controlling healthcare costs while improving quality: employee benefits donald l. eddleman, partner...
TRANSCRIPT
Controlling Healthcare Costs While Improving Quality: Employee Benefits
Donald L. Eddleman, Partnerefg&m, L.P.
HealthCare Forum
• Locally owned and operated Independent Employee Benefits firm
• We work with small to mid-size companies (2-900)
• Employee Benefits (Health Ins) is generally the 2nd to 4th largest expense for these employers
• Our challenge – to design and implement affordable Employee Benefit packages to attract and retain quality employees
Affordability Gap
Strategies for Managing Health Insurance Cost
• Plan Designs• Multiple Option Plan Offerings• Consumer Driven Health Plans• Employer’s Contribution Strategy
BenchmarkingAverage Deductibles in Texas
Source: Data from one of the big four insurance carriers in Central Texas
Plan Offerings
• Plan Designs– Deductibles– Coinsurance– Copays– Prescription Drug Benefits
• Multiple Option Plan Offerings– Base Plan– Buy Up Plan– CDHP
The logic behind Consumer Driven Health Plans
Consumers share additional cost through tax favorable
accounts such as HSAs • To get the consumer more engaged with their
health care decisions • To reduce unnecessary utilization• The idea is that consumers will be better
stewards with their own healthcare dollars
Consumer Driven Health Plans (CDHP’s)
•Health Reimbursement Accounts (HRA)• Employer sponsored plans.
•Health Savings Accounts (HSA)• HSAs are individual accounts that employers
sometimes choose to contribute to.
HSA COMPONENTS
HDHPHigh Deductible Health Plan
THE INSURANCE PIECE
HDHPHigh Deductible Health Plan
THE INSURANCE PIECE
HSAHealth Savings Account
THE ACCOUNT TO FUND DEDUCTIBLE TAX-FREE
HSAHealth Savings Account
THE ACCOUNT TO FUND DEDUCTIBLE TAX-FREE
Insurance Company Financial Custodian
HSA with Qualified High Deductible Plan
• Maximum contribution for 2012: (contribution deadline is April 15 th)• Individual - $3,100 ($3,050 for 2011)• Family - $6,250 ($6,150 for 2011)• Family = employee + 1 or more dependent(s)
• Catch-up Provision – Age 55 and older can contribute an additional $1000.00 each year
• Un-used balance carries over each year• Portable (i.e. you take your account with you if you leave)• Contribution can be made through payroll deductions, online directly,
or by check• Interest-bearing account
Health Savings Account
Are CDHP’s changing behavior?
Wellness 101 – Costs follow Risks
