3 benefit strategies to prepare for health reform   lp
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3 benefit strategies to prepare for health reform   lp 3 benefit strategies to prepare for health reform lp Presentation Transcript

  • 3 Benefits Strategies
    To Help Employers
    Prepare for Health Reform
    Better Manage Health Care Cost Now.
    Prepared by:
    Tom Daly
    Hartwig Moss Benefits
    Toll Free: (800) 410-8140
    Direct: (504) 827-8930
    Cell: (504) 708-4866
    To get more valuable information about our agency and the services we provide, please visit www.hm-b.com or check out my blog at www.dalytom.com.
  • Agenda:
    Health Insurance in U. S. Today and Brief History
    How Did We Get Where We Are?
    What Does Health Reform Mean?
    For Employers?
    For Employees?
    3 Simple Strategies to Prepare for Health Reform.
    Defined Contribution Approach
    Health Reimbursement Arrangements (HRAs)
    Choice and Education
    Questions and Answers
  • Health Insurance in U.S. Today
  • Brief History of U.S. Health Insurance:
    Pre World War II:
    Limited Employer Involvement
    Catastrophic Health Coverage
    Individual/Family Focused
    Post World War II:
    Group and Individual Policies mostly Guarantee Issue
    Wage and Price Controls
    Employer Healthcare exempted from taxes and price controls
    Group Insurance flourished and transformed
    10% - Access to providers offering discounted fees for services
    50% - Access to pre-paid services
    40% - Insurance against financial devastation from serious illness/injury
    1970 – 2010 Individual Policies subject to medical underwriting – except NY, NJ, MA, RI, ME
    2009 Tax parity given to Individual Policies
  • Health Reform Impact to Employers
    Mandated Benefits for All
    No lifetime maximums
    Preventative Care with no copays or deductibles
    Federal Minimum Benefit – rich in comparison to some of the norms
    >50 Employees – Penalty for not offering “Affordable” Mandated Benefits
    $3,000/employee receiving exchange subsidy, $2,000 max on all employees
    <50 Employees – No Requirements, No Penalty
  • Health Reform Impact to Employees
    Mandated Benefits for All Policies
    No lifetime maximums
    Preventative Care with no copays or deductibles
    Federal Minimum Benefit – rich in comparison to some of the norm
    Individual Mandate
    Penalty paid if coverage is not in place. Up to 2.5% of earnings.
    Individual Premium Subsidy:
  • Defined Contribution Approach
    With the ultimate cost of Federally mandated plans still unknown, employers that can, should define their maximum financial contribution to actual premium cost.
    <50 employee groups and >50 employers with a large population of low-wage employees will move towards funding alone.
    >50 employee groups with high wages will have less funding flexibility and need to know how to evaluate appropriate funding levels.
  • Health Reimbursement Arrangements
    Employers can fund healthcare expenses (deductibles, coinsurances, copays) rather than simply paying and deducting as and expense their share of health insurance premiums.
    This gives employers the flexibility to take selected and defined healthcare expense risk while giving access to greater information and greater control over cost.
  • Health Reimbursement Arrangements
    Traditional Group Insurance
    Insurance Company Exposure
    Reinsurance Company Exposure
    RISK
    $
    Reinsurance Premium
    Insurance Company Exposure
    Employee Exposure
    Premium
    Insured Employees
  • Health Reimbursement Arrangements
    Alternate Funding Strategy
    Reinsurance Company Exposure
    RISK
    $
    Reinsurance Premium
    Insurance Company Exposure
    Employer Exposure
    Employee Exposure
    Premium
    Insured Employees
  • Choice and Education
  • Choice and Education
  • Choice and Education
    Copay Plan
    vs.
    HSA eligible Plan
    Copays:
    Coinsurance
    PC Visit:
    Specialist Visit:
    ER Visit:
    HRA
    Prescriptions:
    HRA
    Tier 1:
    Employee Deductible
    Tier 2:
    HSA
    Tier 3:
    Employee Deductible
  • Choice and Education
  • Questions
    Any Questions?