Affordable Care Act changes WKU employee health plan

Trey Crumbie

The Affordable Care Act will be bringing some changes to healthcare benefits for WKU employees in the near future.

Beginning Jan. 1, 2015, WKU employees who work more than 30 hours a week will be eligible for healthcare, as provided by the university because of the act, also known as “Obamacare.”

Tony Glisson, director of Human Resources, said when calculating the work hours of a faculty member, there are factors such as in-class, prep and post-class times.

Glisson said for every credit hour a professor teaches, that translates to three work hours total.

“Teaching is just not the only part of effort that’s counted when you look at faculty position,” Glisson said.

He said this change would affect part-time faculty but not student workers.

“We’ve looked at student population and grad students…and none of that population we believe would be eligible,” Glisson said. “Based on their limited hours that they’re available to work.”

The Department of Human Resources sent out a document last week that addressed some of the questions faculty may have about the ACA.

Glisson said the department decided to send out the documents because they wanted to bring the campus up to speed about the topic and clarify some of the information.

“The ACA itself is several thousand pages in terms of the law,” Glisson said.

He said WKU, along with other higher education organizations, has sought expertise from external institutions to help research, guide, inform and implement the healthcare plan. WKU chose Sibson Consulting.

Glisson said there are several key components to making sure WKU’s health plan benefits are compliant with ACA. These include wellness, out-of-pocket costs, and annual and lifetime plan limits. They’re defined as “value” and “affordability” requirements.

Glisson said each state has the option to set up its own marketplace for health insurance online called an “exchange.” Kentucky has its own exchange called “kynect.” Glisson said this is because of access and availability.

“Most of everything we do now is available online, and conveniently so,” Glisson said.

WKU has its own self-insured health plan, he said.

In the plan, WKU will pay all of or a portion of monthly healthcare payments, or a premium, depending on the type of plan chosen.

If a portion of the monthly premium remains unpaid, that amount comes out of the employee’s paycheck. WKU pays a fee to process claims to Anthem, a health insurance company that administers the WKU’s Health Plan.

WKU also covers other benefits such as retirement and dental and life insurance. Glisson said the money comes from the total operating budget of WKU, which is paid for with tuition, fees, grants and state-appropriated money.

Glisson said there are federally mandated changes in benefits in WKU’s Health Plan, such as allowing a dependent to stay on an insurance plan until age 26, removal of lifetime dollar benefits and direct access to OB/GYN services.

He also said there is also a fee called the Patient-Centered Outcomes Research Institute that WKU has to pay.

The fee goes toward research on the effectiveness of medical procedures. The fee is $1 for every member enrolled