Following a comprehensive months-long review, a
benefits advisory committee has presented to university
administration a series of recommendations intended to save
Johns Hopkins millions of dollars annually while still
maintaining its competitive breadth of offerings.
The review, which involved considerable employee
participation, was prompted by the steadily rising cost of
health care, compounded by the economic downturn in recent
years and the incremental increases in cost of other
benefits areas. The last comprehensive review of JHU
benefits occurred in 1991.
To guide the conception of any new benefits policies
and programs — the majority of which will go into
effect in January 2005 — the 14-member advisory
committee first recommended adopting an official benefits
philosophy that emphasizes flexibility, preventive wellness
and health maintenance, knowledge-based decision making and
affordability, for both Johns Hopkins and its employees.
A primary recommendation is that JHU should enhance
its programs for educating faculty and staff about
benefits. To that end, the university will develop for each
employee an annual compensation statement with specific
details on all the benefits, with corresponding dollar
values, utilized in the past year.
Charlene Hayes, vice
president for human resources, said
that Johns Hopkins wants its employees to focus on "total
"The annual report would show a person his or her
salary, and they would also see that Johns Hopkins paid
this much for health insurance, tuition remission, etc.,"
Hayes said. "It will be personalized for each employee, so
he or she can look at the bottom line: Not only did I earn
such-and-such an amount, but I received benefits that came
to this value."
In terms of existing benefits policies and programs,
the committee recommended looking into changes to the
benefits dollars allocation — for implementation in
2006 — with a goal of making it more equitable.
Benefits dollars represent the university's contributions
to the cost of benefits elected by individual faculty and
Another proposed change to benefits is to make more
preventive services, such as breast exams and annual
checkups, exempt from required co-payments and deductibles.
Some preventive services are currently exempt, but the
university wants to expand the offerings.
"The plan is to go over all the services available to
employees and determine, with health insurance carriers,
the full laundry list of preventive services and how much
they cost and then earmark some as nondeductibles, meaning
they won't count toward the employee's deductible," Hayes
said. "We want to encourage people to take advantage of
preventive services because, in the end, we spend less
money as we end up with fewer hospitalizations and less
To offset the rising cost of health care, employees
enrolled in self-insured plans, such as EHP, will see an
increase in their maximum out-of-pocket expenses,
co-payments and deductibles in a manner consistent with
rising costs, while maintaining cost-sharing levels at
about 80 percent to 20 percent for the university and
employees. HMO plans, such as Kaiser Permanente, will see
increases in co-payments.
Johns Hopkins has not made any adjustments to
co-payments and deductibles in more than 10 years.
"During that period, the cost of health care has just
skyrocketed," Hayes said. "Each year there has been a
significant increase, but we have not passed that on at any
level to employees. It is difficult to wait 10 years and
lower a boom on increases, so we have made the commitment
to review our plans now on an annual basis and make any
needed adjustment. Our hope is that through our preventive
services and other measures we will not see costs for
Hopkins rising as much as they have been."
The committee, which comprised representatives of
numerous university divisions and was chaired by Donald
Steinwachs, chair of Health Policy and Management at the
School of Public Health, and Fred Puddester, executive
director of the Budget Office, also recommended:
Structure prescription drug
co-payments to encourage the use of lower-cost options and
Continue to offer multiple health
plan options to meet employee needs.
Offer disease management programs
to assist the chronically ill with self-care and needed
Seek greater efficiency with the
administration of benefits programs to control costs
without impacting customer services.
The Office of Human Resources is currently searching
for a new senior director for benefits. Hayes said that the
priority of the new director will be to look
comprehensively at the administration of benefits and
determine if things can be done differently in order to
One change already made is to the open enrollment
process, which from now on will rely more heavily on the
Web. Hayes said that in order to save printing and mailing
costs, Human Resources will no longer send out mass
mailings of large benefits booklets.
"Some populations of employees — those who do
not have ready access to the Internet — will continue
to get the booklets sent to them, but we will be asking
everyone else to go to a Web site to enroll from now on,"
Hayes said. "When it's all added up, all these changes
could save the university millions of dollars, and that is
something we need to do. And from here on in, we will try
to stay ahead of the curve."