Benchmarking, Best Practices, and Strategies 2005 Health Plan Survey

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Benchmarking, Best Practices, and Strategies2005
Health Plan Survey
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Health Spending at Crossroads
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FAQs 1, 2, 3, . . .

• Why are costs increasing so much and what can I
  do about it?
• Should I change my plan designs or switch
  vendors?
• Should I implement a high deductible or consumer
  driven plan (HRA, HSA) and how do I go about it?
• Should I consider self-insurance?
• Will a Disease Management program help me?
• How does my time off (vacation, military leave,
  etc.) compare to others?

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Three Hottest Topics
Managing cost increases
Offering competitive plan designs to attract
retain
Communicating to help employees understand and
accept changes
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Local Survey Results
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Summary of Results Top Story

• Cost increases are starting to decline nationally
  
• Locally Cost Increases decreased from 10 in 2004
  to 9 in 2005
• 2005 Plan design values are significantly lower
  than the 2004 survey median
• 2005 HMO and PPO plans decreased in value by 10
  and 3 respectively compared to 2004 Local survey
  median
• Employees share of the premium cost varies among
  employers
• 33 of Local Employers are considering offering a
  Consumer Driven Health Plan in 2006

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Survey Summary Statistics

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Survey Results
2004 POS information is not available for the
Indiana Survey
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Survey Results

• Other Medical
• Specialist Copay
• 22 of companies have a different copay
• Median difference from office visit copay
• HMO - 5
• PPO - 15
• POS - 5
• Retiree medical
• 15 of companies offer Pre-65 coverage
• 9 of companies offer Post-65 coverage

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Survey Results

• Waiting Periods and Eligibility
• 69 of companies have a waiting period of 1-3
  months for full-time employees
• 78 of companies do not offer benefits to the
  part-time employees

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Survey Results

• Prescription Drugs
• Plan type prevalence
• 86.2 of companies have a flat-dollar copay
  structure

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Survey Results
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Survey Results

• Dental
• 62 of respondents offer dental

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Survey Results
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Survey Results

• LTD
• 67 at 60 benefit
• 72 offer benefits To Age 65
• 8 of employers offering LTD also offer a Buy-Up
  Plan
• STD
• 47 at 60 benefit
• 31 offer benefits for 13 weeks
• 61 offer benefits for 26 weeks

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Survey Results

• Average Paid Time Off

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Source D. Altman and L. Levitt, The Sad
History Of Health Care Cost Containment As Told
In One Chart, Health Affairs, Web Exclusive,
Jan. 23, 2002, at www.healthaffairs.org. Updated
with 1960-2003 spending and GDP data from Centers
for Medicare and Medicaid Services, Office of the
Actuary, National Health Statistics Group, at
http//www.cms.gov/statistics/nhe/default.asp
(2003 National Health Care Expenditures Data
Files for Downloading, file nhegdp03.zip)
projected 2004 spending and GDP data from Centers
for Medicare and Medicaid Services, Office of the
Actuary, National Health Statistics Group, at
http//www.cms.gov/statistics/nhe/projections-2004
/proj2004.pdf (National Health Care Projections
Tables, Table 3) and CPI data from Bureau of
Labor Statistics at ftp//ftp.bls.gov/pub/special.
requests/cpi/cpiai.txt (All Urban Consumers, All
Items, 1982-1984100, Not Seasonally Adjusted,
U.S. city average).
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Trend in Personal Health Spending
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Survey Results
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How Can I Control Costs?
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Survey Results

• Funding Strategy Prevalence

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Survey Results

• Leaves of Absence

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What JA Benefits Can Do for You

• Recommend plan design changes
• Benchmark plan designs and costs
• Analyze rates
• Quantify risk to reduce anti-selection
• Analyze employee contribution strategy
• Write and solicit vendor RFPs
• Evaluate and select vendors based on your
  criteria
• Provide you with benefit communications tools

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What JA Benefits Can Do for You

• Proactively manage self-insured plans monitor
  PL, set rates, calculate reserves
• Help you reduce your administrative costs
• Increase FSA participation to save tax dollars
• Identify legal non-compliance and keep you
  up- to-date on new legal issues (HIPAA)
• Research and assess new ideas (HRA, Captives)
  for your unique needs
• Answer ad hoc questions you get from upper
  management

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What JA Benefits Can Do for You
ENSURE YOUR SUCCESS