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Managing Your Health Insurance in Inflationary Times,[object Object],The next era in providing health insurance as an employee benefit,[object Object],Presented by: ,[object Object],Marcus Newman, CBC,[object Object],Vice President, GCG Financial,[object Object]
Let’s Start With the New Law,[object Object]
Patient Protection and Affordable Care Act 2010,[object Object],	Changes Required by the New Law This Year (effective in 6 months),[object Object],[object Object]
Pre-existing condition exclusions for enrollees under age 19 must be eliminated.
Lifetime limits in coverage are no longer allowable.
Annual limits on non-essential benefits are no longer allowable.
Eligibility rules favoring highly compensated employees are prohibited.The implementation of this new law will usher in an era of unprecedented “hyper inflation” to group insurance for both small and mid-sized groups.,[object Object],As if the past 10 years have not been marked by inflation of the cost of health insurance beyond what most employers can easily accept, we are already seeing a dramatic affect on the size of the renewal increases. ,[object Object],This presentation is designed to help you understand how to deal with rapidly rising costs.  We will examine how traditional methods of cost control will help, and look as some creative strategies that can make a difference.,[object Object]
Is There Cause for Concern?,[object Object]
Health Insurance Cost Increase 2006-2007,[object Object],Differential,[object Object],Source: 2006 - 2007 Benefits Benchmark™ Survey – Chicagohealthinsurance.com,[object Object]
Health Insurance Cost Increase 2009-2010,[object Object],Differential,[object Object],Source: 2009 - 2010 Benefits Benchmark™ Survey – Chicagohealthinsurance.com,[object Object]
Just in case the last two slides didn’t make an impact,[object Object],Differential,[object Object],Differential,[object Object]
Cost Control,[object Object]
Traditional Methods of Cost Control,[object Object],Alter Plan Design,[object Object],Deductible,[object Object],Co-Pays,[object Object],Co-Insurance,[object Object],Drug Coverage,[object Object],Max Out of Pocket,[object Object],Change Cost Sharing,[object Object],Pass on Cost,[object Object],Alter Strategy,[object Object],Stop Offering Benefits,[object Object]
Law of Diminishing Returns,[object Object],[object Object]
  Higher Encounter Fees
  Higher Financial Exposure for Illness or Injury        The Continued Degradation			     of the Plan Design,[object Object],The Point of No Return,[object Object],[object Object]
  Employee Distrust Relative to Benefit Decisions
  Loss of employees or potential employees,[object Object]
Employee Cost Sharing as Cost Control,[object Object],2009 Survey Results,[object Object],Increased Employee’s Share of the Premium	25%,[object Object],Methodology,[object Object],Percentage Relationship (i.e. 75/25),[object Object],Flat Dollar Amount (i.e. $200 per employee),[object Object],Based on Longevity (i.e. 1-3 yrs. 50% 4-6 yrs. 75%),[object Object],Source: 2009 Benefits Benchmark™ Survey – Chicagohealthinsurance.com,[object Object]
Legal Compliance May Require New Method of Employee Cost Sharing!,[object Object],[object Object]
Employers offering “unaffordable” coverage will be assessed a $3000 penalty for each full-time employee receiving a federal subsidy (first 30 employees will be excluded.)
Coverage will be deemed “unaffordable” if the employee’s share of the premium exceeds 9.5%  of the family income.Source: Rebecca L. Dobbs, Esq. Smith Amundsen “How Employers Will Be Affected by Health Care Reform,[object Object]
Terminating Health Insurance as an Employee Benefit?,[object Object],[object Object]
Employers who do not offer coverage will be assessed an annual penalty of $2,000 for each employee not covered.  In calculating the amount of the tax, the first 30 employees will be excluded.Source: Jerry Geisel, businessinsurance.com/article 3/30/10 “Understanding key provisions in federal health care reform legislation”,[object Object]
Creative Strategy,[object Object]
Creative Plan Design Using CONSUMERDRIVENHEALTHCARE,[object Object],Qualified High Deductible Health Plans,[object Object],Standardized plan design developed from the Federal Government,[object Object],Price points significantly below traditional PPO (-20 – -30%),[object Object],Health Saving Accounts (HSA),[object Object],Healthcare Reimbursement Arrangements (HRA),[object Object],Employee Education,[object Object]
Traditional PPO Environment,[object Object],Medical Underwriting,[object Object],FINAL RATES,[object Object],Insurance Quote,[object Object]
HRA Provides Leverage,[object Object],FINAL RATES,[object Object],FINAL RATES,[object Object]
Traditional PPO Plan,[object Object],Doctor Co-Pay,[object Object],Deductible,[object Object],NOTES,[object Object],$30,[object Object],$500,[object Object],Why do we have this plan at all?  It is so old and expensive.  I wonder if my employees even appreciate how benefit rich it really is.  At my last job we didn’t have this kind of plan and nobody ever complained.,[object Object],Prescription,[object Object],Drug ,[object Object],Co-Pay,[object Object],$15 / $35 / $50,[object Object],In Network,[object Object],Coverage,[object Object],In Network,[object Object],Max,[object Object],$2,500,[object Object],90%,[object Object]
Proposed Insurance Plan (still a PPO),[object Object],[object Object]
  Everything goes to deductible
  Employee charged negotiated discountsDeductible,[object Object],$1500,[object Object],Doctor Co-Pays,[object Object],NOTES,[object Object],I am not sure that I like this because it seems like the employee would be on the hook for more money.  Doctor visits and prescriptions … they might not like it.,[object Object],Did he say 20-30% reductions in cost.  I like that!!,[object Object],Prescription Drugs,[object Object],In Network,[object Object],Max Out of Pocket,[object Object],In Network,[object Object],Co-Insurance Coverage,[object Object],$3000,[object Object],80%,[object Object]
Proposed HRA Program,[object Object],The reimbursement program is designed to reduce the financial exposure to an employee during the DEDUCTIBLE period of coverage only. ,[object Object],Deductible,[object Object],[object Object]
  Limits Employer reimbursement exposure to $1,000
  Employee max reduced to $2000

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Health Insurance - Inflationary Times

Editor's Notes

  1. Brian
  2. Marcus
  3. Brian
  4. Brian
  5. Marcus
  6. Brian
  7. Brian
  8. Marcus
  9. Brian-Marcus
  10. Marcus