Should ACGME/NRMP mandate full disclosure of health insurance costs at time of interview?

[cbrons]

I've found it incredibly frustrating to call around and pin down the specifics on how much insurance costs (in terms of premiums, deductables, etc.) for various residency programs. Several times I have called human resources directly and they tell me that they have no clue. The program coordinators also don't seem to know either.

This to me seems like something that every single program should be required to disclose at the time of interview. Not only the monthly or bimonthly premium cost for a single resident (which is all the information they usually have), but also deductables for health care and Rx, coinsurance, maximum benefits, etc. If you are a resident with dependents, this information is especially important in making an informed decision on which programs to rank.

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[mimelim]

Is this required when you interview for any other job? I'm not saying that it isn't pertinent information, although admittedly, I did not consider it when applying myself and you are the first that I've heard mention it as an issue.

While useful, it is hard to see anyone mandating this being available to applicants. I mean there are a lot of other useful pieces of information that isn't always readily/easily available that aren't mandated. I'm not sure bloating the system/process is a good idea.

 

[cbrons]

Is this required when you interview for any other job? I'm not saying that it isn't pertinent information, although admittedly, I did not consider it when applying myself and you are the first that I've heard mention it as an issue.

While useful, it is hard to see anyone mandating this being available to applicants. I mean there are a lot of other useful pieces of information that isn't always readily/easily available that aren't mandated. I'm not sure bloating the system/process is a good idea.

Is it really bloating the system though? It could be provided on a single sheet of paper, and from what I've heard, residency programs hire people to gather this kind of information. Believe it or not it actually can be difficult to find, and since residents are working 60-80 hours or more per week, it would be better if they go into a program knowing full well how much of their 48k salary is going to have to go towards health insurance for their family.

 

[mimelim]

Is it really bloating the system though? It could be provided on a single sheet of paper, and from what I've heard, residency programs hire people to gather this kind of information. Believe it or not it actually can be difficult to find, and since residents are working 60-80 hours or more per week, it would be better if they go into a program knowing full well how much of their 48k salary is going to have to go towards health insurance for their family.

Again, in no way disputing it's utility. Most of us are not paying as close of attention to this as we likely should be and those that are impacted more by it (like yourself) are going to pick up on it more than others.

But, yes, it does bloat the system. Someone has to figure it out and put it together. Residencies generally are not flush with cash. You can say that they hire people to gather it, but who exactly? The residency coordinator? (typically stretched very thin and few programs hold onto theirs for very long because of it). It certainly can be done, but it is hard to imagine programs wanting to do it, because it is more work to put together. Program directors aren't really paid more for the large amount of administrative crap they have to put into their jobs. Program coordinators (who this would likely fall to) would likely be able to figure it out, but not much more easily than you.

My point about bloating is that there are a lot of things like this. I'm in general against governing bodies mandating or increasing regulation. In this case, there are probably half a dozen other things that are just as important that aren't mandated to be revealed to applicants. If it is important to you, then spend the time figuring it out, just as you would with any other job application process, in the same way that some of us look up if different programs will cover licensing fees, board fees, loupes costs, lead costs, doppler costs, etc.

 

[235009]

I've found it incredibly frustrating to call around and pin down the specifics on how much insurance costs (in terms of premiums, deductables, etc.) for various residency programs. Several times I have called human resources directly and they tell me that they have no clue. The program coordinators also don't seem to know either.

This to me seems like something that every single program should be required to disclose at the time of interview. Not only the monthly or bimonthly premium cost for a single resident (which is all the information they usually have), but also deductables for health care and Rx, coinsurance, maximum benefits, etc. If you are a resident with dependents, this information is especially important in making an informed decision on which programs to rank.

The details you'll typically have to get from the health insurance company's website once you find out which plan they offer.


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[ProfMD]

This info should be easy for programs to pull together. They will have the same benefits for all residents in the hospital. The GME office could do it pretty easily. You're going to be presented with this info after match day, so they should have it handy.

That being said, I don't see anyone mandating that it happen.

 

[madchemist89]

Such information is always in flux on a calendar-calendar year basis. I would not make any decisions based on it as it can easily change 6 months into your residency.

 

[Wordead]

This info should be easy for programs to pull together. They will have the same benefits for all residents in the hospital. The GME office could do it pretty easily. You're going to be presented with this info after match day, so they should have it handy.

That being said, I don't see anyone mandating that it happen.

We have like 5 different plans for residents and they change constantly. I could see any attempt to consolidate all the information turning into, as mimelim said, a ton of bloat with inaccurate information.

 

[mimelim]

This info should be easy for programs to pull together. They will have the same benefits for all residents in the hospital. The GME office could do it pretty easily. You're going to be presented with this info after match day, so they should have it handy.

That being said, I don't see anyone mandating that it happen.

I don't think it is that easy to pull together. Maybe our system is convoluted, but after studying our system to try to figure out if it made sense to cover my wife, I don't think you could possibly distill it down into a simple pamphlet.

 

[Crayola227]

There's really no excuse why this info isn't more easily available.

I'm not saying we should mandate this, but any employee should be able to contact HR and get a number of who to call to discuss their plan benefits.

Or do we disagree that should be the case for employees??
Surely we must think that programs that have Federal dollars going to insure their residents and residents having premiums withheld for a group plan, must be able to fairly easily obtain this info? By phone? By plan info being mailed?

Even if it changes, there is current info somewhere.

There is no reason why an applicant shouldn't be able to get this info from a PD, Chief, or other resident employee on the plan. Most programs give you contact info for people in the program. There is no reason an applicant should not be able to call HR, or contact a lowly resident whose job would then be to dig in their paperwork and come up with some reasonable answers.

It wasn't until I was hired and HR emailed me all the plan info that I had it. It was a very simple pamphlet. No reason that couldn't be made available had an applicant asked for it later.

 

[Crayola227]

Let's stop making excuses for why the "leg work" can't be done easily on request for applicants.

Let's not act like it might not be a completely reasonable thing to take into account for matching.

If I wanted a baby, I would need a $20,000 biologic infusion. I also needed $4000 a month biologic injections TO DO MY JOB. So you better believe I looked at biologic coverage, one of the drug class coverages that can vary greatly. Also, I had another med that was $700 monthly.

Also, I looked at deductible knowing I would hit it. I took that right off the top of whatever program base salary.

I get that most of you are healthy and can afford to sign on the dotted line and not even think about this, but telling people that seem concerned about it not to be

Even if you're healthy.... my friend was telling me about other programs. In one, a wife had a baby and they owed like $650. Another had one in a different program, and it was $16,000 (normal vaginal birth).

This was actually something a Chief bragged to me about at another program, the delivery coverage for him and his wife.

 

[mvenus929]

There is no reason why an applicant shouldn't be able to get this info from a PD, Chief, or other resident employee on the plan. Most programs give you contact info for people in the program. There is no reason an applicant should not be able to call HR, or contact a lowly resident whose job would then be to dig in their paperwork and come up with some reasonable answers.

I'm sorry, but I have way too much going on in my own life to field questions from prospective applicants about the details regarding whether or not your biologics will be covered under the insurance plan the program provides. I'm more than happy to talk about my life in the program, but me trying to figure out how much you might have to pay if you do end up here is not part of my job description.

I agree that it should be easily accessible. I think for places with many programs, the GME office could put together the information and contact numbers for those who want more. But you should also realize that for most places, open enrollment is after match day, and they make yearly changes to the premiums, deductibles, and copays that may be very different than what you were quoted before rank lists were due.

 

[Crayola227]

I'm sorry, but I have way too much going on in my own life to field questions from prospective applicants about the details regarding whether or not your biologics will be covered under the insurance plan the program provides. I'm more than happy to talk about my life in the program, but me trying to figure out how much you might have to pay if you do end up here is not part of my job description.

I agree that it should be easily accessible. I think for places with many programs, the GME office could put together the information and contact numbers for those who want more. But you should also realize that for most places, open enrollment is after match day, and they make yearly changes to the premiums, deductibles, and copays that may be very different than what you were quoted before rank lists were due.

Fair enough.

I guess I mean if an email had gone out from the PD that a student wanted to know about our plans & did we have any info.... I could have just attached the PDF file I got from HR on my plan. It would have taken less than 5 minutes to do so.

 

[cbrons]

I'm sorry, but I have way too much going on in my own life to field questions from prospective applicants about the details regarding whether or not your biologics will be covered under the insurance plan the program provides. I'm more than happy to talk about my life in the program, but me trying to figure out how much you might have to pay if you do end up here is not part of my job description.

I agree that it should be easily accessible. I think for places with many programs, the GME office could put together the information and contact numbers for those who want more. But you should also realize that for most places, open enrollment is after match day, and they make yearly changes to the premiums, deductibles, and copays that may be very different than what you were quoted before rank lists were due.

Obviously the residents and program directors dont have to know the details. It should just be very clear who the person who knows them is.

Also, most university systems and hospitals are not changing their insurance plans in the middle of the year.

It's pretty important this info be more available, especially for people who have to insure more than themselves. I found out just recently there are a couple places I wasted time interviewing at because if I went there I would not be able to both house and provide health insurance for my wife and kids.

 

[mvenus929]

Obviously the residents and program directors dont have to know the details. It should just be very clear who the person who knows them is.

Also, most university systems and hospitals are not changing their insurance plans in the middle of the year.

It's pretty important this info be more available, especially for people who have to insure more than themselves. I found out just recently there are a couple places I wasted time interviewing at because if I went there I would not be able to both house and provide health insurance for my wife and kids.

My health system has open enrollment in May, in time for the new interns to select their plans to start in July. They make the changes right before open enrollment, which is after Match Day. So, the information given during interview season might not match up with the benefits offered once the contract goes out. Other places may do it differently, but given that the largest turnover for health systems occurs in the May-August time (when people are graduating and looking for jobs, and when people with kids can more easily relocate), I imagine it's not rare to have open enrollment during that time.

 

[Crayola227]

My health system has open enrollment in May, in time for the new interns to select their plans to start in July. They make the changes right before open enrollment, which is after Match Day. So, the information given during interview season might not match up with the benefits offered once the contract goes out. Other places may do it differently, but given that the largest turnover for health systems occurs in the May-August time (when people are graduating and looking for jobs, and when people with kids can more easily relocate), I imagine it's not rare to have open enrollment during that time.

Our program's is in Dec/Jan. They have an exception to enrollment for the June interns. Seems like the plan doesn't change much year to year.