Insurance Consultants Inc The Answer To Healthcare Reform Health Care ReformReality Check The following information is designed to help you understand the changing face of healthcare and the challenges we encounter with the implementation of the new healthcare reform laws Healthcare as w ID: 636566
Download Presentation The PPT/PDF document "Presented By: L. S. & Associates" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Presented By:
L. S. & Associates
Insurance Consultants Inc.
The Answer To Healthcare ReformSlide2
Health Care Reform–Reality Check
The following
information is designed to help you understand the changing face of healthcare and the challenges we encounter with the implementation of the new healthcare reform laws. Healthcare, as we have known it, is a thing of the past.
The
complexities of Health Care Reform present new challenges for employers which have forced them to consider alternative business ideas to
survive. Employers, now more than ever, are relying on their insurance benefits partner to think outside of the box with cutting edge ideas that provide real solutions.
Insurance agents have become complacent and over the years have relied on a few convenient traditional healthcare options that have now run their course of un-productivity. The words new, outside the box. creative, cutting edge are not in their vocabulary or realm of expertise. Employers are looking for a benefits partner that can provide certainty in uncertain times.
Employers are more than ever wanting their agents to earn their keep and identify the services and value they offer. Savvy business owners are tired of the same old games and are partnering with consultants who provide real solutions. Slide3
Average Annual Premiums for Single and Family Coverage 1999-2012
$15,745*
You
can see by looking at this chart, that in a little over 10 years, the average cost of health insurance for a family has gone up by almost $10,000
!.
That
is nearly a 175% increase! Slide4
Continue to do what you have always done and keep listening to the insurance agent that has gotten you into the situation you are in today and hope for the best?
Continue to shift more costs and out-of-pocket expenses to employees by increasing deductible’s, coinsurance limits and employee premium contributions?
Or…
Consider thinking outside the box by using a creative strategy to guarantee savings without risk, and improve benefits at the same time.
How are you responding?Slide5
The Secondary Supplemental
Out-Of-Pocket Medical Insurance Concept
Pair a High Deductible Major Medical Plan with
a Secondary Supplemental Medical Plan
Complexities created by the new healthcare reform laws have opened the door for this creative concept to flourish. Employers
have to meet
the Essential Benefits Guidelines for benefit coverage and
be
within the 9.5% threshold of affordable premiums. Under
the
healthcare guidelines, the secondary plan does not have to be funded by the employer and can be sold on a voluntary basis with certain participation requirements being met which will lower the employers medical contributions towards employee premiums.Slide6
A simple two I.D. card system. One card for Major Medical and another card for the Supplemental Medical.
If a covered claim is
subject to the new high deductible or co-insurance limit by the Major Medical, the bill is applied to the secondary supplemental medical coverage, instead of the insured potentially being responsible. The benefits can be assigned and paid directly to the provider.
How easy is this concept?
This idea has been around for years.
For example: With Medicare, seniors
have out-of-pocket expenses
after
Part A & B
pays
their portion of services. A Medicare Supplement helps
fill the void.Employers can utilize this
concept
with their group health
benefits, giving them phenomenal health coverage and creating substantial savings.Slide7
Why The “Secondary Supplemental Medical Insurance” Concept Works
Cost Effective
Enhanced BenefitsGreater Flexibility of Plan DesignsImplements long range plan to help control medical costs
Spreads the claims riskMinimizes the out-of-pocket expenses related to deductibles & co-insurance
An attractive benefit plan that attracts and retains key employeesSlide8
Modify your current benefit plan to a High Deductible (3k-5k) Health Insurance Plan
(This creates an instant medical premium savings of 30-43%)
Customize the supplemental Out-Of-Pocket Medical Insurance plan that fits your needs
(The supplemental insurance plan covers the increased deductible and coinsurance limit)
How to Implement the Concept:
The two plans combined
in most cases cost
less than
your
current plan
with same or better coverage!
Some models have shown employers saving thousands even hundreds of thousands of dollarsSlide9
Increase your major medical deductible
Create
a substantial savingsCustomize
the supplemental plan that fits your needs bestUse
a portion of the savings generated by moving to the higher deductible to pay for the supplemental medical plan
Enjoy
the substantial premium savings and enhanced benefits for you and your employees
Five Easy Steps to make your benefit dollar work harder for you…Slide10
Old Medical Plan
$1000
DED/20% TO
$2000
New Medical Plan
$5000 100%
+
Secondary
Medical Plan Designs
Primary/Specialist
$25/$50
Copay
$25/$50
Copay
Calendar Year Deductible
$1000
$5000
Co-Insurance Percentage
80% to $2000
100%
Hospital - In & Out-Patient Services
Calendar Year Deductible
$
1000
Per
Insured
$5000
Per
Insured
In Patient Services$1000 Deductible/80% to $2000Secondary plan pays 100% to $5000Out Patient Services Emergency room, Surgery & etc.$1000 Deductible/80% to $2000Secondary plan pays 100% to $3500, Insured pays $1500 on the back endDiagnostic TestingMRI/CT/PET Scans$1000 Deductible/80% to $2000Secondary plan pays 100% to $3500, Insured pays $1500 on the back end Total Out of Pocket$3000$0 Inpatient/$1500 Outpatient
Example Case DesignSlide11
Current Plan:
$1000 Ded/20% to $2500 Co-Ins Limit/$3500 Total Out-of-Pocket
Census
Coverage
Medical
Total
48
Employee
$388.78
$388.78
6
EE/Spouse
$816.44
$816.44
5
EE/Children
$719.25
$719.25
6
Family
$1127.48
$1127.48
65
$33,921.15
$33,921.15
Renewal
Plan:
$1000 Ded/20% TO $2500 C0-Ins Limit /$3500 Total Out-of-Pocket
CensusCoverageMedicalTotal48Employee$427.63$427.636EE/Spouse$898.02$898.025EE/Children$791.12$791.126Family$1240.14$1240.1465$37,310.80
$37,310.80
New Plan $5000 100% + Secondary 100% to $5000 Inpatient /100% to $3500 Outpatient CensusCoverageMedicalSecondaryTotal48Employee$246.11$79.35 $325.46 6EE/Spouse$516.84$182.51 $699.355EE/Children$450.38$150.74 $601.126Family$746.94$253.91 $1000.85 65$21,647.86$7181.02$28,828.88“Annual” Savings versus Renewing As Is = $101,783.04
Actual
ClientSlide12
Additional Services We OfferSlide13
How much can we save you?
FIND OUT TODAY!!
To schedule an appointment:
L. S. & Associates Insurance Consultants Inc.Local: 662-393-9115 Toll Free: 1-888-393-9115