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National Health Access Citizens Health Care Working Group. May 12, 2005. Presented by: Kenneth L. Sperling CIGNA HealthCare. Background. The HR Policy Association Represents the senior HR leadership of Fortune 500 companies Over 240 member companies; cross-section of American industry

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national health access citizens health care working group
National Health AccessCitizens Health Care Working Group

May 12, 2005

Presented by:

Kenneth L. Sperling

CIGNA HealthCare

background
Background
  • The HR Policy Association
    • Represents the senior HR leadership of Fortune 500 companies
    • Over 240 member companies; cross-section of American industry
    • Entry into health care at 2003 annual meeting; formed Health Care Policy Roundtable
    • Identified the uninsured as principal focus
health care policy roundtable
Health Care Policy Roundtable
  • J. Randall MacDonaldIBM Corporation, Chairman, Health Care Policy Roundtable
  • Timothy HughesCox Enterprises, Inc., Chairman, Public Policy Directions
  • Greg LeeSears Roebuck & Co., Chairman, Affordable Health Care Solutions Coalition
  • John ButlerTextron Inc., Chairman, Regional Health Care Quality Reform Initiatives
  • Sid BanwartCaterpillar, Inc., Chairman, Direct Pharmaceutical Purchasing Coalition
charter coalition members

ACS

ALCOA

Aerojet

Allstate Insurance Company

Amerada Hess

Anheuser-Busch

Avon

Caterpillar Inc.

Circuit City Stores, Inc.

Cox Enterprises, Inc.

DTE Energy Company

Eaton Corporation

Edward D. Jones & Company, LP

EMC Corporation

Emerson Electric Company

Episcopal Church Medical Trust

Federal-Mogul Corporation

FedEx Ground

First Data Corporation

Ford Motor Corporation

FPL Group Inc.

Gap, Inc.

General Dynamics

General Electric Company

General Mills

General Motors

Hilton Hotels

Honeywell

The Home Depot

IBM Corporation

Intel

International Paper

Johnson Controls, Inc.

Kelly Services, Inc.

Limited Brands

Lockheed Martin Corporation

Maersk

Manpower Incorporated

Marathon Ashland Petroleum

Marathon Oil Corporation

Marriott

McDonald\'s Corporation

Motorola, Incorporated

Parker Hannifin Corporation

Payless ShoeSource, Inc.

Pitney Bowes

Prudential Financial

Sears Roebuck & Company

Sprint

Standard Parking

Starbucks Corporation

Starwood Hotels & Resorts

SYSCO

Target

Textron Inc.

Toys "R" Us, Inc.

United Parcel Service

United Technologies

Verizon Communications

Verizon Wireless

Charter Coalition Members
  • Initial population – 1.3 million
    • Employees, independent contractors, pre-65 retirees
    • 3 million including dependents
affordable health care solutions coalition
Affordable Health Care Solutions Coalition
  • Concept
    • Address the issue of the “working uninsured” by aggregating large groups of employees not receiving a health care benefit subsidy from a broad cross-section of American industry
    • Create more viable individual health care market
    • Promote dissemination of provider efficiency and effectiveness data
  • Focus on uninsured populations in large corporations, specifically—
    • Full-time, part-time, temps without coverage
    • Contract workers, independent agents, consultants
    • Pre-Medicare retirees
affordable health care solutions coalition6
Affordable Health Care Solutions Coalition
  • Goals
    • Fully insured
    • No required direct employer subsidy
    • Guaranteed issue (i.e., no medical questions or underwriting)
    • National solution
    • Range of options and price points significantly better than current individual health insurance market, including comprehensive major medical coverage
    • Provider cost and quality transparency
national health access offering for fall 2005
National Health Access Offering for Fall 2005

Level VI

Major Medical—$1,100 Deductible (HSA)1

Level V

Major Medical—$2,000 Deductible (HSA)1

Level IV

Scheduled Inpatient &

Outpatient Benefits

Scheduled Outpatient Benefit

Level III

Level II

Wellness Benefit

Discounted Network

Level I

Guarantee Issue (with waiting periods)

Guaranteed Issue (no waiting periods)

1Depending on location, individual products may be offered that do include individual underwriting

states with major medical offerings
States with Major Medical Offerings

Current configuration leads to Major Medical options in 32 states representing 87% of the eligible population

challenges
Challenges
  • Adverse selection concerns on major medical coverage led to a fragmented state-by-state solution
  • Could not cover franchisees or small employers
  • Need to build front-end infrastructure for eligibility, enrollment, billing, and service
  • Lack of industry consensus on provider quality measurement and reporting
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