University insurance policies are in line with state regulations, according to the Illinois Department of Insurance.
Michael McRaith, director of the Illinois Department of Insurance, said for group policies the maximum exclusion period for pre-existing conditions is 12 months, which matches the university policy.
“That’s consistent with Illinois (regulations),” McRaith said.
The issue with insurance coverage began when SIUC graduate student Josh Potter lodged a complaint with the Illinois Department of Insurance because the university would not cover treatment for tumors growing in his thyroid, citing it as a pre-existing condition.
“In a year, they will let me use the coverage; but what am I supposed to do until then?” Potter said in Tuesday’s edition of the Daily Egyptian.
Jim Hunsaker, the university’s insurance administrator, said the pre-existing condition clause is a standard health care policy throughout the nation, and many other universities have similar policies where the student can be covered for any condition, pre-existing or not, after a 12-month period of coverage.
“This is not something that’s uncommon throughout the nation for that matter. (Illinois State University) does the exact same thing,” Hunsaker said.
For fall 2009, SIUC students pay $126.60 in fees for primary coverage and $284 for extended coverage, according to the SIUC Office of Records and Registration. At Illinois State University, students pay $161 for coverage in fall 2009, according to the ISU Student Insurance Office Web site. At the University of Illinois at Urbana-Champaign, undergraduate students pay $206 for coverage in fall 2009 and their policy includes coverage of pre-existing conditions, according to the university’s Student Insurance Office Web site.
Hunsaker said the university has considered changing the policy to include coverage of pre-existing conditions as recently as last year, but that change would cause an increase in student fees.
“Our student insurance claims payments are funded through the student health insurance or the student extended benefit fee,” Hunsaker said. “In order for us to increase that benefit … we were looking at a fee increase of roughly between $9 and $13 that would have to be passed onto the student.”
Hunsaker said the university insurance policy does not take effect until 72 hours prior to the start of classes each semester. If a student breaks their leg a week before classes start, Hunsaker said that would be considered a pre-existing condition, which would then not be covered by the university policy.
“I’m not at all minimizing Mr. Potter’s condition, but at the same time we have to take into account all of the students that we have here at SIU and how that’s going to impact everybody,” Hunsaker said.
But university policies could change depending on the outcome of the national health care reform debate. McRaith said Illinois would benefit from some of the reforms being discussed in Washington, such as the public option, which would ban coverage denial because of pre-existing conditions.
“Companies will not any longer be able to deny coverage based on a pre-existing condition,” McRaith sad.
While that would be applicable to corporations and companies throughout the state, McRaith said the expectation is that if the public option were to pass, once the state changed to those policies, non-private institutions, such as SIUC, would follow suit.
Christina Spakousky contributed to this report.
Madeleine Leroux can be reached at 536-3311 ext. 254.
