Controlling Healthcare Costs While Improving Quality: Employee Benefits Donald L. Eddleman, Partner...
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Transcript of Controlling Healthcare Costs While Improving Quality: Employee Benefits Donald L. Eddleman, Partner...
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Controlling Healthcare Costs While Improving Quality: Employee Benefits
Donald L. Eddleman, Partnerefg&m, L.P.
HealthCare Forum
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• 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
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Affordability Gap
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Strategies for Managing Health Insurance Cost
• Plan Designs• Multiple Option Plan Offerings• Consumer Driven Health Plans• Employer’s Contribution Strategy
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BenchmarkingAverage Deductibles in Texas
Source: Data from one of the big four insurance carriers in Central Texas
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Plan Offerings
• Plan Designs– Deductibles– Coinsurance– Copays– Prescription Drug Benefits
• Multiple Option Plan Offerings– Base Plan– Buy Up Plan– CDHP
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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
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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.
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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
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• 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
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Are CDHP’s changing behavior?
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Wellness 101 – Costs follow Risks
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