October 2001

More Market-based Organizations Join the Catholic Health Initiatives Medical Plan


Dedicated customer service team provides excellent response

More than 12,000 employees from 10 market-based organizations are joining employees from national offices and 16 market-based organizations in open enrollment for benefits under the Catholic Health Initiatives medical plan. "As of January 1, more than 20,000 employees will be covered by our medical plan," said Renee Tehi, vice president of employee benefits for Catholic Health Initiatives. "With more of us coming together under one plan, Catholic Health Initiatives will have greater ability to manage the cost and benefits of the plan, which is more important than ever when medical inflation is on an upward spiral." As a country-wide employer, Catholic Health Initiatives has national account status with Blue Cross Blue Shield of Illinois, the primary administrative partner for the medical plan. "This gives us economies of scale, but what is even more important is that our employees get better customer service," said Tehi. "Blue Cross provides us with a dedicated customer service team that answers questions and pays claims only for the employees of Catholic Health Initiatives. This team understands our culture and our expectations, and they are experts on our medical plan. They are doing a terrific job of serving our employees." The major objectives of moving all employees into the Catholic Health Initiatives medical plan include: · Ensuring that medical benefits are consistent with core values. Because the medical plan is self-funded, Catholic Health Initiatives determines the level of coverage for specific services. "This allows us to ensure that our benefits plan is consistent with the core values of our organization," said Tehi. For example, in keeping with ethical and religious directives for Catholic health care providers, the Catholic Health Initiatives medical plan does not pay for contraceptives but does provide a generous benefit for fertility treatment. Other services, such as physical therapy, that are often limited under other plans can continue under the Catholic Health Initiatives medical plan for as long as they are medically necessary. · Encouraging the use of market-based organizations’ facilities. The plan encourages the use of Catholic Health Initiatives’ facilities by providing an enhanced benefit for facility charges that employees or dependents incur at any market-based organization. "About 70 percent of the hospital expense paid through the Catholic Health Initiatives medical plan is going back into our own facilities," said Tehi. "Employees receive the enhanced benefit at any Catholic Health Initiatives facility, not just where they work." ·Customizing communications for employees. Catholic Health Initiatives provides customized communications materials to market-based organizations to help employees understand and appreciate the medical benefits available to them. "We are providing each market-based organization with Catholic Health Initiatives-branded materials rather than standard booklets from health plans," said Tehi. "We’re also providing complete enrollment kits for each employee." In addition, Catholic Health Initiatives supports market-based human resources leaders with weekly conference calls that will continue through the implementation and open enrollment period. "After each implementation, we survey human resources leaders to find out how we can improve the process," said Tehi. "The entire medical plan was created based on employee feedback, and we continue to gather input." ·Lightening the load for market-based human resources professionals. The Catholic Health Initiatives medical plan removes an administrative and paperwork burden from market-based human resources teams. "Because employees can take questions about the medical plan directly to the dedicated customer service team, market-based human resources staff members have more time to devote to other priorities," said Tehi. · Contributing to more complete data on medical benefits. All market-based organizations will be enrolled in the medical plan by July 2002. Then, Catholic Health Initiatives will have the data it needs to manage the plan in the most effective way. "For the first time, we’ll have system-wide enrollment and cost data in one place," said Tehi. Long-range initiatives to control costs Once every Catholic Health Initiatives market-based organization offers the Catholic Health Initiatives medical plan, the organization will be able to pursue a number of aggressive, long-term methods for controlling costs. "When all of our employees are in the plan, Catholic Health Initiatives will have one risk pool that will help absorb fluctuations in each market-based organization’s claims activity from year to year," Tehi said. With all employees in one medical plan, Catholic Health Initiatives will also be able to use claims data to track illness and injury trends across the organization and focus disease management and cost control programs on these areas. "We’ll work with market-based organizations to understand the successful disease management programs they have in place, as well as areas in which Blue Cross programs may help," Tehi said. The system-wide plan will also make it possible for Catholic Health Initiatives to move toward a common strategy for sharing the cost of medical benefits with employees. "We must first understand the total cost of medical benefits across the system," said Tehi. "Then, we can optimize our spending to best serve the needs of our organization and our employees. Making sure that we offer employees coverage that they can afford is certainly part of the Catholic Health Initiatives commitment to caring for people." All of these objectives will take two to three years to begin to realize and to be reflected in plan costs, according to Tehi. "One more thing that we would like to accomplish is to streamline the rate structure, if possible, by grouping market-based organizations that have similar pricing and claims experience," she said. "Today, each market-based organization has a separate cost of coverage, which ensures that no market-based organization is subsidizing others that are located where costs are higher. However, over time we would like to reduce the number of rates to create larger pools of people, which should smooth rate fluctuations from year to year. We can do this when we have adequate information."

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