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HealthCare Forum

Controlling Healthcare Costs While Improving Quality: Employee Benefits Donald L. Eddleman, Partner efg&m, L.P. 512.671.9385 don@efgmbenefits.com. HealthCare Forum. Locally owned and operated Independent Employee Benefits firm We work with small to mid-size companies (2-900)

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HealthCare Forum

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  1. Controlling Healthcare Costs While Improving Quality: Employee BenefitsDonald L. Eddleman, Partnerefg&m, L.P.512.671.9385don@efgmbenefits.com HealthCare Forum

  2. Locally owned and operated Independent Employee Benefits firm • We work with small to mid-size companies (2-900) • Employee Benefits (Health Ins) is generally the 2nd to 4th largest expense for these employers • Our challenge – to design and implement affordable Employee Benefit packages to attract and retain quality employees

  3. Affordability Gap

  4. Strategies for Managing Health Insurance Cost • Plan Designs • Multiple Option Plan Offerings • Consumer Driven Health Plans • Employer’s Contribution Strategy

  5. Benchmarking Average Deductibles in Texas Source: Data from one of the big four insurance carriers in Central Texas

  6. Plan Offerings • Plan Designs • Deductibles • Coinsurance • Copays • Prescription Drug Benefits • Multiple Option Plan Offerings • Base Plan • Buy Up Plan • CDHP

  7. The logic behind Consumer Driven Health Plans Consumers share additional cost through tax favorable accounts such as HSAs • To get the consumer more engaged with their health care decisions • To reduce unnecessary utilization • The idea is that consumers will be better stewards with their own healthcare dollars

  8. Consumer Driven Health Plans (CDHP’s) • Health Reimbursement Accounts (HRA) • Employer sponsored plans.   • Health Savings Accounts (HSA) • HSAs are individual accounts that employers sometimes choose to contribute to.

  9. HSA with Qualified High Deductible Plan HSA COMPONENTS HDHP High Deductible Health Plan THE INSURANCE PIECE • HSA • Health Savings Account • THE ACCOUNT TO FUND DEDUCTIBLE TAX-FREE Insurance Company Financial Custodian

  10. Health Savings Account • Maximum contribution for 2012: (contribution deadline is April 15th) • Individual - $3,100 ($3,050 for 2011) • Family - $6,250 ($6,150 for 2011) • Family = employee + 1 or more dependent(s) • Catch-up Provision – Age 55 and older can contribute an additional $1000.00 each year • Un-used balance carries over each year • Portable (i.e. you take your account with you if you leave) • Contribution can be made through payroll deductions, online directly, or by check • Interest-bearing account

  11. Are CDHP’s changing behavior?

  12. Wellness 101 – Costs follow Risks

  13. don@efgmbenefits.com 512-671-9385

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