Affordable Healthcare: The Ethics of Increasing Family Premiums

This session describes a working case study on the decisions that a Jesuit University makes when considering how to adjust insurance premiums to account for increasing medical costs without the corresponding increase in employee wages. Each university in CJBE shares common values of social justice, care, and leadership for the margins. As the pandemic spread and our universities adapted, so did other industry structures. Supply chains were disrupted, governments and corporations went into debt, and individuals struggled with housing and safety. As economies and organizations have begun to assess the damages of this global health and economic trauma, inflation began rising at rates the world had not seen for a while. It is now time for organizations to restructure and reassess how they can be sustainable again. For one not-for-profit Jesuit university, the benefit reenrollment process is about to cause controversy. This case looks at a university that uses a self-funded medical insurance plan. Over the last couple years, employee medical claims have increased exponentially and at the rate the university is not able to afford. The natural reaction is to raise rates to cover the costs. However, under the Affordable Care Act, rates can only be so high as to not cost an employee more than 9.5% of their monthly wages. Without an increase in wages, the university cannot raise employee rates. However, the university can raise the rates to cover dependents. Thus, employees with families needing coverage could be paying much more per person and use less of the funds than employees without dependents. At a Jesuit university, this scenario lends itself to a protest, policy changes, potential labor disputes. What is a Jesuit university to do? Within this session, a professor of HR will speak alongside a VP of HR at the university to describe the processes used to make premium and funding decisions. They will talk about the ethical considerations and communications strategies. We plan to use this evolving case study in an upper-level HRM undergraduate course this fall to teach the complexities of benefit administration.