To opt out or not to opt out: For Simon Fraser's health plan, this is the question

Students with a basic provincial health care plan cannot opt out of Simon Fraser Student Society's new student health plan.

According to Todd Buttenham, national health plan administrator for the Canadian federation of students, SFU undergraduate and graduate students cannot opt out unless they have extended coverage elsewhere. Students will be automatically billed the $105 yearly cost of the plan and must provide proof of other coverage to be excluded.

At SFU, a referendum asking students if they wanted the plan was held in March, 1995. Of the 1317 students who voted on the health plan, 748 voted in favour.

The original wording of the ballot: "students with coverage elsewhere (through parents, spouse, employer, etc.) can opt out of the plan and be refunded the whole premium" did not clarify whether students who do not want coverage or have only basic coverage elsewhere can opt out.

Frank Karabotsos, the student society's treasurer, said "I think during the campaign period, which is now two years ago, it was made pretty clear to everyone. You weren't able to opt out even if you didn't want coverage. You were only able to opt out if you had an extended health plan."

The SFU plan is to start January, 1997 as part of the National student health network, a service of the Canadian Federation of Students. The Simon Fraser Student Society is the eighth student group at a Canadian university to sign up for the plan.

According to an information pamphlet from the Simon Fraser Student Society "In the current climate of increasing health care costs, students on fixed incomes are particularly vulnerable. Each year, the cost of prescription drugs and basic health services take increasingly large portions out of the limited budgets of many students. With continued cutbacks in provincial health plans, students have fewer and fewer options for complete and quality health care."

Katherine Whitbread, student representative on SFU's board of governors said that she is in favour of the plan because it is affordable compared to other extended health plans. She also said that innovations like benefits for same-sex couples and more affordable coverage for families make the plan a good one.

Though university administration was originally concerned that the plan used negative option billing, an illegal practice in B.C., the Simon Fraser's Board of Governors approved the plan this month.

Karabotsos said that the board of governors decided that the plan was not negative option billing because students were given a choice via referendum about whether they wanted coverage, while negative option billing does not allow for a choice.

Still, the onus is on students to provide proof that they are covered elsewhere. When asked if he thought student concern that they can only opt out with extended coverage elsewhere is legitimate Karabotsos said: "I think it's a legitimate concern, but I think that for the health plan to be effective, for it to cost only 70 dollars for the two semesters or $105 for the year, that's the conditions that have to be placed on it."

York university in Ontario has been the largest member of the National health network since 1991. York's local health plan administrator, Naomi Naimji, said that it was clear in York's referendum that only students with extended coverage could opt out.

Naimji added that the biggest complaint they get is still about who can opt out. "A lot of students think that they should be able to pick and choose the services they want," she said.

Naimji estimated that one-third of the 13,000 students covered by the plan at York opt out because they have extended coverage elsewhere.

The Canadian Federation of Students receives money for national administration and training of local coordinators; in addition, insurance broker Canadian Actuarial receives a commission. However, neither Buttenham nor Charles Jefferson from Canadian Actuarial would estimate the amount of money that the federation and broker would receive.

"In some cases, it has been interpreted that the CFS gets money for doing things that it already does," said Buttenham. He said that this is not true; the Network provides administrative support through its head office that the broker is not willing to provide.

Karabotsos said that approximately five dollars from each student will pay for the local administration of the plan at SFU, though this year the student society only expects three dollars per student for administration costs.

Karabotsos added that if the society has to increase the cost of the health plan, it will be put to referendum because the student society did not provide for cost increases in the wording of the original referendum question.

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