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What the Health and Dental survey means for student insurance

By Matty Hume, April 27 2018 — 

At the April 10 meeting of the Student Legislative Council, outgoing Students’ Union vice-president operations and finance Ryan Wallace presented results from a SU Health and Dental Plan student survey, launched at the beginning of the winter 2018 semester. The survey is a follow-through on his original campaign goal of reviewing the existing Health and Dental Plan in an effort to mitigate financial losses and ensure students’ needs are met within the plan’s coverage.

According to Wallace’s third-trimester report, the survey is a response to two issues regarding the existing insurance plan. The first issue was the discrepancy between the cost of providing the program and the fees collected from students. The second issue involved students who begin programs in the summer months and don’t have access to their health and dental plan until September.

According to Wallace’s report from October 2017, 2,500 of students are estimated to utilize the plan’s dental benefits. Of the nearly 16,400 currently covered by the Health and Dental Plan, 2,566 made insurance claims during the 2016–17 fiscal year. For every student over the estimation, the SU faces a $400 charge. The overage of 66 students resulted in a $26,400 charge to the SU — a large increase from the $9,695 overage charge in 2015–16. The overage charges are covered by the SU’s Health and Dental Reserve Fund — which exists for this very reason.

According to Wallace, the survey had 2,426 individual respondents, or 14.8 per cent of the students currently covered by the SU Health and Dental Plan. Fifty-two per cent of respondents said that the SU Health and Dental Plan is their only option for affordable insurance. In addition, Wallace said that respondents highlighted an interest in expanding dental and vision coverage.

The SU Health and Dental Plan is provided by Gallivan: Student Health & Wellness. For $193 per year, full-time undergraduate students under the age of 70 are eligible for coverage through the plan. According to the SU, the $193 annual rate is the least expensive coverage when compared to other Albertan institutions such as the University of Alberta at $235 per year and Mount Royal University at $265 per year. The SU also reports that the health plan and dental plan fees have not increased since 1993 and 1991, respectively.

Prescription drugs are additionally relevant considering a 1994 referendum in which U of C students voted to approve a reduction in prescription drug coverage, mitigated by the National Managed Drug Formulary which qualifies many prescription medications for insurance coverage. For the undergraduate demographic, a common connection to prescription drug coverage is mental health.

According to the Canadian Mental Health Association, anxiety disorders affect five per cent of the country’s household population. In a 2010 article in the Statistics Canada Catalogue, Stats Canada analyst Heather Gilmour reported that the 15–24 age group is more likely to experience mental illness than any other demographic. Additionally, the lowest income group of Canadians are three to four times more likely to report poor mental health than the highest income group.

In a 2016 article for the Canadian Journal of Psychology, researchers found that only half of Canadians undergoing a major depressive episode receive “potentially adequate care.” Such care includes consultation with a health professional and prescription medications. According to a 2014 survey on living with chronic illness in Canada, the Government of Canada stated that 23 per cent of Canadians did not consult a health professional at all about their mental disorders within the past year, while 93 per cent of Canadians with mood or anxiety disorders have or were currently taking prescription medication and only 23 per cent received psychological counselling. The existing coverage under the SU Health and Dental Plan reflects these trends.

Students can be reimbursed at 80 per cent to a maximum of $3,000 for prescription drugs. Alberta College of Family Physicians figures show many common medications for mental health treatment and beyond fall within the current coverage. Antidepressants can range from $140 per year for citalopram — which is covered by both Alberta Blue Cross and Indian Affairs — to $1,120 per year for treating extreme cases of depression with desvenlafaxine, which is not covered by Blue Cross or Indian Affairs. Anti-anxiety medication is even less of a burden under existing coverage, with most medications sitting at approximately $80 per year. Contraceptives often range from $200–340 per year, which is well within the Health and Dental Plan’s coverage.

In the case of treatment from health practitioners, the SU Health and Dental Plan allows students to be reimbursed at 80 per cent to a maximum of $20 per visit for a maximum of $300 per year. And when the cost of private counseling or therapy can range from $50–240 as reported by Informed Choices About Depression, the current plan is reflective of discrepancy between treatment through medications and professional therapy.

Regardless, the primary concerns from students, according to Wallace, fall under vision and dental coverage. The current SU plan reimburses students at 100 per cent at a maximum of $50 for an eye exam and a maximum of $150 for glasses and contacts once every two years. Dental coverage is similarly snug, allowing students to be reimbursed only at Dental Choice locations at 100 per cent for a maximum of $750 per year. When a dental checkup and cleaning can cost upwards of $260 in Alberta, and cavity fillings as high as $250, the cost of treatment can add up quickly.

Still, the yearly fee of $193 per year for the SU Health and Dental plan is comparatively low — sitting $72 dollars lower than MRU. A financial analyst at a Calgarian Co-operators Insurance location told the Gauntlet a basic health and dental plan for an average individual whose employer has opted to pay half of the fees would still be paying approximately $480 per year. The analyst also suggested that a quote for an individual health and dental plan from a Blue Cross competitor would start at around $936 for a 20-year-old male. And in regards to the massive overage charges to the SU over the past two years, a company like the Co-operators would not charge overage fees for a group plan, but would “adjust” premiums based on the extra rates in the next year. Considering the static longstanding static fee for the SU’s plan, leaving a provider like Gallivan may do more harm than good in the long term.

According to his April 10 report, Wallace hopes the SU will continue to consult with students to assess their needs and assess a new health and dental fee that minimizes the overage charges incurred over the past two years. Wallace also states that the SU and U of C are moving to implement a “rolling 12 program,” meaning a new 12-month financial period will begin on the first day of each month, potentially addressing the problem of summer students being ineligible for coverage until the fall.

Wallace’s report indicating the findings of the health and dental survey can be found on the SU website.

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