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Why exiting your group
health plan and providing
cash may be the right thing!
Brian Poger, CEO
Hi,
I’m Brian, CEO
of Benefitter
Employers have traditionally
offered health insurance for
two reasons
© Benefitter Insurance Solutions, Inc. 2014
© Benefitter Insurance Solutions, Inc. 2014
Retain
Employees
Attract
Employees1 2
Since WWII, employer
sponsored insurance has
stayed largely the same…
© Benefitter Insurance Solutions, Inc. 2014
© Benefitter Insurance Solutions, Inc. 2014
…even as our world has
changed around us
until now
© Benefitter Insurance Solutions, Inc. 2014
The Affordable Care Act
(ACA) created two profound
market changes that affect
how all companies look at
health coverage.
© Benefitter Insurance Solutions, Inc. 2014
© Benefitter Insurance Solutions, Inc. 2014
First, it created
a market for
insurance where
anyone, healthy
or sick can get
covered
© Benefitter Insurance Solutions, Inc. 2014
Second, it
provided federal
subsidies to help
about 70% of
the population
buy insurance
These subsidies can be
enormous
© Benefitter Insurance Solutions, Inc. 2014
© Benefitter Insurance Solutions, Inc. 2014
A family of four spends on average
$16,000 per year on health insurance
Group Health
Insurance
© Benefitter Insurance Solutions, Inc. 2014
Subsidized
Individual
Insurance
With subsidies, their total cost can be
reduced to $7,000 per year, or less
© Benefitter Insurance Solutions, Inc. 2014
But there’s a
catch (of course)
© Benefitter Insurance Solutions, Inc. 2014
=Group Health
Insurance
Employees who qualify for group
health insurance cannot access
these subsidized plans
Subsidies
© Benefitter Insurance Solutions, Inc. 2014
So for employers,
the best way to
help your workers
access subsidies,
is to stop offering
group insurance
© Benefitter Insurance Solutions, Inc. 2014
Counter-intuitive? Yes.
Dropping group coverage is
in some cases the only way
to “do right” by your
employees.
© Benefitter Insurance Solutions, Inc. 2014
These rules might make you feel like you’re
stuck between a rock and a hard place…
© Benefitter Insurance Solutions, Inc. 2014
But we’ve already seen some
companies take action.
Several Fortune 500s have reduced
their benefits and moved employees
to the exchange.
By 2025, “fewer than
20 percent of workers
…will receive …
employer-sponsored
health insurance”
- Zeke Emanuel
Why employers will
stop offering insurance
March 2014
And soon, more may follow….
© Benefitter Insurance Solutions, Inc. 2014
Drop
Coverage
?
Employee
Impact?
Employer
Impact?
For the average employer or broker,
determining the appropriate course of action
is no easy task
© Benefitter Insurance Solutions, Inc. 2014
Subsidies are based on income
So by dropping group coverage, some employees will
come out ahead, while others will come out behind
© Benefitter Insurance Solutions, Inc. 2014
But savvy employers who recognize this
can provide extra compensation to make it
fair for all employees
© Benefitter Insurance Solutions, Inc. 2014
To do this right, you must account for:
• Individual market rates
• Plan design
• Post-tax employer contributions
• Government subsidies for exchange plans
• Employer mandate penalties
• Payroll tax
• Other tax effects
© Benefitter Insurance Solutions, Inc. 2014
Sound complicated?
© Benefitter Insurance Solutions, Inc. 2014
We make
it simple
Good news…
© Benefitter Insurance Solutions, Inc. 2014
With Benefitter
Advisor, brokers
can guide their
clients to easily
compare the costs
of group vs
individual health
insurance.
© Benefitter Insurance Solutions, Inc. 2014
We take into
account the detailed
makeup of an
employee
population, to
predict the net
effect of federal
subsidies
© Benefitter Insurance Solutions, Inc. 2014
We predict the
value of subsidies
that will be
available, based on
employee income
and household size
(using estimates
that can be refined)
© Benefitter Insurance Solutions, Inc. 2014
And using an
employee-lens, we
develop an approach
to adjusting
compensation in a
smart, individualized
manner
© Benefitter Insurance Solutions, Inc. 2014
We’re entering a whole new world of
health benefits. I invite you to learn more
by clicking the link below.
Click to learn more
Brian Poger, CEO
info@benefitter.com
www.benefitter.com
@benefitterHQ
© Benefitter Insurance Solutions, Inc. 2014

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Why exiting your group health plan and providing cash may be the right thing

  • 1. Why exiting your group health plan and providing cash may be the right thing! Brian Poger, CEO
  • 3. Employers have traditionally offered health insurance for two reasons © Benefitter Insurance Solutions, Inc. 2014
  • 4. © Benefitter Insurance Solutions, Inc. 2014 Retain Employees Attract Employees1 2
  • 5. Since WWII, employer sponsored insurance has stayed largely the same… © Benefitter Insurance Solutions, Inc. 2014
  • 6. © Benefitter Insurance Solutions, Inc. 2014 …even as our world has changed around us
  • 7. until now © Benefitter Insurance Solutions, Inc. 2014
  • 8. The Affordable Care Act (ACA) created two profound market changes that affect how all companies look at health coverage. © Benefitter Insurance Solutions, Inc. 2014
  • 9. © Benefitter Insurance Solutions, Inc. 2014 First, it created a market for insurance where anyone, healthy or sick can get covered
  • 10. © Benefitter Insurance Solutions, Inc. 2014 Second, it provided federal subsidies to help about 70% of the population buy insurance
  • 11. These subsidies can be enormous © Benefitter Insurance Solutions, Inc. 2014
  • 12. © Benefitter Insurance Solutions, Inc. 2014 A family of four spends on average $16,000 per year on health insurance Group Health Insurance
  • 13. © Benefitter Insurance Solutions, Inc. 2014 Subsidized Individual Insurance With subsidies, their total cost can be reduced to $7,000 per year, or less
  • 14. © Benefitter Insurance Solutions, Inc. 2014 But there’s a catch (of course)
  • 15. © Benefitter Insurance Solutions, Inc. 2014 =Group Health Insurance Employees who qualify for group health insurance cannot access these subsidized plans Subsidies
  • 16. © Benefitter Insurance Solutions, Inc. 2014 So for employers, the best way to help your workers access subsidies, is to stop offering group insurance
  • 17. © Benefitter Insurance Solutions, Inc. 2014 Counter-intuitive? Yes. Dropping group coverage is in some cases the only way to “do right” by your employees.
  • 18. © Benefitter Insurance Solutions, Inc. 2014 These rules might make you feel like you’re stuck between a rock and a hard place…
  • 19. © Benefitter Insurance Solutions, Inc. 2014 But we’ve already seen some companies take action. Several Fortune 500s have reduced their benefits and moved employees to the exchange.
  • 20. By 2025, “fewer than 20 percent of workers …will receive … employer-sponsored health insurance” - Zeke Emanuel Why employers will stop offering insurance March 2014 And soon, more may follow….
  • 21. © Benefitter Insurance Solutions, Inc. 2014 Drop Coverage ? Employee Impact? Employer Impact? For the average employer or broker, determining the appropriate course of action is no easy task
  • 22. © Benefitter Insurance Solutions, Inc. 2014 Subsidies are based on income So by dropping group coverage, some employees will come out ahead, while others will come out behind
  • 23. © Benefitter Insurance Solutions, Inc. 2014 But savvy employers who recognize this can provide extra compensation to make it fair for all employees
  • 24. © Benefitter Insurance Solutions, Inc. 2014 To do this right, you must account for: • Individual market rates • Plan design • Post-tax employer contributions • Government subsidies for exchange plans • Employer mandate penalties • Payroll tax • Other tax effects
  • 25. © Benefitter Insurance Solutions, Inc. 2014 Sound complicated?
  • 26. © Benefitter Insurance Solutions, Inc. 2014 We make it simple Good news…
  • 27. © Benefitter Insurance Solutions, Inc. 2014 With Benefitter Advisor, brokers can guide their clients to easily compare the costs of group vs individual health insurance.
  • 28. © Benefitter Insurance Solutions, Inc. 2014 We take into account the detailed makeup of an employee population, to predict the net effect of federal subsidies
  • 29. © Benefitter Insurance Solutions, Inc. 2014 We predict the value of subsidies that will be available, based on employee income and household size (using estimates that can be refined)
  • 30. © Benefitter Insurance Solutions, Inc. 2014 And using an employee-lens, we develop an approach to adjusting compensation in a smart, individualized manner
  • 31. © Benefitter Insurance Solutions, Inc. 2014 We’re entering a whole new world of health benefits. I invite you to learn more by clicking the link below. Click to learn more

Editor's Notes

  1. Hi, I’m Brian Poger, CEO of Benefitter, kicking off 3 minutes to launch. It’s clear to me based on the the last talks that I’m here to help create a little lively coffee debate… So, let’s get started…
  2. For the past 60 years, employers offered group health insurance (CLICK) to attract and retain employees. Without a company plan, many employees couldn’t qualify for coverage or if they could, they couldn’t afford it. But the Affordable Care Act, or ACA, changes everything. In an ACA world, many employers would be better off dropping their group health insurance and giving employees money to buy their own insurance.
  3. Now, as you know, the ACA, at its core, does two things: (CLICK) 1) creates a market for insurance where anyone, healthy or sick can buy health insurance, (CLICK) 2) provides federal subsidies for about 70% of the population These subsidies can be enormous! For the average family of 4, group health insurance costs CLICK about $16K / year. The same family can buy subsidized coverage In the marketplace CLICK for only $7K. But, here’s the CATCH.
  4. Now, as you know, the ACA, at its core, does two things: (CLICK) 1) creates a market for insurance where anyone, healthy or sick can buy health insurance, (CLICK) 2) provides federal subsidies for about 70% of the population These subsidies can be enormous! For the average family of 4, group health insurance costs CLICK about $16K / year. The same family can buy subsidized coverage In the marketplace CLICK for only $7K. But, here’s the CATCH.
  5. These subsidies can be enormous! For the average family of 4, group health insurance costs CLICK about $16K / year. The same family can buy subsidized coverage In the marketplace CLICK for only $7K. But, here’s the CATCH. Employees who qualify for group health insurance cannot access these subsidized plans. And these economics create a strong incentive for many employers to consider dropping their group plans.
  6. These subsidies can be enormous! For the average family of 4, group health insurance costs CLICK about $16K / year. The same family can buy subsidized coverage In the marketplace CLICK for only $7K. But, here’s the CATCH. Employees who qualify for group health insurance cannot access these subsidized plans. And these economics create a strong incentive for many employers to consider dropping their group plans.
  7. Employees who qualify for group health insurance cannot access these subsidized plans. And these economics create a strong incentive for many employers to consider dropping their group plans. We’re already seeing this happen. Many Fortune 500 employers are reducing their group health insurance benefits, and moving employees to the public marketplaces. And that’s just the tip of the iceberg.
  8. We’re already seeing this happen. Many Fortune 500 employers are reducing their group health insurance benefits, and moving employees to the public marketplaces. And that’s just the tip of the iceberg. It was big news when the NY Times reported Zeke Emanuel, one of the ACA architects and administration advocates, predicted the demise of employer sponsored health insurance. But if I’m an employer, what should I do?
  9. It was big news when the NY Times reported Zeke Emanuel, one of the ACA architects and administration advocates, predicted the demise of employer sponsored health insurance. But if I’m an employer, what should I do? Should I drop coverage? CLICK What’s the impact for my business? CLICK For my employees?
  10. Should I drop coverage? CLICK What’s the impact for my business? CLICK For my employees? Many of my employees may get big subsidies, but others will be small and some none at all... If I’m an employer and I simply drop my group plan, the folks with the big subsidies will be CLICK
  11. Many of my employees may get big subsidies, but others will be small and some none at all... If I’m an employer and I simply drop my group plan, the folks with the big subsidies will be CLICK (glad, but my other employees may be sad or even mad)
  12. So rather than simply drop coverage, savvy employers will adjust compensation so all of their employees can still purchase health insurance affordably. Unfortunately, given the complex way subsidies work, that’s easier said than done… Until Now! Today, we’re releasing our new BenefitterAdvisor tool
  13. Until Now! Today, we’re releasing our new BenefitterAdvisor tool With Benefitter Advisor, employers can quickly CLICK compare the cost of their group health insurance to the new subsidized individual market. CLICK And, we make it easy to create a compensation strategy that’s a win for employers AND their employees!
  14. With Benefitter Advisor, employers can quickly CLICK compare the cost of their group health insurance to the new subsidized individual market. CLICK And, we make it easy to create a compensation strategy that’s a win for employers AND their employees! Benefitter advisor takes into account the detailed makeup of the employee population
  15. Benefitter Advisor takes into account the detailed makeup of the employee population To predict how subsidies available in the individual market can impact the net cost of employees’ individual insurance.
  16. To predict how subsidies available in the individual market can impact the net cost of employees’ individual insurance. AND, it’s this employee lens, and our proprietary approach to adjusting compensation in a smart, individualized manner, that makes tapping into the $1 trillion in federal subsidies accessible and beneficial.
  17. AND, it’s this employee lens, and our proprietary approach to adjusting compensation in a smart, individualized manner, that makes tapping into the $1 trillion in federal subsidies accessible and beneficial. We’ve entered into a whole new ACA world. A world where dropping health insurance and providing money is better for many employers and their employees.
  18. I’m Brian Poger, CEO of Benefitter. Thanks very much for letting me share how our technology can help employers and employees benefit from healthcare reform!