美国保险业协会hr分析的报告.pptVIP

Employers Becoming Less Involved (Camp 2) Employers desire to “know their cost” Dollar-based plans (often account-based) Reimbursement plans Access Only plans “Capped Plans”…typically retiree medical What these approaches share is an eye toward reducing employer cost at the expense of employees/retirees * Account-Based Approaches Defines employer’s commitment as a defined dollar contribution instead of a defined medical benefit Commitment can be monthly, annual, aggregate Commitment can be based on retiree-only or recognize dependents Amounts available for health care only; employer contributions are tax-free to the retiree and deductible for employer under Sections 105, 106 and 162 of IRC Can be funded or unfunded For Medicare-eligible, Medicare+Choice, Medigap and traditional Medicare available; HIPAA may eventually make this a viable option for pre-Medicare retirees * Account-Based ApproachesExamples Monthly/annual promise Retirees receive monthly (or annual) credits of a specified dollar amount (e.g., $100/monthly; $5/month/year of service for 20 years of service) Fixed or increases annually; “flat” or tied to service; amount not used can be carried over or not Aggregate (“lump sum”) promise Employer promise is one-time credit (e.g., $30,000; $1,000 per year of service for 30 years of service); accounts earn interest (e.g., at T-bill rate) or not; no employer pre-funding required Payment options “Draw-down” on funds (retiree uses funds to pay portion of retiree medical cost; ends when fund exhausted), or “lump sum” is converted to an annuity (multiple options) * Comparison of Overall Growth Cumulative medical care CPI 89% greater than overall CPI since 1967 Data based on January 1 CPI values * Employers’ Cost Increases Out-Pace Other Indicators Largest increase since 1990 (all employers) Includes medical, dental and pharmacy Source: 2002 Mercer/Foster Higgins National Survey of Employer-sponsored Health Plans Results for Employers with 500 or more lives 6.9%