Title: Penn-Ohio Regional Health Care Alliance
1Penn-Ohio Regional Health Care Alliance
The Insurance Dollar
Breaking Down The Costs Copays Deductibles Coinsurance
2The Insurance Dollar Cost Sharing Methods
Copay - Designed to offer reimbursement on high frequency/low severity costs.
Deductible - Designed to offer reimbursement on high severity/low frequency costs.
Coinsurance - Designed to maintain insured's "engagement" in costs.
Penn-Ohio Regional Health Care Alliance
3The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
4The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
5The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
6The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
7The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
8The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
9The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
10The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
11The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
12The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
13The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
14The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
15The Insurance Dollar
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17The Insurance Dollar
- Integrating Employee Engagement Through HRA's
- Employer offers "High" Deductible Plan with no
employer funding of deductible. - What Happens?
- Employer sees immediate cost savings.
- Employee see the actual costs of healthcare
(becomes a gatekeeper) - Employee bears the "first dollar" costs up to
the deductible. - With Coinsurance, "out of pocket" maximum is
also important. - Depending on market environment, may or may not
be a competitive benefit package.
Penn-Ohio Regional Health Care Alliance
18The Insurance Dollar
- Integrating Employee Engagement Through HRA's
- Employer funds a portion of the deductible.
- What Happens?
- Employee sees the actual costs of healthcare
(becomes a gatekeeper) - Employee Rollovers have a savings effect on
some employees (No use it or lose effect). - Employer is in the insurance business (Takes
Risk/Reward) - Opportunity to build common goals.
Penn-Ohio Regional Health Care Alliance
19The Insurance Dollar
- Integrating Employee Engagement Through HRA's
- Employer funds a portion of the deductible.
- What Happens?
- Employee sees the actual costs of healthcare
(becomes a gatekeeper) - Employee Rollovers have a savings effect on
some employees (No use it or lose effect). - Employer is in the insurance business (Takes
Risk/Reward) - Opportunity to build common goals.
Penn-Ohio Regional Health Care Alliance
20The Insurance Dollar
- Integrating Employee Engagement Through HRA's
- Employer HRA funding affects more than the HRA
Balance. - 90/10 ER/EE Split Does this put enough of the
employees skin in the game to affect behavior? - 50/50 ER/EE Split
- 10/90 ER/EE Split Does this offer enough of the
Y/Y savings opportunity to affect behavior?
Penn-Ohio Regional Health Care Alliance
21The Insurance Dollar
Open Dialogue
Penn-Ohio Regional Health Care Alliance