EHPTF: Not Just Another Acronym
What does EHPTF really stand for?
The Employee Health Plan Task Force (EHPTF) is a multi-stakeholder forum to provide guidance to the University of Maine System (UMS) regarding health care benefits for employees and their dependents.
Why is their work so important?
Because the University of Maine System is “self-insured” – As a self-insured employer, UMS pays for all medical and prescription claims for covered employees and dependents. All the risk of increased costs – as well as the benefit of slowing the rate of increase in health care costs – goes to UMS and employees in the form of monthly contributions costs. Each year monthly employee contribution amounts are determined based upon the most recent twelve months of closed claims. (For more information on what it means to be self-insured, go to www.fairhealthconsumer.org and enter “self-insured” in the keyword search).
If UMS is self-insured, why does my insurance card come from CIGNA?
UMS hires CIGNA as our plan administrator. CIGNA is paid an administrative fee to process claims, administer our medical and prescription plans and provide related services such as Disease Management, 24-Hour Health Information Line, Home Delivery Pharmacy, and Customer Support. (Go to www.MyCIGNA.com to access or get information on these and other resources such as CIGNA’s Health Cost Estimator and My WebMD Health Manager.)
What happens if the current year actual claims are more than predicted?
If at any time the actual claims expense is more than the established contribution amount, UMS must make up for the shortfall through other, unrestricted UMS financial resources.
What happens if actual claims are less than predicted?
If claims expense is 1% or more below the predicted contribution rate over a two-year period, current bargaining agreements and Board of Trustees policy provide for a rebate to be paid to affected employees.