Usnh medical plan options
This presentation is the property of its rightful owner.
Sponsored Links
1 / 8

USNH Medical Plan Options PowerPoint PPT Presentation


  • 59 Views
  • Uploaded on
  • Presentation posted in: General

USNH Medical Plan Options. April 20, 2011. Definitions. Copay – an amount paid by the insured person each time a medical service is accessed Plan deductible – amount that must be paid before insurance “kicks in” Premium – annual amount charged for health plan.

Download Presentation

USNH Medical Plan Options

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Usnh medical plan options

USNH Medical Plan Options

April 20, 2011


Definitions

Definitions

Copay – an amount paid by the insured person each time a medical service is accessed

Plan deductible – amount that must be paid before insurance “kicks in”

Premium – annual amount charged for health plan


What options could accomplish these goals and save 2 million

What options could accomplish these goals and save $2 million?

The SPPC reviewed two basic options for the majority of the cost savings:

  • Increase annual % of premium paid by employee

    • 1.5% increase (above current contribution) for all tiers saves $750k per year

    • Employee cost-individual $126(4.85), two party $253(9.73), family $379(14.58)

      or:

  • Implement an annual Plan deductible

    • $200 individual/$400 family saves $1,372,000


Two conceptual plan design models

Two Conceptual Plan Design Models

Two conceptual models have been developed for review:

Both models include:

a) a reduction in the incentive to waive coverage ($173,000 in cost avoidance)

b) establishment of a Physical, Speech, Occupational therapy copay of either $5 or $10 ($105,000 to $210,000 in cost avoidance)

c) establishment of a high tech imaging copay of either $50 or $100 ($105,000 to $210,000 in cost avoidance)

d) no copay for designated preventative services, including but not limited to, routine physical and gynecological exams, preventive screenings, routine vaccinations, annual childhood check-ups


Two models

Two Models

Alternative 1 - “Minimize Cost at Point of Care” (Increased Premium Contribution)

Spreads the cost over all participants by increasing employee contributions 1.5% and adds small increases to current copays for frequently used services such as visits to the Primary Care Physician and Specialist.

Alternative 2 - “Behavior Change and Consumerism” (Deductible)

This option introduces a $200/$400 annual deductible and increases the copay for Specialist office visits. This model increases employee awareness of medical costs and engages employees in managing those costs.


Alternative 1 minimize out of pocket costs at the point of care

Alternative 1 - Minimize Out of Pocket Costs at the Point of Care

* Includes reducing the medial waiver payment from $800 to $550 and employees covered by a USNH medical/dental plan are not eligible for the waived medical/dental coverage payment.

** Physical/Speech/Occupational therapy (also includes cardiac rehab visits).

*** High tech imaging includes MRIs, CAT scans and PET scans. All other imaging including X-rays are covered in full.


Usnh medical plan options

Alternative 2 – Behavior Change and Consumerism

7

* Includes reducing the medial waiver payment from $800 to $550 and employees covered by a USNH medical/dental plan are not eligible for the waived medical/dental coverage payment.

** Physical/Speech/Occupational therapy (also includes cardiac rehab visits).

*** High tech imaging includes MRIs, CAT scans and PET scans.

**** Current hospital inpatient and outpatient copays remain. All hospital (inpatient and outpatient), diagnostic imaging, x-ray and lab subject to the deductible and applicable copays.

7


Next steps

Next steps

SPPC meets on May 19th

Vote on a recommendation for a new medical plan design

USNH Administrative Board meets on May 26th

Review SPPC’s recommendation, approve/disapprove proposed medical plan design

Plan design changes approved will be implemented on January 1, 2012.


  • Login