Procedure may increase premiums

Mai Hoang

Insurance premiums for Western’s 1,500 faculty and staff may increase next year in light of a recent decision by administrators to finance a bone-marrow transplant for an employee’s daughter.

The university will use funding from its faculty and staff self-insurance reserve pool to pay for the procedure. The move may cause a jump in premiums, said Len Kogut, chair of Western’s Benefits Committee.

Faculty regent Mary Ellen Miller said members of the benefits committee told her that faculty and staff premiums could increase $20 per person, per month because of the procedure’s expense.

The tranplant has been reported to cost as much $500,000, said John Grise, an attorney for Western.

Western’s decision to dip into the reserve came after HCC Life, the company that handles Western insurance claims greater than $75,000, denied coverage for Presley Nash, the 4-year-old daughter of university employee Staci Nash and Brian “Slim” Nash, a Bowling Green city commission candidate.

The Nash family filed a lawsuit against Western last month in response to the insurance company’s refusal.

Grise said HCC denied coverage because the bone marrow transplant is considered an “experimental procedure” by the Food and Drug Administration.

But President Gary Ransdell said the state insurance bureau was not convinced the transplant was experimental and recommended the university provide coverage if HCC would not.

“That gave us the confidence that we should cover it,” Ransdell said.

But Miller said the benefits committee has said that Presley Nash’s bone-marrow transplant is a procedure no insurance company in the country would cover.

Kogut said the reserve fund will now be used to cover all medical expenses for Presley Nash’s transplant and all travel, lodging and meals required for the family during the procedure, minus a $1,000 deductible.

Despite the university’s decision to pay for the transplant, the Nashes have yet to drop their lawsuit. The family could not be reached for comment yesterday.

The family’s attorney, Janice Weiss of Louisville, said family members are at a Minnesota hospital where Presley Nash is receiving treatment.

She refused to comment on the case because it is a “sensitive issue.” She would not say if the family plans to drop its suit.

Western filed a response to the Nash’s lawsuit asking a federal judge to dismiss the case.

“It seems to me that the lawsuit is moot,” Grise said. “The thing they sued for has been granted.”

If the lawsuit finds a courtroom, Ransdell said any legal fees will also be covered by the reserve fund and increase the possibility of a raise in premiums.

Kogut said other factors, including other employee insurance claims and rising medical costs, may play a role in future raises in premiums.

“One case doesn’t drive everything,” he said.

If premiums increase, faculty and staff will be hit with higher insurance costs for the fourth consecutive year.

Miller said though some faculty are disappointed with the university’s decision, most are willing to absorb the premium increase for a child.

Connie Foster, a librarian at Helm-Cravens Library, said she understood the university’s reasoning for providing coverage to the family.

“If they have to increase, I would just as soon see the increase for a good cause,” Foster said.

University Senate president Robert Dietle said it wouldn’t be fair to blame the Nash family for any future increases.

“I think premiums are going up anyway,” he said. “I suspect only a small portion of an increase in insurance premiums can be attributed to the situation of the Nash family. Insurance is about shared risk. You can’t point to them and say they raised our insurance premiums.”

Reach Mai Hoang at [email protected]