Benefit Alternatives Pat Haines SVP, Benefits. Defining the Need The Economics of the BOP Plan...

Benefit Alternatives

Pat HainesSVP, Benefits

• Defining the Need• The Economics of the BOP Plan• Public Exchange Basics• Available Resources

2

Topical Overview

• Church Size• Congregational Resources• Growth in Part-time Ministry

3

Defining the Need

• Current Demographics• Minimum vs. Maximum Participation• Average Cost of Coverage• Relationship between Dues and Cost

4

The Economics of the BOP Traditional Plan

• Members participating in Traditional Medical Plan as a result of their employment with a church or employing organization:

• 11,575 Total Members

• 66% (7,659) are Teaching Elders

• 34% (3,916) are Lay employees

5

Covered Population Demographics

• 18% (1,385) of Teaching Elders participate at the 2014 minimum of $42,000

• 62% (2,435) of Lay members participate at the 2014 minimum

• 33% (3,820) of all members participate at the 2014 minimum

6

Participation at Minimum

• 1.9% (145) of Teaching Elders participate at the 2014 maximum of $124,000

• 1.5% (57) of Lay Members participate at the 2014 maximum

• 1.7% (202) of all Members participate at 2014 maximum

7

Participation at Maximum

8

Population by Salary

$42,000 and Under

$42,001 - $52,500

$52,501 - $63,000

$63,001 - $73,500

$73,501 - $84,000

$84,001 - $94,500

$94,501 - $104,500

$104,501 - $115,000

$115,001 - $124,000

Above $124,000

0

250

500

750

1,000

1,250

1,500

1,750

2,000

2,250

2,500

2,750

2,435

693

327

181109 60 27 15 12 57

1,385

1,866

1,542

1,173

679

417

252129

71145

LAY TEACHING ELDER

2013 FTE SALARY

ME

MB

ER

CO

UN

T

80% of Lay members42% of Teaching Elders

1.8% of Lay members2.8% of Teaching Elders

9

Average Medical Plan Costs

Per Family Unit

2012 2013

$7,200

$6,700

Members Covering at Least One Dependent

2012 2013

$13,000

$14,300Participating at Member-Only

=

+

2012 2013

$12,000

$13,000

10

• The Value of Community Nature

• 2014 Minimum Dues

$9,660 = 74% of $13,000 Average Cost

• 2014 Maximum Dues

$28,520 = 219% of $13,000 Average Cost

Relationship Between Dues and Cost

11

The Value of Community Nature

Relationship Between Dues and Cost

Average Cost$13,000

2014 2014 2014

$9,600

28520

219% of Average Cost

74% of Average Cost

2014 Maximum Dues Participation Basis

2014 Minimum Dues Participation Basis

• Primary Objectives• Address Access and Affordability

• Approach• Individual Mandate• Uniform Coverage Standards• Premium Tax Credits

12

The Affordable Care Act

• Exchange Essentials• State based• Designed for individuals and small businesses• Metallic plan options

13

Public Exchanges: Accessible and Affordable Coverage as of 1/1/2014

• Core Functions• Consumer Assistance• Plan Management• Eligibility• Enrollment• Financial Management

14

Public Exchanges: Accessible and Affordable Coverage

• Marketplace Decisions: • State Based: 17 (includes DC)

State operates all exchange activities• Federally Facilitated: 27

HHS operates• Partnership: 7

State operates activities for Plan Management

and/or consumer assistance

15

Public Exchanges: Current State

Marketplace Decisions

16

http://kaiserfamilyfoundation.files.wordpress.com/2014/01/state-health-insurance-marketplace-decisions-healthreform.png

• Open Enrollment: October 2013 – March 2014• Enrollment statistics• Early concerns

• Systems issues• Consumer confusion• Narrow networks• Geographic (urban vs. rural) variability: choices

and cost

17

Public Exchanges: Current State

• Plans Offered: Minimally, one silver and one gold

• Plan Types: HMO, PPO, High Deductible, provided they achieve actuarial value

• Distinguishing Product Characteristics: provider network, customer service, ancillary products

18

Public Exchanges: How They Are Designed To Work

• Eligibility: 85% of those purchasing coverage on exchange will likely qualify • Household income < 400% of FPL ($95,400

family of four)• No access to “affordable” coverage through

employer• Impact

• Caps coverage cost (for 2nd lowest cost Silver Plan) at 2% - 9.5% of household income

19

Public Exchanges: Premium Subsidy

• Enriches Silver Plan• Reduces out-of-pocket maximum• Converts Silver to Platinum for those earning

< 200% FPL ($47,700 for family of four)

20

Public Exchanges: Cost-Sharing Subsidy

• Traditional Plan (23% effective salary) • Minimum Dues Basis ($42,000)

$805/month; $9,660/year

• Median Dues Basis ($54,500)

$1,363/month; $16,350/year

• Maximum Dues Basis ($124,000)

$2,377/month; $28,520/year

21

Understanding the BOP Benchmarks

• Affiliated Benefits Program

22


Coverage Level Monthly Annual

Member Only $624 $7,488

Member + Covered Partner

$926 $11,112

Member + Child(ren) Only

$1,281 $15,372

Member + Family $1,668 $20,016

• Seminary Students

23




Member + Covered Partner

$702 $8,424

Member + Child(ren) Only

$702 $8,424

Member + Family $805 $9,660

• Medical Continuation Coverage

24




Member + Family $1,466 $17,592

• It All Starts Here

https://www.healthcare.gov/

25

Public Exchanges: How To “Shop”


26

Public Exchanges: Some Pricing Samples

LocationState/County

Demographics Plan Design

Monthly Cost

MonthlyABP

PA/Philadelphia Family of Four, Ages 54, 53, 21, &18Household Income: $54,000

PPO Gold$20 PCP $60 Specialist $10 Generic Rx

$1,634 (before credit)$695 (after credit)

$1,668

27




Monthly Cost

MonthlyMed

Continuation

FL/Palm Beach

Family of Two, Ages 61 & 63Household Income: $60,000

PPO Gold$30 PCP $60 Specialist $4 Generic Rx


$1,466

28




Monthly Cost

MonthlySeminary

GA/Fulton Family of Four, Ages 38, 34, 6, & 4Household Income: $65,000

HMO Gold$20 PCP $50 Specialist $10 Generic Rx


$805

29




Monthly Cost

Monthly Med

Continuation

CA/San Diego Family of Two, Ages 64 & 59Household Income: $55,000

HMO Gold (Kaiser)$20 PCP $40 Specialist $5 Generic Rx


$1,466

30



Demographics Plan Design Monthly Cost

Monthly ABP

CT/Hartford Family of Three, Ages 45, 13, &16Household Income: $45,000

PPO Silver Anthem$2,300 Ded.$30 PCPDed. applies to Specialist$15 Generic RX

$373 $1,281

• It All Starts Here


• And Now Here

https://www.healthcare.gov/find-premium-estimates/

31

Public Exchanges: Let’s “Shop”




Benefit Alternatives Pat Haines SVP, Benefits. Defining the Need The Economics of the BOP Plan...

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