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FRIC meeting notes
November 2, 2012
Meeting was called to order at 11:30 am in 302 USB.
Members in attendance: Steve Bernholtz, Nancy Davin, Katherine Dudley, Matthew Glasson, Mary Greer, Daniel Katz, Sheldon Kurtz, Bernard Sorofman, Anand Vijh, Michael Wichman.
Members absent: Jon Garfinkel, Heather Schnoebelen, Victoria Sharp, Katherine Tachau.
Administrative Officers present: Sue Buckley, Richard Saunders.
Guests present: Rick Borchard, William Buss, Carla Clark, Dan Fick, Suzanne Hilleman, Debra Hughes, Susan Klatt, Gerald Rose.
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Committee members, administration representatives, and guests introduced themselves.
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The minutes of meeting from October 5, 2012, were approved unanimously.
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Richard Saunders updated committee members about the expected refund of $1.4 million every six months from TIAA-CREF. Like any other fund management company, TIAA-CREF charges fund fees. These fees exceed their costs, which may be due to increased asset values in a rising stock market or improved cost efficiencies. They say that they cannot easily lower their expenses for specific organizations since such action would require a substantial approval process. Since they are a non-profit organization, they are passing on the rebate to us. It is a significant amount. The University of Iowa has about $6 billion in retirement funds, out of which $3.8 billion is in TIAA-CREF funds eligible for this rebate. It works out to a payback of $2.8 million / $3.8 billion = 0.07% of fund assets every year (compared to fund expenses in the range of 0.40% to 0.50% every year).
The received rebate amount will be distributed to UI employees on a pro-rata basis. (More accurately, it will be re-invested in their TIAA-CREF funds.) That means employees would receive a rebate proportional to their holdings of TIAA-CREF retirement funds. Note this excludes funds from other investment companies, annuity accounts, mutual funds, etc. It works out to $98 per participant per year on average, but there will be considerable variation depending on retirement assets.
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The committee next took up the matter of UIHC (University of Iowa Hospitals and Clinics) privacy policy. The matter concerns uninvited solicitations to contribute to various research programs of UIHC sent by the UI Foundation. The Foundation was also being notified in advance of medical visits occurring. It was facilitated by the UIHC disclosing consumer information to UI Foundation. The practice was not in violation of any state or federal law as UIHC has an implicit agreement with consumers whereby this information can be disclosed unless they explicitly opt out. But it is inconsistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and the desires of many consumers based on anecdotal evidence. In October 9, 2012, Sheldon Kurtz and Nancy Davin, co-chairs of FRIC, had written a letter to UIHC Vice President Jean Robillard and UI Foundation President Lynnette Marshall concerning this privacy matter. The officials have since agreed to discontinue the practice the advance notice practice and the inclusion of the provider’s name. The opt-out clause in the patient agreement will be clarified and made simpler to accomplish including through the online medical record that is available.
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The discussion moved on to the topic of transgender medical coverage. This is a relatively rare medical procedure whereby a person changes his or her sex. The treatment may involve surgery and/or hormonal treatment. It usually requires additional support services, such as psychotherapy, and it costs around $40,000. It is also relatively rare. For example, under the University of California system a total of 42 persons have had this procedure since 2005. That includes seven years and a population of over 300,000 employees, which works out to about one case per year per 50,000 employees. One should be cautious in extrapolating from this number, however, since the availability of coverage is bound to increase the number. Richard Saunders informed the committee that there have been some queries about this procedure from UI students, but none from current employees. The University of Iowa has had around 4 known people who have undergone this treatment over the past 26 years.
Given low demand and the need for comprehensive services, at present only around 14 states have medical providers performing this type of surgery. Iowa is one of them with providers in Grinnell and Des Moines. UI HC is discussing the option of offering this treatment.
The question before the committee is whether the UICHOICE should cover this treatment. Coverage could involve the medical procedure, counseling, and incidentals. The legal question of whether we can be required to cover such treatment is not clear. In general, gender discrimination is illegal, but this is just a medical procedure. Employers not offering any health coverage at all are not accused of gender discrimination, so it is not clear how employers not offering this coverage could be accused of gender discrimination. Saunders will discuss the legal issue with the University General Counsel’s Office.
Most committee members seemed favorable to considering transgender medical coverage. Saunders will also contact the University of Michigan since it was mentioned that they might be covering it.
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Michael Wichman raised the question of whether secretarial help could be obtained for taking the minutes of FRIC meeting. The issue is nontrivial as it may set a precedent for all other charter committees to ask for such help. Besides, Sue Buckley pointed out that the points discussed by the committee are rather deep and anyone other than a fully involved committee member is unlikely to do justice to the minutes of the meeting.
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Among miscellaneous issues, Sue Buckley informed the committee that there had been barely any complaints and only a couple of queries about the elimination of CHIP 2 health insurance plan. Thus, this change is going well despite concerns expressed by some committee members. It is notable that a significant proportion of UI employees have already registered their benefits choices. Finally, Sheldon Kurtz informed the committee of Iowa Governor Terry Branstad’s recommendation that state employees volunteer to pay 20% of their health plan costs.
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The meeting adjourned around 12:45 p.m.
Recorder: Anand M. Vijh