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Penn-Ohio Regional Health Care Alliance

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Penn-Ohio Regional Health Care Alliance The Insurance Dollar Breaking Down The Costs: Copays Deductibles Coinsurance The Insurance Dollar Cost Sharing Methods ... – PowerPoint PPT presentation

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Title: Penn-Ohio Regional Health Care Alliance


1
Penn-Ohio Regional Health Care Alliance
The Insurance Dollar
Breaking Down The Costs Copays Deductibles Coinsurance

2
The 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
3
The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
4
The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
5
The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
6
The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
7
The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
8
The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
9
The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
10
The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
11
The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
12
The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
13
The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
14
The Insurance Dollar
Penn-Ohio Regional Health Care Alliance
15
The Insurance Dollar
16
The Insurance Dollar
17
The 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
18
The 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
19
The 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
20
The 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
21
The Insurance Dollar
Open Dialogue
Penn-Ohio Regional Health Care Alliance
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