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GAP 3.0 and 4.0 ppt presentation

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Dick gap3and4 generic powerpoint v9audio

  1. 1. Cost Saving Employee Benefit StrategiesToday and TomorrowGAP 3.0 and GAP 4.0
  2. 2.  Premium increases? Continue shifting costs to employees? Aging workforce and early retirees? ACA Compliance?Everyone’s goal: multiple year strategy thatreduces costs ANDmaintain (or improve) your current benefit levels?Cost of Health Insurance-Today’s Trends
  3. 3. Options for Employer GroupsDo nothing, hope for the best, then dumpyour employees to the Exchanges in 2014.Reduce employees “real” benefits byincreasing employee deductibles andpremium contributions.Or...Use one of 2 new, safe strategies toguarantee savings without risk…Andstill maintain (or improve) benefits…
  4. 4. GAPInsuranceHighDeductiblePlanThe “GAP” Insurance StrategyGAP Insurance is fully compliant under HIPAA and the Public HealthService Act (PHS Act)
  5. 5. MAJOR MEDICAL + GAP Insurance Equivalent (or better)coverage to current plans Same employee out-of-pocketexpenses (or better) Lower annual premium costs Stabilized annual insuranceincreases Typical annual savings up to$2k per employee!Combined plans cost lesswith same (or better)coverage!
  6. 6. Similar “GAP” Insurance Strategies Medicare + “Medigap” Supplemental PlansWe Love ourMediGap Plan
  7. 7. How “GAP” Works Employees receive two insurance cards; one for MajorMedical Plan and one for the GAP Plan. If the service is covered by Major Medical but is subjectto the new high deductible, employee’s bill will be paidby the GAP plan. No Claims forms necessary.
  8. 8. The “GAP 3.0 ” Strategy “Duplicate coverage” Increase major medical deductible to lower premiums. BCBSM CB 15/0 or 15/20 (5k ded) BCBS SB 4000 HRA MCLAREN POS 3K DED/ 3K COINSURANCE “Backfill” the new large deductible sufficient enough toduplicate existing benefit plan. New Benefit platform saves premium dollars whilemaintaining existing employee deductible/coinsurancedesign. We call this our “INSURED HRA”
  9. 9. The “GAP 3.0 ” Strategy “Duplicate coverage”
  10. 10. Sample Case – GAP 3.0 “Duplicate Coverage”
  11. 11. Sample Case – GAP 3.0 “Duplicate Coverage”Census Status Medical Total58 Employee $471.11 $471.1123 2 Person $1,130.67 $1,130.6710 Family $1,366.19 $1,366.1991 $66,991.69 $66,991.69Census Status Medical Total58 Employee $494.39 $494.3923 2 Person $1,186.55 $1,186.5510 Family $1,483.18 $1,483.1891 $70,797.07 $70,797.07Census Status Medical GAP 3.0 Total58 Employee $320.36 $101.84 $422.2023 2 Person $768.88 $195.05 $963.9310 Family $961.09 $276.52 $1,237.6191 $45,876.02 $11,926.59 $57,802.61$155,933.52Annual Savings Versus Renewal PlanSAMPLE GAP 3.0 COMPANYCurrent Plan: BCBS $500 DED/20% TO $1500Renewal Plan: BCBS $500 DED/20% TO $1500BCBS $5K DED/2.5 COINSURANCE + GAP 3.0 = $500 DED/20% TO $1500
  12. 12. The “GAP 4.0 ” Strategy “Improve Coverage” Increase major medical deductible/coinsurance to lowerpremiums. 2 “Bucket” approach Bucket 1 Inpatient Benefits1st dollar Inpatient benefits.GAP 4.0 covers the entire deductible/coinsurance .100% Inpatient benefits- 1st dollar coverage Bucket 2 Outpatient Benefits1st dollar Outpatient benefits.GAP 4.0 covers Outpatient services up to 70%Inpatient benefits- 1st dollar coverage We are calling this the “REVERSE HRA”
  13. 13. The “GAP 4.0 ” Strategy “Improve Coverage” Increase major medical deductible/coinsurance to lowerpremiums. BCBSM SB 4000 HRA MCLAREN POS 3K DED/3KCOINSURANCE UHC ALLSAVERS TOTAL HEALTH POS
  14. 14. The “GAP 4.0 ” Strategy “Improve Coverage”
  15. 15. Sample Case – GAP 4.0 “Improve Coverage”BCBS $500 DED/20% TO $1500 BCBS 5K DED/20% + GAP 4.0Primary $30 Copay $30 CopaySpecialist $30 Copay $30 CopayChiropractic $30 Copay $30 CopayX-Ray 80% After Deductible 100% to $5250, 20% thereafterBlood/Lab Tests 80% After Deductible 100% to $5250, 20% thereafterDeductible perCalendar year$500 Per Person $0 inpatient/$0 outpatientIn Patient Services 80% After Deductible 100%Out Patient Services 80% After Deductible 100% to $5250, 20% thereafterMRIs/CT/PET Scans 80% After Deductible 100% to $5250, 20% thereafterEmergency Room $100 Copay $100 CopayUrgent Care $50 Copay $50 CopayOut of Pocket: $2000 Per Person $0 inpatient/$2250 outpatientPrescription Drugs Covered - Tiered Copays Covered - Tiered CopaysSAMPLE GAP 4.0 COMPANYYOUR BENEFITS AT A GLANCEOffice VisitsHospital - In & Out-Patient ServicesDeductibles capped at two per family
  16. 16. Sample Case – GAP 4.0 “Improve Coverage”Census Status Medical Total58 Employee $471.11 $471.1123 2 Person $1,130.67 $1,130.6710 Family $1,366.19 $1,366.1991 $66,991.69 $66,991.69Census Status Medical Total58 Employee $494.39 $494.3923 2 Person $1,186.55 $1,186.5510 Family $1,483.18 $1,483.1891 $70,797.07 $70,797.07Census Status Medical GAP 4.0 Total58 Employee $320.36 $88.19 $408.5523 2 Person $768.88 $183.43 $952.3110 Family $961.09 $255.92 $1,217.0191 $45,876.02 $11,893.11 $57,769.13$156,335.28"Annual" GAP 4.0 Savings Versus Renewal PlanSAMPLE GAP 4.0 COMPANYCurrent Plan: BCBS $500 DED/20% TO $1500Renewal Plan: BCBS $500 DED/20% TO $1500BCBS $5K DED/2.5 COINSURANCE + GAP 4.0 = $7500 inpatient/$5250 outpatient
  17. 17. How We Communicate Benefits to EmployeesWe create 30 second video clipsof every employee benefit yourcompany offers and upload themto your own Online Channel.Employees can view 24/7 oncomputers or smartphones.Scan here to view our Smartphone VideoBenefit Tool or visit:Www.vimeo.com/channels/abctoolcompany
  18. 18. Call Chelten Benefits Group248-464-6544

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