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Frequently Asked Questions: Affordability

Stanford’s health insurance plan for dependents of students who are enrolled in Cardinal Care

What are the premiums?
For the 2019-2020 and 2020-2021 plan years, the Stanford Student Dependent Health Insurance Plan monthly costs for the student/family are as follows*:
Spouse                               $461.63
Child                                   $240.04
Children (2 or more)     $432.07
Spouse + child                 $701.69
Spouse + children          $893.69
*Note – these amounts reflect the cost to the student/family. The actual premium cost is higher.

Why are the premiums so high? Why are premiums increasing so much?
Each year, a number of factors contribute to health insurance costs for students and their dependents. Chief among these factors are plan experience (the actual cost of all services provided in the prior year), trends in usage (what types of services enrollees are using), and where care is occurring, to name a few. Ways to reduce costs, including those that might result from modifications in enrollee behavior (such as the use of ‘urgent care’ services instead of ‘emergency’ services if a situation allows it) are routinely considered. Ultimately, the insurance plans reflect the combination of cost and coverage that we feel best serves the needs of our diverse populations.

For the Dependent Plan specifically, taxes and fees imposed by state and federal governments have also contributed to the rise in cost over time, but even more of a factor for this smaller group of enrollees has been high rates of utilization of care, coupled with decreasing enrollment. Since the plan experience occurs among a small number of individuals, the impact of use is greater on cost and is reflected in the premiums. (The Affordable Care Act and the subsequent advent of Covered California in recent years has provided student families with new and competitive options for coverage. And, of course, some student families with a spouse/partner who has coverage through an employer choose to enroll dependents in that employer’s plan. The decrease in Dependent Plan enrollment means there are fewer members over which to spread risk, a phenomenon that contributes to cost rise.)

Finally, regional and national trends also impact premiums. Health care costs in many regions increase at a rate higher than inflation, a phenomenon that has been true in Northern California.

Does Stanford earn a profit on Dependent Plan insurance premiums?
Stanford does not make a profit. To the contrary, the premium students pay for their dependents is just part of the total cost of coverage. Stanford is subsidizing the program by drawing on university resources. This includes a grant provided by the provost for each of the past two years. Without these subsidies, the cost to a student family to cover dependents this year would be much higher.

Options to University sponsored health insurance

What other options are available to student families? How do these options compare to the university sponsored plan?
Comparable options for coverage may be available through the Covered California Health Insurance Marketplace for some families, and Vaden Health Center is also able to connect students with insurance brokers who can assist with identifying options in the market.

Stanford’s Dependent Plan was designed with Stanford’s dependent population in mind. It is a Preferred Provider Organization (PPO) plan with an actuarial value that places it in the gold category on the marketplace exchange, meaning the benefits level is robust. For utmost convenience, it offers in-network access to Palo Alto Medical Foundation (Sutter Health) and Stanford Health Care, the two big local providers.

Alternatives (take Kaiser, for example) may have lower premium cost, but they typically come with restrictions such as closed provider networks and geographic distance that do not work as well for the Stanford population(s).

How do Stanford’s plans compare to peer institutions?
It is extremely difficult to accurately compare Stanford’s plans (Cardinal Care and/or the Dependent Plan) with other institutions’ plans because so many variables are in play with plan design. Some schools have health fees that include dependent care, some do not. Benefits levels (i.e., what is covered versus not) differ. The mix of enrollees and amounts and types of utilization differ.  All of these factors are drivers in cost. Stanford is in an expensive geographic region and the cost of health care is proportionately higher than in many other areas. Stanford’s student and dependent plans, respectively, also offer very robust coverage.

How do Stanford’s plans compare with Covered California?
The university has compared its offerings (Cardinal Care and the Dependent Plan) to options available through the Covered California exchange each year, over the last few years. A key variable in any of these comparisons is how much government subsidy a student and/or student family will qualify for through the exchange. In very general terms, the university’s plans (with subsidies offered through Stanford) compare very favorably to similar plans (offering, for example, access to Stanford Medical Center) on the exchange.

Will the immigration status of an international student and family be affected if the family chooses a public health insurance plan?
This is an evolving situation. As it stands now, and as we understand it, the use of public benefits may impact an individual's eligibility to receive any immigration benefits such as change of immigration status (from international student to H-1 and beyond to permanent resident), extension of status, or admission to the United States. Out of an abundance of caution, we advise international students and scholars to avoid taking any public benefit if at all possible.

How Stanford assists student families with health insurance costs

Is Stanford committed to dependent health insurance over the long term?
Stanford is committed to offering a health insurance option for student families.

Does Stanford provide any resources to help with these costs?
Yes. For students with dependent children, the Graduate Family Grant was established in June 2018 to provide up to $10,000 per year per student family for expenses such as childcare, healthcare and rent. Effective January 2020, the Graduate Family Grant maximum has been increased and will provide up to $15,000 for academic year 2019-20 for each family. These increases will occur automatically for current recipients; students will not need to reapply.  New applications are welcome.

For students without dependent children, but who are covering a spouse through the Dependent Plan, effective January 2020 for the 2019-20 academic year, the Graduate Student Aid Fund has been expanded to provide up to $2,500 to students covering their spouse only. Eligible students will be notified in January and invited to apply.

Both the Graduate Family Grant and Graduate Student Aid Fund are based on financial need and are administered by the Financial Aid Office.  Student Loans are an additional option available to students with these expenses.

What will the university do in the future to further decrease spouse and dependent health insurance costs for students?
Health insurance is connected to larger concerns about the affordability of living in Northern California. The university’s Affordability Task Force will include dependent health care costs in its considerations. In addition, the university is actively exploring less costly coverage alternatives that could still meet the needs of the dependent population.

How the university works with students on this and related concerns

Does the university consult with students?
Students are providing valuable input. The university has been in discussions with concerned graduate students about how best to support them and their families. The Graduate Family Grant was an outcome of these discussions. Vice Provost for Student Affairs, Susie Brubaker-Cole, and Vice Provost for Graduate Education, Stacey Bent, will continue to engage with students on this topic.