Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Gts short version 97 2003 two


Published on

TRICARE covers 3.33 million military retirees and dependents under age 65. Most of them work in governments and businesses in the USA. Their employers can virtually eliminate paying insurance premiums/claims on them simply by offering a voluntary TRICARE SUPPLEMENT.

Published in: Business, Economy & Finance
  • Be the first to comment

  • Be the first to like this

Gts short version 97 2003 two

  1. 1. Group TRICARE Supplement (GTS)Serving Employers and TheirMilitary Retiree Employees and Spouses
  2. 2. What is TRICARE?TRICARE is a health care benefit similar to anemployer sponsored health plan that isprovided by the US Department of DefenseMilitary Health SystemA military retiree and eligible spouse (usuallywith 20+ years of service) retains TRICARE toage 65There are 3.3 million military retirees andspouses (some work for you!)Whitley Agency, Inc.
  3. 3. So What?When a TRICARE employee is hired, he/she isoffered the new employer’s health care planWhen the employer’s plan is elected, It paysfirst, and TRICARE considers what’s left overThis, obviously, is not as good for the newemployer as TRICARE paying firstAnd why would someone who already has agood benefit plan, want more insurance?Whitley Agency, Inc.
  4. 4. Why Buy More Insurance?New Employee is:*Older – Likely to have more claims*Unhealthy – Likely to have more claims*Fear of future illness*Wants insurance company to pay outof pocket expenses rather than self-payWhitley Agency, Inc.
  5. 5. What is the GroupTRICARE Supplement?The Group TRICARE Supplement (GTS) is aninsurance plan designed to pay what TRICAREdoes not payOffering the GTS allows TRICARE employees touse TRICARE as primary coverage, with thesupplement paying all or most of the balanceThe employee is not on the employer’s healthplan and any associated costs are savedWhitley Agency, Inc.
  6. 6. Why Offer the GTS?Fully insured plans pay no premium onemployees who are not coveredSelf-funded plans pay no claims on employeeswho are not coveredSince the GTS premium is generally less thanpayroll deductions for the employer plan, thelikelihood of someone joining the employerplan as health care needs increase, is virtuallyeliminatedWhitley Agency, Inc.
  7. 7. Why Offer the GTS?Offering the GTS is an additional wayto show support for those who havegiven much to protect our freedomsIt allows TRICARE beneficiaries tochoose an alternate health caresolution that better serves theirneedsWhitley Agency, Inc.
  8. 8. Why Offer the GTS?The average age of a GTS enrollee is 55, and isat higher risk to have more frequent and highercost claims than the average age employeeAs TRICARE eligible employees choose to beremoved from (or do not enroll in) theemployer sponsored plan, the employer plan’srisk level is reduced, which results in lowercosts for other employees and the employer;everyone wins!Whitley Agency, Inc.
  9. 9. TRICARE Offers Two Plans Prime—Managed Care, HMO type plan:1. High benefits and low out of pocket costs (lesslikely to buy additional insurance)2. Restrictive network of mainly militaryproviders3. Requires an annual enrollment fee4. Prime is currently primary coverage forapproximately 49% of military retirees andtheir covered dependents**According to a 2011 GAO reportWhitley Agency, Inc.
  10. 10. TRICARE Offers Two Plans Standard—Fee for service plan1. Lower benefits and higher out of pocket coststhan Prime (more likely to buy insurance)2. No restrictive network—use civilian or militaryproviders3. No annual enrollment fee4. Standard is primary coverage forapproximately 26% of military retirees**According to a 2011 GAO reportWhitley Agency, Inc.
  11. 11. TRICARE Has A Cost Problem From 2001 through 2010, Department of Defense health carespending rose from $19 billion to $49 billion* a $30,000,000,000 increase! + 158% When Prime and Standard plans were created, they weredesigned so more people would choose Prime, and it worked The problem is that Prime costs about 25% more thanStandard In order to save money, Prime members are being forced tomove from Prime to Standard As this happens, more TRICARE employees will opt into theiremployer’s plan, especially those in poor health Or they will buy the GTS if it’s offered to them*According to a 2011 GAO reportWhitley Agency, Inc.
  12. 12. Self-fund or Buy Insurance?For individual health risk; deductibles, copays, cost share,costs unpaid by the employer plan or TRICARE, can be paidby the employee (self-fund) or by an insurance company(buy insurance)Self-funding is chosen when risk is low; out of pocket costsare low (Prime), the person is healthy and has financialresources to pay unpaid billsBuying Insurance is chosen when risk is high; out of pocketcosts are higher (Standard), the person is unhealthy andlacks cash on hand to pay unpaid bills, or is diagnosed witha costly illness or has a high-cost accidentAs risk increases, employees buy insurance, either theemployer health plan or the GTS!Whitley Agency, Inc.
  13. 13. The GTS Works Like aGroup Benefit No underwriting, no health questions, everyone isaccepted No pre-existing waiting period, GTS pays from theeffective date No minimum enrollment required Any employer may offer the GTS Group rates, everyone pays the same rate No restrictive provider network, use civilian ormilitary providers Full portability when employment terminatesWhitley Agency, Inc.
  14. 14. Implementation Is Easy*We provide:Enrollment meetings / assistance, as necessaryEmployee communicationsStaff training, as necessaryA micro-website, customized for your company, toprovide GTS information and enrollment for youremployees*Since TRICARE covers Active Military Members as well as Military Retirees, most ofthese employees have been covered by TRICARE for at least 20 years. They alreadyknow what it is and how it works, which makes the GTS much easier to implement andmaintain.Whitley Agency, Inc.
  15. 15. More Important FactsThe GTS has been available since 1998Underwritten by Transamerica and MonumentalInsurance Co. (both are TransamericaCompanies)Administered by Association and SocietyInsurance Company (ASI) Offered by more than 500 corporations Offered by 19 of the top 20 US defense contractors Offered by many state and local governmentsWhitley Agency, Inc.
  16. 16. Is This Legal?YES!In 2007, the federal government reviewed thisproduct and legislated its permissibility in Section 707of the John Warner National Defense Authorization Actof 2007Employers may not pay any portion of the GTSpremiumThere are several conditions employers are requiredto meet in order to legally offer the GTSWe provide what you need in order to certify yourcompliance with federal regulations!Whitley Agency, Inc.
  17. 17. For More InformationBilly A Whitley, CHC, HIAEmployee Benefit ConsultantWhitley Agency, Inc.1019 Bent Pine CtColumbus, Georgia 31909706-507-9764 Office706-332-4585 CellRequest a Proposal at:http://grouptricaresupplement.combilly.whitley@grouptricaresupplement.comWhitley Agency, Inc.