Due to the Federal Affordable Care Act, Knox College was forced to rework its student health care programs over the summer, leading to the implementation of mandatory fees after the announcement of all other fees.
The late announcement of the mandatory fees was a point of consternation for many students, especially those accustomed to opting out of the college’s coverage in favor of staying under their parents’ insurance plans instead.
Vice President for Finance Tom Axtell was equally displeased with the late announcement, attributing the delay to the complexity of finding alternative programs that would satisfy the requirements of the ACA.
“It is abhorrent to think that a mandatory fee will be implemented after our fees are announced. … We all know that it was a very awkward summer; we would never choose to do what happened, but we had to figure out something that was really imposed on us initially by federal regulation, which made what we were doing unworkable,” Axtell said.
The relatively new legislation rendered the former health care plan insufficient as the minimum monetary coverage levels were raised far beyond what the college was previously offering.
“Last year, our mandatory health insurance had limits on it of $12,500. That was the maximum coverage that would be available if you had no other insurance,” Axtell said. The new federal requirements have a minimum coverage limit of $100,000 dollars for the year we’re in now, next year that is going to scale up.”
A resource the college used in attempting to understand the new requirements was Lawrence Smith, of Lawrence E. Smith & Associates, Inc., who has been involved in providing student health care to the college for multiple years.
Issues faced by the college concerning how to provide adequate coverage at a reasonable price mirrored those debated on the national stage.
“It’s the same issue as the national debate. … What’s the best way to provide options for students and families regarding insurance? We decided that it just didn’t make sense for the college to require everybody to buy an expensive health insurance program,” Axtell said.
This decision resulted in the development of the current student healthcare program, consisting of a mandatory accident insurance plan, a mandatory health services fee and voluntary health insurance plans identified by Knox for both domestic and international students.
“Trying to sort through what should be mandatory … what should be optional, came down to trying to reinforce access to on-campus health services and accident insurance, including the supplemental evacuation coverage,” Axtell said. “The optional piece was, if you don’t have health insurance, that decision we thought ultimately, particularly in this rapidly changing political environment, would be a decision that is made by families and students.”
The sole fee assessed to all students is the accident insurance plan, offered at the pro-rated price of $83 per year. In order to have the fee make sense for all students, on campus and abroad, the college supplemented the accident insurance with evacuation coverage.
“So we took that one time mandatory accident fee and supplemented it so that it really makes sense for all students, no matter if you’re here or if you’re abroad. The mandatory aspect was really a way of keeping the cost as low as possible and to have what we thought was very good coverage for the price,” Axtell said.
The evacuation aspect of the insurance will cover evacuation in the case of medical emergency, whether as student is on campus or at an off-campus program, and political unrest.
A health services fee of $70 per term is assessed to all students studying on campus. The fee, according the Axtell, “made sense in a different light because, in the absence of mandatory health insurance, we wanted to have the basic access to first-level medical issues be available on campus. The 70 bucks a term is actually what covers the on-campus health program.”
The fee is not assessed to students involved in off-campus programs, as they are unable to take advantage of resources available at the health center.
Due to the high prices of plans that would satisfy the requirements of the ACA, which could come to as much as $800 per year according to Axtell, a voluntary health care plan was instituted. This represents a significant shift from last year, which featured a mandatory health care plan with a strict opt-out waiver, requiring proof that the student is covered under their parent’s plan.
Axtell is unsure as to whether the fees will be included in tuition or kept separate in the following years, as portions of the fees are not determined or retained by the college. However, Axtell assured that the incremental costs of evacuation supplementation would be covered by the fees and not result in adverse effects on the college’s finances.
“In the future, we will not have this problem,” Axtell insisted.