Joel Allumbaugh CEO, National Worksite Benefit Group President, Maine Association of Health Underwriters ext. 201

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Joel Allumbaugh CEO, National Worksite Benefit Group President, Maine Association of Health Underwriters 207.623.1110 ext. 201 joel@nwbgroup."

Transcription

1 Joel Allumbaugh CEO, National Worksite Benefit Group President, Maine Association of Health Underwriters ext. 201

2 How Does Insurance Work? Employee Perspective Best case have coverage, don t use any health care and remain healthy (net premiums cost only) Worst case have coverage, have catastrophic health event (net premiums + maximum out of pocket) Everyone in between Important Terms Premium Deductible Maximum Out of Pocket 13% 5% 82%

3 How Much Health Care Do People Actually Use? 18% 13% Adults age (privately insured all year in Northeast, 2005) 20% 33% Median (half more/half less) $626 Average (mean) $2,178 16% $0 $1 $500 $501 $1,000 $1,001 $2,500 $2,501+ Source: Medical Expenditure Panel Survey, 2005,

4 Once a High User, Always a High User? For the top 10 of every 100 health care consumers (using more than $5,000 in 2005) in a given year (who consume 65% of all health care used) only 4 will be in the top 10 the following year (41%). However, those 50 with the lowest consumption (less than $800 per person in 2005, using 7% of all health care used) 38 will be low users the following year (75%). Source: Agency for Healthcare Research and Quality, Nov 2007, Statistical Brief #191.

5 Patient Centered Plans Majority of Patients Control All Their Spending Health Care Used by Patient $15,000 $12,500 $10,000 $7,500 $5,000 $2,500 $ At $2,500 deductible: 76% of patients control all health care dollars used All patients collectively control 41% of all health care dollars used Percent of All Patients

6 If so many spend so little, why is insurance so expensive? Pricing Insurance: Expense x Probability + Admin. Cost $100,000 expense, 2% chance you will incur it, 15% admin $100,000 x 2% = $2, % admin = $2,300 cost to insure Common 100% Probability expenses in most insurance policies: Routine exams Maintenance medication There are many other high probability items in most insurance policies.

7 Family Chamber Blue Options $30,000 $29,994 $26,127 $24,000 $18,000 $12,000 $6,000 $17,000 $7,894 $21,551 $8,000 $11,151 $17,747 $10,000 $7,747 $22,372 $10,000 $6,000 $13,127 $14,572 Tax Consequence Annual Individual Max Out of Pocket Annual Family Premium $0 PPO $7k ded. PPO $2k ded. HSA - $10k ded. HMO $2k ded. HMO $1k ded.

8 Changing your approach Employer Perspective Premium Old Model Premium New Patient Centered Model Health savings account (HSA) with optional employer contribution Health reimbursement account (HRA) employer promise to pay

9 $450 $400 $405 $395 $350 $96.25 $300 $250 $83.00 $200 $ $150 $100 $ $50 $0 Current Contributions HSA Contribution Premium Contribution Total Recommended Contributions

10 $6,000 $5,000 $5,000 $4,000 $3,000 $3,900 $ $3, $2,000 $1,000 $0 $3, Current $ $ New Patient Centered ER funded HRA Maximum Out of Pocket (remaining) ER funded HSA Premium Contribution Total

11 5 Year Trend Employer $ $500 $250 $405 $445 $490 $539 $593 $ $396 $406 $418 $430 $442 $ $227 $238 $250 $263 $276 $ HMO Premium HSA Premium HSA ER Contribution HRA ER Funding

12 Case Example Mobius, Inc to Present Change from Old Plan to Patient Centered Plan in 2007 Employee Only Coverage $4,000 $1,400 $3,500 Employee Only Premium $1,200 $1,000 $800 $600 $400 $200 $3,000 $3,000 $1,875 $1,300 $793 $721 $655 $596 $596 $535 $473 $455 $457 $473 $700 $700 $3,000 $2,500 $2,000 $1,500 $1,000 $500 Employee Max OOP (Worse Case) $ $0 Year 1 At Renewal New Plan Add Patient Centered Plan Projected/ Actual Projected/ Actual National Worksite Benefits Group Old Plan Patient Centered Plan Max Employee OOP

13 Case Example Bar Harbor Biotechnology, Inc to Present New Patient Centered Plan in 2007 Employee Only Coverage $4,000 $1,400 Employee Only Premium $1,200 $1,000 $800 $600 $400 $200 $427 $2,500 $2,500 $555 $555 $1,100 $270 $611 $850 $672 $850 $428 $456 $3,000 $2,000 $1,000 $0 $1,000 Employee Max OOP (Worse Case) $ $2,000 Jackson Lab Estimated new plan cost New Patient CenteredPlan Projected/ Actual Projected/ Actual National Worksite Benefits Group Old Plan Patient Centered Plan Max Employee OOP

14 Keys to An Effective Patient Centered Benefit Fostering a culture of health care consumerism among all employees, beginning with senior executives Implementing a focused employee education campaign Offering wellness programs and incentives for healthy behaviors, as well as 100 percent coverage for preventive care Carefully constructing a benefits package that includes appropriate levels of employee financial responsibility

15 Key Findings of Patient Centered Employees 1. Committed in Wellness The Blue Cross Blue Shield Association 2007 CDHP Member Experience Survey showed HSA plan members were more engaged in wellness and prevention: Smoking cessation 6% 20% Stress management 8% 22% Nutrition/diet program 12% 27% Exercise program 12% 29% 0% 5% 10% 15% 20% 25% 30% Patient Centered Traditional

16 Key Findings of Patient Centered Employees 2. Focused on Cost & Quality The Blue Cross Blue Shield Association 2008 CDHP Member Experience Survey showed HSA plan members researched cost and quality of providers much more: Search the Internet for a lower priced Rx 15% 21% Use mail order Rx 30% 43% Ask doctor about cost of treatments 33% 52% Choose lower cost treatment option 23% 36% 0% 10% 20% 30% 40% 50% 60% Patient Centered Traditional

17 Key Findings of Patient Centered Employees 3. Saved for the Future The Blue Cross Blue Shield Association 2008 CDHP Member Experience Survey showed HSA plan members planned for health expenses more thoroughly: Discussed Health Expenses with Physician 27% 38% Estimated Future Health Care Expenses 22% 38% Tracked Health Care Expenses 40% 72% 0% 10% 20% 30% 40% 50% 60% 70% 80% Patient Centered Traditional

18 Joel Allumbaugh President, Maine Association of Health Underwriters CEO, National Worksite Benefit Group ext. 201

HEALTH INSURANCE CONSULTING FEBRUARY 21, 2013

HEALTH INSURANCE CONSULTING FEBRUARY 21, 2013 1 HEALTH INSURANCE CONSULTING FEBRUARY 21, 2013 2 INSURANCE BROKER TOOLKIT Medical Dental Life Disability Vision Employee Assistance Program (EAP) Supplemental (AFLAC) Flexible Spending Account (FSA) Health

More information

Central Susquehanna Intermediate Unit Professional Leadership Day

Central Susquehanna Intermediate Unit Professional Leadership Day Central Susquehanna Intermediate Unit Professional Leadership Day 1 Healthcare Benefit Trends & Practices Jon Sapochak, Consulting Actuary, F.S.A., M.A.A.A. Society of Actuaries Motto 2 The work of science

More information

Choosing the Right Health Insurance Plan What is the different between PPO, HMO, POS and HSA plans?

Choosing the Right Health Insurance Plan What is the different between PPO, HMO, POS and HSA plans? Choosing the Right Health Insurance Plan What is the different between PPO, HMO, POS and HSA plans? Choosing the right health insurance plan can be confusing. When open enrollment rolls around at your

More information

The President s Health Savings Account Proposals

The President s Health Savings Account Proposals The President s Health Savings Account Proposals Roy Ramthun, National Economic Council Kate Baicker, Council of Economic Advisers March 10, 2006 Broader Policy Goals Create a system where spending decisions

More information

Alternatives for Employee Health Care in Today s World of Health Insurance

Alternatives for Employee Health Care in Today s World of Health Insurance Alternatives for Employee Health Care in Today s World of Health Insurance sponsored by NFIB Health Plans, Administered by JLBG Health WWW.NFIBHEALTHBENEFITS.COM 1-866-706-8028 Webinar Overview Learn about

More information

IU High Deductible Health Plan Health Savings Account. Get Healthy and Get Ahead with the HDHP PPO Plan

IU High Deductible Health Plan Health Savings Account. Get Healthy and Get Ahead with the HDHP PPO Plan IU High Deductible Health Plan Health Savings Account & Get Healthy and Get Ahead with the HDHP PPO Plan 2014 PLAN 1Plan Advantages Medical Coverage ADVANTAGE The HDHP PPO & HSA has several advantages

More information

Health Insurance. Where should you SHOP for your health insurance coverage? Decision-Making Guide presented by Bob Hopper Insurance Services

Health Insurance. Where should you SHOP for your health insurance coverage? Decision-Making Guide presented by Bob Hopper Insurance Services Health Insurance Where should you SHOP for your health insurance coverage? Decision-Making Guide presented by Bob Hopper Insurance Services We ll help you locate the health plan that offers the best value

More information

2016 Health Plan Options. Copyright 2015 Five Points ICT, Inc. All rights reserved.

2016 Health Plan Options. Copyright 2015 Five Points ICT, Inc. All rights reserved. 2016 Health Plan Options 2016 Health Insurance Options ❶ Benefit Levels ❷ Provider Networks ❸ Premium Levels Partnership Plan Standard Plan New Options Limited + Gap Plan CDHP BlueCross BlueShield of Tennessee

More information

Retirement: - NC Local Government Retirement System - All benefits eligible employees make a mandatory 6% contribution every pay period.

Retirement: - NC Local Government Retirement System - All benefits eligible employees make a mandatory 6% contribution every pay period. General Employee Benefits are offered to employees working at least 30 hours per week. Health Insurance - Coverage becomes effective the first day of the month following 60 days of employment. Both you

More information

State Health Benefit. Benefit Comparison HMO. Presentation to Members of the State Health Benefit Plan

State Health Benefit. Benefit Comparison HMO. Presentation to Members of the State Health Benefit Plan State Health Benefit Plan (SHBP) Benefit Comparison for HRA, HDHP and HMO Presentation to Members of the State Health Benefit Plan DCH Mission ACCESS RESPONSIBLE HEALTHY Access to affordable, quality health

More information

Southern Illinois Healthcare Amy Niemann, MSEd Employee Health, Wellness & Benefits System Manager

Southern Illinois Healthcare Amy Niemann, MSEd Employee Health, Wellness & Benefits System Manager Southern Illinois Healthcare Amy Niemann, MSEd Employee Health, Wellness & Benefits System Manager Health Insurance What is Health Insurance? Health insurance is insurance against the risk of incurring

More information

how to choose the health plan that s right for you

how to choose the health plan that s right for you how to choose the health plan that s right for you It s easy to feel a little confused about where to start when choosing a health plan. Some people ask their friends, family, or co-workers for advice.

More information

Nevada Health Plan Project

Nevada Health Plan Project Nevada Health Plan Project Health Plan Basics Health Savings Accounts A Threat - The Fair Share Act New Trends - Wellness Programs Opportunity - High Risk Pools 1 Who is NAHU? Larry S. Harrison, President

More information

Health Insurance Part 1. Health Policy Eric Jacobson

Health Insurance Part 1. Health Policy Eric Jacobson Health Insurance Part 1 Health Policy Eric Jacobson Introduction The field of health care has made great strides during the last century. This increase in quality has been accompanied by a much greater

More information

2015 Business health insurance plans

2015 Business health insurance plans 2015 Business health insurance plans Live well. We ll insure you do. page 1 About us Healthy businesses depend on healthy employees. MercyCare s business health plans are backed by a company that s been

More information

Consumer-Driven Health Plan (CDHP) A Fresh Approach to Health Care Services

Consumer-Driven Health Plan (CDHP) A Fresh Approach to Health Care Services Consumer-Driven Health Plan (CDHP) A Fresh Approach to Health Care Services A Different Type of Health Coverage By offering the HealthFlex consumer-driven health plan (CDHP), your annual conference or

More information

Consumer-Driven Strategies: What do we know about Health Savings Accounts and Other Account-Based Health Plans?

Consumer-Driven Strategies: What do we know about Health Savings Accounts and Other Account-Based Health Plans? Consumer-Driven Strategies: What do we know about Health Savings Accounts and Other Account-Based Health Plans? Paul Fronstin, Ph.D. Director, Health Research & Education Program March 14, 2007 Copyright

More information

2015 Why Are There Changes With Healthcare? Copyright 2014 Five Points ICT, Inc. All rights reserved.

2015 Why Are There Changes With Healthcare? Copyright 2014 Five Points ICT, Inc. All rights reserved. 2015 Why Are There Changes With Healthcare? Health Care Reform Beginning Jan 1, 2015 HCR Requires: Large employers must offer a health plan: To employees averaging 30+ hrs per week That is considered HCR

More information

Consumer Driven Health Plan (CDHP) with Health Savings Account (HSA)

Consumer Driven Health Plan (CDHP) with Health Savings Account (HSA) Consumer Driven Health Plan (CDHP) with Health Savings Account (HSA) Interact with this ebrochure. Here s how. This ebrochure is designed for onscreen viewing, allowing you to navigate through the document

More information

Workshop D. 1:00 pm. to 2:30 p.m.

Workshop D. 1:00 pm. to 2:30 p.m. Workshop D Advanced Practices Significant Impact of the Affordable Care Act on Participatory Wellness Programs, ROI, and Compliance with Regulations Effective January 1st 1:00 pm. to 2:30 p.m. Biographical

More information

SPD Benefits. October 29th through November 19th, 2014 at Noon EST

SPD Benefits. October 29th through November 19th, 2014 at Noon EST SPD Benefits October 29th through November 19th, 2014 at Noon EST 2015 Overview What stays the same in 2015? No plan design changes for Dental and Vision. No premium changes for Dental and Vision. No changes

More information

PALADINA HEALTH ONSITE 2.0 THE EVOLUTION OF ONSITE CLINICS AND ITS IMPACT ON CLAIMS. Revolutionizing Healthcare for Employers

PALADINA HEALTH ONSITE 2.0 THE EVOLUTION OF ONSITE CLINICS AND ITS IMPACT ON CLAIMS. Revolutionizing Healthcare for Employers PALADINA HEALTH ONSITE 2.0 THE EVOLUTION OF ONSITE CLINICS AND ITS IMPACT ON CLAIMS Revolutionizing Healthcare for Employers Today s Agenda 2 Evolution of Onsite Clinics Incentives of an Onsite 2.0 Model

More information

Health Pool Comparison Matrix NLC-RISC Trustees Conference, Newport, Rhode Island

Health Pool Comparison Matrix NLC-RISC Trustees Conference, Newport, Rhode Island Pool Size - Member groups - Covered lives - Annual premium - Current surplus 590 covered entities 56,655 covered lives $404.5 million annual contributions $88.7 million current surplus 265 member groups

More information

Mercer s National Survey of Employer-Sponsored Health Plans 2007

Mercer s National Survey of Employer-Sponsored Health Plans 2007 February 21, 2008 s National Survey of Employer-Sponsored Health Plans 2007 Bob Boyer, Indianapolis Services provided by Health & Benefits LLC Welcome! About the survey Largest and most comprehensive annual

More information

Insurance Terms 101. Patient Access Specialists I

Insurance Terms 101. Patient Access Specialists I Access Management Insurance Terms 101 University of Mississippi Medical Center Patient Access Specialists I As a Patient Access Specialist Your job is to collect ACCURATE patient information during registration.

More information

Learn with Anthem Understanding Your Out Pocket Expenses

Learn with Anthem Understanding Your Out Pocket Expenses Learn with Anthem Understanding Your Out Pocket Expenses 1 Key terms Deductible The amount you pay each year before your plan starts to pay Copay A flat fee you pay for covered services like doctor visits

More information

Your UnitedHealthcare Definity SM Health Reimbursement Account

Your UnitedHealthcare Definity SM Health Reimbursement Account Your UnitedHealthcare Definity SM Health Reimbursement Account At UnitedHealthcare, we believe that health insurance is much more than just coverage when you re ill or injured. When you are sick, your

More information

Health Insurance 101. A brief overview of health insurance 10/15/09

Health Insurance 101. A brief overview of health insurance 10/15/09 Health Insurance 101 A brief overview of health insurance 10/15/09 Health Care vs. Health Insurance Health Care is Provision of Medical Services by Private Physicians and Hospitals (private pay or insurance)

More information

State Health Plan Benefits North Carolina Retired Governmental Employees Association April 2015

State Health Plan Benefits North Carolina Retired Governmental Employees Association April 2015 State Health Plan Benefits North Carolina Retired Governmental Employees Association April 2015 Presentation Overview Medicare Eligible Plan Options 2015 Annual Enrollment Results Outreach Events Enrollment

More information

Medical Plan Comparison - Retirees Age 65 or Over

Medical Plan Comparison - Retirees Age 65 or Over l Plan Comparison - Retirees Age 65 or Over Program Name Group Prime Solution Group Prime Solution for Seniors for Seniors Type of Policy re Cost Plan with re Prescription Drug re Cost Plan with re Prescription

More information

HARRISBURG AREA COMMUNITY COLLEGE REQUEST FOR PROPOSAL #07 44 HEALTH INSURANCE CONSULTING SERVICES ADDENDUM #1 ANSWERS TO QUESTIONS APRIL 27, 2007

HARRISBURG AREA COMMUNITY COLLEGE REQUEST FOR PROPOSAL #07 44 HEALTH INSURANCE CONSULTING SERVICES ADDENDUM #1 ANSWERS TO QUESTIONS APRIL 27, 2007 HARRISBURG AREA COMMUNITY COLLEGE REQUEST FOR PROPOSAL #07 44 HEALTH INSURANCE CONSULTING SERVICES ADDENDUM #1 ANSWERS TO QUESTIONS Question 1: PROGRAM REQUIREMENTS APRIL 27, 2007 B. POROPOSAL PRICING

More information

2016 Business health insurance plans

2016 Business health insurance plans 2016 Business health insurance plans Live well. We ll insure you do. MercyCare Health Plans is a Qualified Health Plan issuer in the Health Insurance Marketplace. About us Healthy businesses depend on

More information

Medical Plan Comparison - Retirees Age 65 or Over

Medical Plan Comparison - Retirees Age 65 or Over l Plan Comparison - Retirees Age 65 or Over Program Name U of M Retiree Plan with Group reblue SM Rx Group Platinum Blue SM Plan C withgroup reblue SM Rx Freedom Plan & Retiree National Choice Freedom

More information

Delta s Healthy Rewards Program. Administration Services

Delta s Healthy Rewards Program. Administration Services Delta s Healthy Rewards Program Administration Services Helping You Navigate the Winding Road of Healthcare Reform The crisis is real. Chronic diseases, such as diabetes and heart disease, are steering

More information

Your Independence Blue Cross. 2016 Blue Solutions Renewal Guide. For small employers

Your Independence Blue Cross. 2016 Blue Solutions Renewal Guide. For small employers Your Independence Blue Cross 2016 Blue Solutions Renewal Guide For small employers Table of Contents Get ready to renew your health plan 3 Two ways to offer plans 4 Blue Solutions Web-based Blue Solutions

More information

FOR YOU HEALTH PLANS THAT WORK EMPLOYER MATERIALS 1

FOR YOU HEALTH PLANS THAT WORK EMPLOYER MATERIALS 1 HEALTH PLANS THAT WORK FOR YOU Blue Cross & Blue Shield of Rhode Island understands that when it comes to health plans, small businesses have different needs. Affordability is important, but so are quality

More information

Health Savings Account: What it could mean for you and CSU? 4/2/15

Health Savings Account: What it could mean for you and CSU? 4/2/15 Health Savings Account: What it could mean for you and CSU? 4/2/15 Diana Prieto Executive Director and Chief Human Resource Officer Teri Suhr Chief Total Rewards Officer Discussion Items Medical Plan Funding

More information

Anthem HealthKeepers Renewal Information for Benefit Managers (for groups in the Large Group market)

Anthem HealthKeepers Renewal Information for Benefit Managers (for groups in the Large Group market) Anthem HealthKeepers Renewal Information for Benefit Managers (for groups in the Large Group market) Thank you once again for offering your employees Anthem HealthKeepers health care coverage. We d like

More information

Comparisons of Other Health Benefit Options

Comparisons of Other Health Benefit Options Comparisons of Other Health Benefit Options COMPARISONS OF OTHER HEALTH BENEFIT OPTIONS QUESTION HEALTH SAVINGS ACCOUNT (HSA) HEALTH REIMBURSEMENT ARRANGEMENT (HRA) FLEXIBLE SPENDING ACCOUNT (FSA) WHO

More information

Your UC. Medical Insurance. An overview for active employees

Your UC. Medical Insurance. An overview for active employees Your UC Medical Insurance An overview for active employees Agenda Your Options Pre-paid medical Other Insurance Plans Conclusion Your Options Your options UC offers four types of medical plan o HMO plans

More information

Consensus Principles for Health Care Delivery

Consensus Principles for Health Care Delivery Consensus Principles for Health Care Delivery TABLE OF CONTENTS Consensus Principle for Healthcare Delivery... 3 Responsibilities of Various Parties to the Health Care System... 4 Individuals and Families...

More information

MERCER S NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS. MTEBC, February, 2013

MERCER S NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS. MTEBC, February, 2013 MERCER S NATIONAL SURVEY OF EMPLOYER-SPONSORED HEALTH PLANS MTEBC, February, 2013 Agenda Top Stories Market developments (influence of Health Reform) Details on cost and design CDHP - H.S.A - H.R.A PPO

More information

2014 Medical Plans. Health Net Blue & Gold HMO Kaiser HMO UC Care Blue Shield Health Savings Plan Core

2014 Medical Plans. Health Net Blue & Gold HMO Kaiser HMO UC Care Blue Shield Health Savings Plan Core 2014 Medical Plans Health Net Blue & Gold HMO Kaiser HMO UC Care Blue Shield Health Savings Plan Core UC Care PPO Blue Shield of California claims administrator & network UC Select Providers Customized

More information

Using A High Deductible Health Insurance Plan

Using A High Deductible Health Insurance Plan Better Coverage With Lower Costs Using A High Deductible Health Insurance Plan Presented by: Jonathan Burr Principal Benemax, The Benefit Management Company Debbie Zapasnik Human Resources Manager Community

More information

A partnership that offers an exclusive insurance product! The Chambers of Commerce in Hamilton County and ADVANTAGE Health Solutions, Inc.

A partnership that offers an exclusive insurance product! The Chambers of Commerce in Hamilton County and ADVANTAGE Health Solutions, Inc. The Chambers of Commerce in Hamilton County and ADVANTAGE Health Solutions, Inc. SM A partnership that offers an exclusive insurance product! CHAMBER OF COMMERCE The Chambers of Commerce in Hamilton County

More information

Oak Ridge National Laboratory. New Coverage New Choices

Oak Ridge National Laboratory. New Coverage New Choices Oak Ridge National Laboratory New Coverage New Choices What we ll cover today What is changing and why? How this affects you Introducing Extend Health Medicare marketplace Going forward Questions & answers

More information

When a potential employee is interviewing,

When a potential employee is interviewing, Considerations for Selecting Your Company s Health Plans Peter C. Savage When a potential employee is interviewing, benefits are the second most important consideration after compensation. The benefit

More information

Controlling Medical Insurance Premiums. August 7, 2007

Controlling Medical Insurance Premiums. August 7, 2007 Controlling Medical Insurance Premiums August 7, 2007 Damon Thompson Graduated from Austin College in 1979. Immediately began working with business owners for their insurance needs. Began working with

More information

SISC HEALTH BENEFITS 101. South Orange County Community College District August 11, 2015

SISC HEALTH BENEFITS 101. South Orange County Community College District August 11, 2015 1 SISC HEALTH BENEFITS 101 South Orange County Community College District August 11, 2015 2 SISC Schools Helping Schools Established in 1979, Self-Insured Schools of California (SISC) operates as a public

More information

Presented by Select Pointe LLC Gary Adkins Gary.adkins@selectpointe.com 615-504-1422

Presented by Select Pointe LLC Gary Adkins Gary.adkins@selectpointe.com 615-504-1422 Presented by Select Pointe LLC Gary Adkins Gary.adkins@selectpointe.com 615-504-1422 The letter announced that the AVMA GHLIT C.A.R.E. Insurance Exchange/Marketplace, a private insurance exchange for AVMA

More information

CRITICAL INSURANCE CHANGES TO CONSIDER WHEN YOUR DISTRICT IS IN FINANCIAL DISTRESS TODAY S TOPICS INSURANCE MARKETPLACE OVERVIEW 9/13/2013

CRITICAL INSURANCE CHANGES TO CONSIDER WHEN YOUR DISTRICT IS IN FINANCIAL DISTRESS TODAY S TOPICS INSURANCE MARKETPLACE OVERVIEW 9/13/2013 CRITICAL INSURANCE CHANGES TO CONSIDER WHEN YOUR DISTRICT IS IN FINANCIAL DISTRESS Chadd Hodkinson Account Executive SET SEG Employee Benefits TODAY S TOPICS Health care marketplace overview Money saving

More information

230 S. Bemiston; Suite 900 Clayton, MO 63105 (314)727-5522 FAX (314)727-5568 www.mrctbenefitsplus.com www.mrctquote.com

230 S. Bemiston; Suite 900 Clayton, MO 63105 (314)727-5522 FAX (314)727-5568 www.mrctbenefitsplus.com www.mrctquote.com Life & Health Insurance Advisor MRCT Benefits Plus is a comprehensive employee benefits, wellness and Human Resources consulting firm offering a variety of financial services to businesses and individuals

More information

Comparative Analysis of State Health Plans

Comparative Analysis of State Health Plans Comparative Analysis of State Health Plans Board of Trustees Meeting January 26, 2016 Presentation Overview Executive Summary Selected States for Comparison Comparative Analysis Methodology Comparative

More information

Controlling Employee Healthcare Costs for Small Business Owners

Controlling Employee Healthcare Costs for Small Business Owners Hardwood Manufacturers Association National Conference March 15, 2011 Controlling Employee Healthcare Costs for Small Business Owners Presented by: Gary S. Koppele CPA, ARM Hardwood Manufacturers Association

More information

HIGH DEDUCTIBLE HEALTH PLANS & HEALTH SAVINGS ACCOUNTS

HIGH DEDUCTIBLE HEALTH PLANS & HEALTH SAVINGS ACCOUNTS HEALTH PLAN STUDY HIGH DEDUCTIBLE HEALTH PLANS & HEALTH SAVINGS ACCOUNTS C O M M I T T E E M E M B E R S M A R C I A D E D D E N S D O R E E H Y D E J O H N K I R B Y G I N G E R M A D D E N B R E T T

More information

PayPal Blue Shield of California Consumer Directed Health Plan with Health Savings Account (CDHP with HSA) Frequently Asked Questions

PayPal Blue Shield of California Consumer Directed Health Plan with Health Savings Account (CDHP with HSA) Frequently Asked Questions PayPal Blue Shield of California Consumer Directed Health Plan with Health Savings Account (CDHP with HSA) Frequently Asked Questions What is the Blue Shield of California CDHP with HSA? The Blue Shield

More information

Health Care. Why medical insurance. Group plan

Health Care. Why medical insurance. Group plan Health Care You positively must have a health plan HMO s vs. health insurance Deductibles, co-payments, coinsurance Ben Affleck Why medical insurance To cover three types of financial losses due to injury

More information

Copayment: The amount you must pay for each medical visit to a participating doctor or other healthcare provider, usually at this time service.

Copayment: The amount you must pay for each medical visit to a participating doctor or other healthcare provider, usually at this time service. Basic Terms How to calculate Out of Pocket Costs on a Hospital Stay: If you have a $2000 deductible and 30% coinsurance health insurance plan. If you have a $10,000 emergency room or hospital stay your

More information

Evaluating Prospective Health Insurance Funding Arrangements for Your Firm

Evaluating Prospective Health Insurance Funding Arrangements for Your Firm Evaluating Prospective Health Insurance Funding Arrangements for Your Firm Presented by Mark Shore HR04 9/13/2014 9:15 AM - 10:30 AM Evaluating Prospective Insurance Funding Arrangements Presented by:

More information

HRA: An Innovative Approach to the Financing of Health Care

HRA: An Innovative Approach to the Financing of Health Care HRA: An Innovative Approach to the Financing of Health Care By Cheri Gillfillan President One Source Advisors, Inc. You know better than anyone the obstacles and challenges that must be overcome in regard

More information

High Deductible Health Plans A Cost-Conscious Option. Smart Benefit Solutions. White Paper. September 2011

High Deductible Health Plans A Cost-Conscious Option. Smart Benefit Solutions. White Paper. September 2011 Smart Benefit Solutions White Paper High Deductible Health Plans A Cost-Conscious Option September 2011 40950 Woodward Ave. Suite 360 Bloomfield Hills, MI 248-594-5550 www.austinfg.com 2 Table of Contents

More information

Cabrillo College Retiree Benefits and Medicare Frequently Asked Questions

Cabrillo College Retiree Benefits and Medicare Frequently Asked Questions Cabrillo College Retiree Benefits and Medicare Frequently Asked Questions Table of Contents What is Medicare?... 3 What are the different parts of Medicare?... 4 What does Medicare help cover Part A?...

More information

HEALTH INSURANCE CHALLENGES FACING NON-PROFITS

HEALTH INSURANCE CHALLENGES FACING NON-PROFITS HEALTH INSURANCE CHALLENGES FACING NON-PROFITS Presented by: Diane Goldman, New Agency Partners Warren Cooperstein, Benefit Mall Rob Schlossberg, Benefit Mall December 12, 2012 THE PROBLEM Steadily Increasing

More information

2015 Annual Enrollment Retirees with Medicare

2015 Annual Enrollment Retirees with Medicare 2015 Annual Enrollment Retirees with Medicare 2015 Annual Enrollment WHAT HAS NOT CHANGED: Plan Offerings PPO and HMO plans still offered Provider Network Blue Cross and Vantage National Networks WHAT

More information

Effective Date: The date on which coverage under an insurance policy begins.

Effective Date: The date on which coverage under an insurance policy begins. Key Healthcare Insurance Terms Agent: A person who represents an insurance company and solicits or sells the company s insurance products. An agent may represent a single company or multiple companies.

More information

GLOSSARY OF MEDICAL AND INSURANCE TERMS

GLOSSARY OF MEDICAL AND INSURANCE TERMS GLOSSARY OF MEDICAL AND INSURANCE TERMS At Westfield Family Physicians we are aware that there are lots of words and phrases we used every day that may not be familiar to you, our patients. We are providing

More information

State Health Plan 101

State Health Plan 101 State Health Plan 101 Cost-Savings Tips Get the Most Out of Your Benefits June 2016 Agenda Tips to Get the Most Out of Your Benefits Blue Options Designated Providers/Find a Doctor Demonstration In-Network

More information

Health Insurance Options for Small Business Employers

Health Insurance Options for Small Business Employers Health Insurance Options for Small Business Employers April 2, 2008 Insure the Uninsured Project Rebecca Pizzitola and Lucien Wulsin, Jr. www.itup.org Funded by: L.A. Care Health Plan The California Endowment

More information

Teachers Retirement Insurance Program

Teachers Retirement Insurance Program Comparison of Illinois State Retiree Health Insurance Options with Traditional Medicare and Medicare Supplement (Medigap) Insurance Teachers Retirement Insurance Program Insuraprise, Inc. (C) Copyright

More information

2015 Summary of Healthcare Plan Changes

2015 Summary of Healthcare Plan Changes 2015 Summary of Healthcare Plan Changes Change Plan names the OA POS plan becomes the Comprehensive Care Plan and the HSA OA POS plan becomes the Consumer Choice HSA plan Comprehensive Care Plan Increase

More information

Manage your health care and your budget

Manage your health care and your budget Manage your health care and your budget Aetna HealthFund Health Reimbursement Arrangement (HRA) Plan A new way to manage your family s health Integrated Rx 32.02.302.1 E (8/08) An easy-to-use threemanage

More information

Frequently Asked Questions

Frequently Asked Questions Healthcare Plans Frequently Asked Questions What medical plans pa will be made available aaabeo to professional staff under the District s contract proposal? Personal Choice 1 (PPO) Personal Choice 10/20/70

More information

Critics of the Current System Say: Chapter 15: Medical Expense and Disability Income Insurance. Defenders of the Current System Say:

Critics of the Current System Say: Chapter 15: Medical Expense and Disability Income Insurance. Defenders of the Current System Say: Chapter 15: Medical Expense and Insurance Critics of the Current System Say: Americans pay too much for health care Health care cost increases Many Americans do not have adequate access Waiting to change

More information

Health Plans That Work for You

Health Plans That Work for You Health Plans That Work for You Blue Cross offers a variety of high-quality, affordable health plan options to fit your employees needs and your bottom line. VantageBlue Ideal if you re looking for: Traditional

More information

Understanding Your Health

Understanding Your Health Understanding Your Health 2015 Objectives of Understanding Your Health After today s presentation, you will: Have a basic understanding of what is driving healthcare costs and how wellness and preventive

More information

Medicare & UC Medical Benefits

Medicare & UC Medical Benefits Medicare & UC Medical Benefits UCSB Health Care Facilitator Program Laura Morgan 893-4201 UC Retirement Administration Service Center (RASC) 1-800-888-8267 This presentation is intended for communication

More information

Budget Work Session Employee Self-Funded Medical Plan. Human Resources May 5, 2015

Budget Work Session Employee Self-Funded Medical Plan. Human Resources May 5, 2015 Budget Work Session Employee Self-Funded Medical Plan Human Resources May 5, 2015 Purpose To provide the BCC with an overview of the Employee Self-Funded Medical Plan and proposed FY 2016 Budget. Presentation

More information

SOA Annual Symposium Shanghai. November 5-6, 2012. Shanghai, China. Session 4b: Health Insurance Market in China. Jesse Song

SOA Annual Symposium Shanghai. November 5-6, 2012. Shanghai, China. Session 4b: Health Insurance Market in China. Jesse Song SOA Annual Symposium Shanghai November 5-6, 2012 Shanghai, China Session b: Health Insurance Market in China Jesse Song Jesse Song, FSA, MAAA Agenda China health insurance market overview US health insurance

More information

Indiana University Peer Institution Benefits Comparison July 2009 Health Care Plans

Indiana University Peer Institution Benefits Comparison July 2009 Health Care Plans Indiana Peer Institution Benefits Comparison July 2009 Summary of comparison with Big 10 universities and/or large employers: Most IU peers also provide healthcare benefits to part time employees (IU provides

More information

Chiropractic Assistants Insurance Verification Training Guide

Chiropractic Assistants Insurance Verification Training Guide Chiropractic Assistants Insurance Verification Training Guide What You Will Learn: How to Obtain Maximum Chiropractic Benefits Tools Needed to Verify Benefits Understanding Why You Are Verifying Understanding

More information

Frequently Asked Questions

Frequently Asked Questions Frequently Asked Questions Health Savings Account Questions Q: What is a Health Savings Account? A: A Health Savings Account is a tax exempt account you set up with a qualified High Deductible Health Plan

More information

New Coverage & New Choices for Medicare-eligible Retirees

New Coverage & New Choices for Medicare-eligible Retirees New Coverage & New Choices for Medicare-eligible Retirees What We Will Cover Today What is changing. How this affects Medicare eligible retirees. Extend Health and the services and health plans available

More information

Invest in your employees and the long-term health of your company.

Invest in your employees and the long-term health of your company. Invest in your employees and the long-term health of your company. SM A company is only as healthy as its employees It s no secret that the foundation of a healthy company relies on the health of its employees.

More information

Health Insurance Marketplace in Illinois Plan Comparison Charts

Health Insurance Marketplace in Illinois Plan Comparison Charts 2015 Independent Authorized Agent for An Independent Licensee of the Blue Cross Blue Shield Association Health Insurance Marketplace in Illinois Plan Comparison Charts preventive services and maternity

More information

PPO Choice. It s Your Choice!

PPO Choice. It s Your Choice! Offered by Capital Advantage Insurance Company A Capital BlueCross Company PPO Choice It s Your Choice! Issued by Capital Advantage Insurance Company, a Capital BlueCross subsidiary. Independent licensees

More information

EMPLOYEE BENEFIT OPTIONS Non Managers PLAN YEAR: 7/1/2013 6/30/2014 Medical PLAN YEAR: 7/1/2013 12/31/2013 MBA Master Plans

EMPLOYEE BENEFIT OPTIONS Non Managers PLAN YEAR: 7/1/2013 6/30/2014 Medical PLAN YEAR: 7/1/2013 12/31/2013 MBA Master Plans EMPLOYEE BENEFIT OPTIONS Non Managers PLAN YEAR: 7/1/2013 6/30/2014 Medical PLAN YEAR: 7/1/2013 12/31/2013 MBA Master Plans W e r e c o g n i z e t h a t b e n e f i t s a r e a n i m p o r t a n t p a

More information

CDH Refresher Cindy Otley Director Marketing and Product Development

CDH Refresher Cindy Otley Director Marketing and Product Development CDH Refresher Cindy Otley Director Marketing and Product Development Cindy.Otley@CareFirst.com 410-998-7788 Visual Presentation Only CareFirst BlueCross BlueShield is an independent licensee of the Blue

More information

Partial Self Funding and Population Health Management. Facts, Concepts, and Strategies

Partial Self Funding and Population Health Management. Facts, Concepts, and Strategies Partial Self Funding and Population Health Management Facts, Concepts, and Strategies Spring-Summer 2016 Agenda Framing the Conversation Opportunity provided by the ACA How do Fully Insured / Self Funded

More information

FREQUENTLY ASKED QUESTIONS ID CARDS / ELIGIBILITY / ENROLLMENT

FREQUENTLY ASKED QUESTIONS ID CARDS / ELIGIBILITY / ENROLLMENT FREQUENTLY ASKED QUESTIONS ID CARDS / ELIGIBILITY / ENROLLMENT BENEFIT INFORMATION CLAIMS STATUS/INFORMATION GENERAL INFORMATION PROVIDERS THE SIGNATURE 90 ACCOUNT PLAN THE SIGNATURE 80 PLAN USING YOUR

More information

Health Savings Accounts & High Deductible Health Plans

Health Savings Accounts & High Deductible Health Plans Health Savings Accounts & High Deductible Health Plans Definitions Consumer Driven Health Plan ( CDHP ) A health insurance plan designed to give you more control over your health care spending. CDHPs incorporate

More information

MODERNIZE YOUR HEALTH PLAN BY INCREASING INDIVIDUAL HEALTH OWNERSHIP

MODERNIZE YOUR HEALTH PLAN BY INCREASING INDIVIDUAL HEALTH OWNERSHIP MODERNIZE YOUR HEALTH PLAN BY INCREASING INDIVIDUAL HEALTH OWNERSHIP Lancaster County Business Group on Health, Forecast Breakfast, September 25, 2014 Impact of ACA & Pharmacy on UHC Clients Financial:

More information

Choosing a Health Insurance Plan for 2016

Choosing a Health Insurance Plan for 2016 Choosing a Health Insurance Plan for 2016 Alan Sager BUSPH School Assembly 27 October 2015 This talk rests heavily on a report prepared for the BUSPH Faculty Senate. Alan Sager prepared that report, at

More information

Massachusetts Small Group Plan Design Comparison January 1, 2014 Plan Year or Calendar Year Available for All Plans

Massachusetts Small Group Plan Design Comparison January 1, 2014 Plan Year or Calendar Year Available for All Plans Non- ER Medical Individual/ Family HMO Value 250 $15 $100 $250 $100 No 26% Basic 25 $25 $125 $500 $100 No $2,500/$5,000 17% 500 after after after $500/$1,000 8% 1000 after after after 1 (baseline) * after

More information

Summary of Plans. Flex Choice PPO 2000 Cigna Network. 25th of month Prior to Effective date

Summary of Plans. Flex Choice PPO 2000 Cigna Network. 25th of month Prior to Effective date Summary of Plans 1 2 3 4 5 Benefits Flex Choice PPO 1000 Flex Choice PPO 2000 Flex Choice PPO 2500 Flex Choice PPO 3500 Flex Choice PPO 5000 $125 Processing Fee Referrals Req'd No No No No No Plan Anniversary

More information

UC Retiree Medical Plans. Presented by Glenn Rodriguez HealthCare Facilitator UC Irvine

UC Retiree Medical Plans. Presented by Glenn Rodriguez HealthCare Facilitator UC Irvine UC Retiree Medical Plans Presented by Glenn Rodriguez HealthCare Facilitator UC Irvine Agenda Your Options Medicare and UC Plan Overviews StayWell Conclusion 2 Your Options 3 Your options UC offers four

More information

Selling Health Savings Accounts & the CelticSaver HSA Health Plan. CelticSaver HSA3.0 AGT 3/09

Selling Health Savings Accounts & the CelticSaver HSA Health Plan. CelticSaver HSA3.0 AGT 3/09 Selling Health Savings Accounts & the CelticSaver HSA Health Plan CelticSaver HSA3.0 AGT 3/09 Presentation Topics Introduction to HSA Programs The CelticSaver HSA Health Plan Celtic s Agent HSA Sales Support

More information

Service AvMed Cigna Leon Cares Humana HMO Humana PPO UnitedHealthcare. Out-of- Network

Service AvMed Cigna Leon Cares Humana HMO Humana PPO UnitedHealthcare. Out-of- Network 2016 Medicare Advantage Plans Comparison Chart This comparison chart is a side-by-side representation of services offered through the AvMed, Cigna, UHC, and Humana Medicare Advantage Plans for both in-network

More information

Health Reimbursement Arrangement (HRA) A Member Guide

Health Reimbursement Arrangement (HRA) A Member Guide Health Reimbursement Arrangement (HRA) A Member Guide 1 Table of Contents Maximize your healthcare dollars with an HRA through BCBSRI...3 How to pay your medical expenses... 4-5 Online portal instructions

More information

Student Health Insurance Plan Discussion 2015-2016. Phyllis M. Lombardi Business Operations Manager University Health Services

Student Health Insurance Plan Discussion 2015-2016. Phyllis M. Lombardi Business Operations Manager University Health Services Student Health Insurance Plan Discussion 2015-2016 Phyllis M. Lombardi Business Operations Manager University Health Services Agenda Dependent Rate Parity Effect on Student Health Insurance Plan (SHIP)

More information

Take the Wheel Benefits for the Road Ahead

Take the Wheel Benefits for the Road Ahead Take the Wheel Benefits for the Road Ahead Ithaca Hourly Benefis Highlights 2015 Welcome Center. It s time again to Take the Wheel as you head out on your benefits enrollment journey. BorgWarner s annual

More information