Small Price to Pay

For most Americans, the biggest barrier to health insurance coverage is cost. They cannot afford the $7,000 average premium or higher rate if they have a pre-existing condition. For many college students, though, cost is actually a much smaller hurdle. FSU sells the policies through its carrier, which this year is Blue Cross and Blue Shield of Florida (BCBS Florida). A basic plan with limited benefits costs $929 for the full year. A more comprehensive option costs $1,250.

The relatively low costs are one effect of the school requiring all of its students to have coverage. More students in the plan means more students to spread the insurance risk. While most FSU students get coverage through one of their parents, the number of students getting a policy through the university-chosen carrier has jumped to 4,200 this year from 900 just three years ago.

FSU makes the insurance enrollment process simple. Students, or more likely their parents, can sign up for coverage online without ever talking to an agent. It even has a tutorial on its web site to walk applicants through the process.

John Urbanek, a vice president at BCBS Florida, said the insurance mandate at FSU is a success story for all involved — students, the school, and the insurer. “We hope this will be a model that others will follow,” said Urbanek, who has a daughter at the university.

Having the school mandate insurance coverage “really gives us a large group to work with so we can keep our costs low and the risk pool becomes more predictable,” Urbanek said.

Until recent years, major carriers largely ignored the college campus market, leaving it to smaller specialty carriers. But the growing number of individual schools nationwide to mandate coverage in addition to some states and university systems has made the market more enticing. “We thought this would be a market that we could be competitive in,” Urbanek said.

BCBS Florida outbid rival Aetna this year to be FSU's main insurance carrier for students.

Aetna made a big move into the student health insurance market when it bought the specialty carrier, The Chickering Group, in 2004.

“We support the efforts of colleges and universities to ensure students have access to affordable, quality health care,” said Kate Begley, head of Aetna Student Health. “At Aetna, we work closely with campus health and counseling centers, as well as community and travel service providers, to offer students access to convenient care at an affordable price, no matter where they are located.”

Whether a student is attending college for the first time or returning to campus for another year, Aetna offers these tips for parents to consider when selecting a student health insurance plan:

o Weigh the difference of carrying a dependent on your plan with the benefits of a school plan. For example, will your plan cover a non-emergency?

o Evaluate the access to care for a typical student who is traveling to school, home, participating in travel abroad programs, medical rotations, or internships. A portable plan with national and international coverage is essential.

o Identify a health contact on campus and review the school's web site and literature. Visit the campus health center.

o Understand the school's health insurance requirements and plan provisions, including specific annuals and other benefit limits and exclusions. Talk with the school health insurance staff for guidance.

Coverage Options

“Choosing a student health insurance plan that is right for your child is a personal decision and one that should be examined carefully, particularly in today's uncertain economy,” Begley said.

Provisions of college student health insurance vary widely. Some limit the number of doctor visits, prescription drug coverage, and length of hospital stays. The maximum benefits on these plans can also be extremely low, such as $2,500 per condition (per year) to $1 million per lifetime, according to the GAO.

Even if universities do not mandate that students carry insurance, schools often contract with an insurer or local agency to obtain a preferred rate. Insurance experts say it is wise for parents to consult with an agent before making any decisions.

“It is always a good idea to shop around and, depending on what plan the college endorses, to find an agent to evaluate other products,” said David Sherrill, executive director of the Florida Association of Health Underwriters in Altamonte Springs.

Sherrill said the university-endorsed plan is often a good deal, particularly for international students, but that in-state students should look at all their options.

Despite the growing trend, most Florida agents get few inquiries about coverage for college students. “It happens every once in a while,” said Stephanie Joy, an agent with Plastridge Insurance in West Palm Beach. Joy said parents should consider keeping or adding their college-bound children to their own policy or have a rider added to their policy. They also should consider making sure that whatever plan is chosen has a provider network both at the college and in their hometown that can be used in case of a serious illness.

The University of Florida (UF) has contracted with the Gainesville-based Scarborough Co. for 12 years to develop health plans for its students. This year, it offers a plan that costs as little as $1,391
a year.

“Demand is higher this year than previous years,” said Rick Scarborough, owner of the insurance agency. The agency helps write policies through Aetna for about 8,000 undergraduate and graduate students at UF. He attributes increased interest in student health insurance to the worsening economy, which has caused many parents to lose their jobs, along with their family health insurance coverage.

Nonetheless, he said student health insurance remains a tough sell. “Health insurance is pretty far down the list of students' priorities,” Scarborough said.

BCBS Florida estimates it has about 8,000 to 10,000 students enrolled at FSU and the six other Florida colleges where it has contracts.

Unlike Florida, some states and higher education governing boards have implemented health insurance requirements for college students. For example, Massachusetts and New Jersey require students attending college in their states to have health insurance as a condition of enrollment.

Florida lawmakers have considered such a proposal the past few years, but it has never been implemented for fear it would make the overall cost of going to college too expensive.

Sacher of FSU is still hoping to get an alliance of universities in Florida to join together in requiring students to have coverage. “Together we would have stronger bargaining chip with insurers,” she said. But today, FSU is the only state school to require student health coverage.

Starting this October, a new federal consumer protection will help secure student coverage. Under Michelle's Law, all group insurance plans must cover students on medical leave for up to one year. The law is named for Michelle Morse, a student in New Hampshire who died of colon cancer in 2005. She had continued her full college course load throughout her treatment so she could keep her health insurance.