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Limited Medical Plans: Unlimited Possibilities

Limited Medical Plans: Unlimited Possibilities. William Kramer Reliance Standard Life Insurance Company March 22, 2007. Why should we care?. As Americans:. Percentage of Nonelderly Americans Without Health Insurance Coverage, 1987-2004. Why should we care?. As Americans:.

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Limited Medical Plans: Unlimited Possibilities

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  1. Limited Medical Plans:Unlimited Possibilities William Kramer Reliance Standard Life Insurance Company March 22, 2007

  2. Why should we care? As Americans: Percentage of Nonelderly Americans Without Health Insurance Coverage, 1987-2004

  3. Why should we care? As Americans: Uninsured Nonelderly Population by Family Poverty Status, 2004

  4. Why should we care? As Employers: Annual Growth Rates for Health Insurance Premiums, Workers Earnings, and Overall Inflation, 1988-2005

  5. Why should we care? As Benefits Producers: Nonelderly Adult Uninsured Workers by Firm Size, 2004

  6. What are options • Big Government • More laws • More taxes • Big Insurance • Higher deductibles/HSAs • Limited Medical

  7. History of Limited Medical • 25-plus years • Origins in Big-Box, Retail, Restaurant industries • Designed for part-time, seasonal, hourly and temporary employees • Differentiator for employers fighting turnover, lost productivity

  8. Workers in wholesale and retail trade and personal services account for 63.4 percent of all uninsured workers! Nonelderly Adult Uninsured Workers by Industry, 2004

  9. Nonelderly Adult Uninsured Workers by Work Status, 2003 More than half of all working uninsured are employed full time!

  10. Guaranteed acceptance/no adverse selection No Pre-Ex No deductibles Wellness care included Rx discounts Ancillary and dependent coverages available COBRA eligible HIPAA, ERISA compliant Today’s Plans

  11. Why Limited Medical Works Out-of-Pocket Spending as a Percent of Total Private Spending, 1960-2014 Health insurance has replaced out of pocket spending on medical expense

  12. Why Limited Medical Works Percentage of Covered Workers Facing Various HMO Copayment Amounts for Physician Office Visits, 1996-2005 Doctor copays are going up!

  13. Why Limited Medical Works Average Copayments Per Prescription in Multi-Tier Arrangements, 2000-2005 Drug costs are outpacing other health expenses

  14. What’s Next? • Increasing, maybe explosive growth • Mini-Major Plans • Split the difference • Gap Plans • Get employees to a place where they can participate in their Major Medical

  15. How to Evaluate 1 2 3 4 5 UnfavorableFavorable

  16. Access 1 2 3 4 5 Barriers to Access Open Access

  17. Flexibility 1 2 3 4 5 Off the shelfCustomized to my work force and company culture

  18. Value 1 2 3 4 5 Out of reach/IrrelevantAffordable/Valuable

  19. Ease of Administration 1 2 3 4 5 High-touchTurnkey

  20. How to Evaluate • 15-20 = BUY IT! • This is probably a best-in-class plan • 12-15 = Consider it • You may want to shop around or push back • 8-12 = Keep an eye on it • Something about the case could change, but it’s not a match right now • 0-8 = Forget it

  21. Q&A

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