Aetna audits added to health insurance waiver process

By Dixita Viswanath     8/28/13 7:00pm

Rice University's student health insurance waiver process changed for this academic year, according to Director of Benefits and Compensation Elaine Britt.

Like many higher educational institutes, Rice requires that all students have adequate health insurance. In order to guarantee that all students have basic health care, Rice asks all students to provide proof of existing coverage if enrolled. 

Previously, according to Britt, this process was managed internally by Rice. However, this year, the waiver process has been changed to include an electronic auditing system, which manages the insurance coverage and waiver processes.

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"This option was more cost-effective when compared with adding internal resources to review the student health insurance coverage," Britt said. "Aetna has been the insurance company for the student health plan for a number of years, so it's important to understand that we did not change insurance providers."

Aetna was selected to administer the waiver process by the Student Health Insurance Committee, whose members include students, faculty and staff. This method of auditing was chosen because it provides a more thorough check for all students,  Britt said.

"It ensures that all students have the health insurance coverage they need in the event they experience an injury or illness," Britt said. "In addition, since international health plans are so different and require so much expertise to evaluate, we didn't have the resources internally to determine if their health insurance met the compliance standards set by the U.S. government for their student visas .... [International students] now have the option of waiving out and [maintaining] the confidence that they are still in compliance with visa requirements."

The site went live July 29, later than expected. Between July 29 and August 15, Britt said 1,681 students enrolled in Rice's Aetna student plan. In all, there were 4,094 approved waivers and only 189 failed waivers out of 5,964 attempts. 

According to Student Association President Yoonjin Min, the SA got involved when students complained about declined waivers and potential conflicts of interest. 

"Since Aetna makes more money when waivers are not accepted (because then, students will enroll in their insurance), they could be making the process intentionally difficult or cumbersome for students," Min said. 

However, Britt said there is no conflict of interest in this process because Rice still retains control of the waiver process. 

"Aetna is only administering the waiver process for us based on the criteria we have set," Britt said. "We can intervene at any time, and we are monitoring the waivers and audits daily."

Brown College sophomore Spencer Seballos, whose waiver was initially denied and later accepted, said the entire process was unnecessarily stressful. 

"My health insurance, which is through my father's company, had not changed from last year," Seballos said. "The waiver last year was quickly approved without issue .... When I received the denial, I immediately wanted to know why this was rejected. Since nothing changed on my end, it had to be on Rice/Aetna's end."

Seballos said he had to fill out additional forms to prove his health care coverage complied with the Rice requirements.

McMurtry College freshman Minoti Kale said the process was smooth and easy to complete.

"After reading what some people on [Facebook] had written about the time and trouble it took for their waivers to get accepted, I really didn't expect mine to get accepted in a day," Kale said.

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