical claims experience data is controlled by the Department of Employee Relations and is not broken out separately for University and non-University employees. The only way to generate reliable premium estimates in different scenarios (e.g. total replacement, BHCAG model) would be to obtain the University’s claims experience and to run actuarial models with the four sets of factors identified above. Without these data elements, any estimate of the projected premium expense to the University faculty and staff would be highly suspect. However, an actuarial analysis of the University’s experience is the logical next step if the faculty and staff want to be fully informed in moving from its current purchasing partnership with SEGIP. This report represents the first step in a larger evaluation of the benefits and costs of alternative purchasing arrangements.