2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the...
Transcript of 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the...
![Page 1: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/1.jpg)
2014 Fall Health Care Symposium
![Page 2: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/2.jpg)
Agenda
• ACA – What’s Happening Now
• Group vs. Individual Coverage
• Alternative Funding Options
• Why Wellness Matters
• Transforming HR Through Technology
![Page 3: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/3.jpg)
Understanding Obamacare
• In order to insure the uninsured, we first have to un-insure the insured.
• Next, we require the newly uninsured to be re-insured.
• To re-insure the newly uninsured, they are required to pay extra charges to be re-insured.
• The extra charges are required so that the original insured, who became uninsured, and then became re-insured, can pay enough extra so that the original uninsured can be insured, which will be free of charge to them.
![Page 4: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/4.jpg)
![Page 5: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/5.jpg)
The ACA Health Care Coverage Landscape - Changes in Effect Prior to 2014
• Loss of Medicare Part D retiree subsidy deduction
• $2500 PY cap on FSA salary reductions (Notice 2012-40)
• Amendment required by 12/31/2014
• Significant Limitations on HRAs Announced in 2013
• January 2013 FAQ Guidance
• Transition (spend down) rule for some pre-existing HRAs
• September 13, 2013 - Notice 2013-54
• Curtails stand-alone HRAs, prohibits pre-tax individual policies
• Carryover Guidance for FSAs - Notice 2013-71
• Up to $500
• Cannot be combined with FSA grace period changes
![Page 6: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/6.jpg)
The ACA Health Care Coverage Landscape - Changes in Effect 2014 and Beyond
• Individual mandate - no penalty imposed due to coverage gap if individual enrolls by end of open enrollment (March 31, 2014)
• Employer play or pay requirement - NOW DELAYED UNTIL 2016 for employers with less than 100 FTE employees. With some limited “Sledgehammer" transition relief for larger employers.
• Employer Coverage Reporting. DELAYED UNTIL 2015
(Final regs March 2014)
• Required to report minimum essential coverage and premium costs
• Applies to insurers and self funded plans
![Page 7: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/7.jpg)
The ACA Health Care Coverage Landscape - Changes in Effect 2014 and Beyond
• Exchanges - First open enrollment for individual coverage commenced October 2013
• October 1st Exchange Notice Requirement; on-going for new hires
• Changes Generally Effective First Plan Year On/After January 1, 2014
• Employer Quality of Care Coverage Reporting - Delayed pending guidance
• Will require information on health care outcome, safety, and wellness
• Must make available to enrollees and on internet
![Page 8: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/8.jpg)
Court Decisions of Interest
• Hobby Lobby Decision
• Religious objections to providing contraceptives
• Supreme Court ruled in favor of for-profit employers under Religious Freedom Restoration Act (RFRA)
• But state contraceptive equity laws may still apply
• Other challenges working their way through the courts
• Halbig and King - Availability of federal tax subsidies in state run exchanges
![Page 9: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/9.jpg)
Reforms Effective Plan Years On/After 2014
• (ALL) No pre-existing condition exclusions or limitations are permitted • First wave of reforms applied only to persons under age 19
• (ALL) Prohibition on excessive waiting periods- i.e. no waiting period in excess of 90 days • March 2013 Proposed Regulations substantially retained • Final Regulations issued February 2014 • New 30 day "orientation period" • Eliminates HIPAA Certificates after 12/31/14
• (NGF) Fair Health Insurance Premiums (applicable only to health insurers of small group plans) • Limitations on premium setting (e.g. limitations on
premium setting based on age 3:1. tobacco use 1.5:1, geography)
• Final Regulations issued in February 2013
![Page 10: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/10.jpg)
Reforms Effective Plan Years On/After 2014
• (NGF) No discrimination based on health status is permitted • Essentially, the same rules that currently exist under HIPAA • The law raises maximum incentive amount for wellness
programs that provide the incentive based on achieving a health standard from 20 to 30 percent of the COBRA cost of coverage • Also gives the Secretaries of Labor, HHS, and the Treasury leeway to
increase the percentage to 50 percent • Final regulations published June 3, 2013 • Some new requirements for standard based wellness plans (activity
only vs. standard based distinction) • 50% limited to tobacco cessation
• (All) Coverage of dependent children to age 26 - end of special rule for GF plans • Under transition rule, GF plans could exclude adult children if
the adult child is eligible to enroll in an eligible employer-sponsored health plan other than a group health plan of a parent This special rule for GF plans does not apply to plan years beginning on or after January 1, 2014
![Page 11: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/11.jpg)
Reforms Effective Plan Years On/After 2014
• (NGF) Cost limitations • ALL PLANS - Out-of-pocket expenses do not exceed the
amount applicable to coverage related to health savings accounts (HSAs) ($6350 single, $12700 family
• 2015 amounts $6600 and $13,200 differs from HSA amounts ($6450,$12900)
• ACA compliance does not mean HSA eligible • Small Fully Insured Plans - Deductibles do not exceed $2,000
for single coverage and $4,000 for family coverage (as indexed)
• February 2013 final Regulations clarify • the deductible requirement only applied to fully insured plans in
small group market, but OOP applies to ALL • Transition OOP relief allowed where separate PBM administrator
only for the 2014 plan year
• Medicare SGR Fix (Sec 213) • Eliminates deductible (but not OOP) limit • Reopens door for Integrated HRA arrangements coupled with
super high deductible coverage
![Page 12: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/12.jpg)
Reforms Effective Plan Years On/After 2014
• (NGF) Fully insured plans in small group market must provide essential health benefits (EHB) as determined by reference to a State benchmark plan
• Not applicable to fully insured plans in large group market or self-funded plans • For purposes of applying the prohibition on lifetime and
annual limits, large group and self-funded plans may use any single permissible benchmark plan
• Final regulations address Minimum Value for pay/play purposes and IRS issues MV calculator
• (NGF) Group and individual plans required to cover routine costs of participation in clinical trials by qualified individuals
• Agency FAQ says good faith compliance standard applies until guidance is issued
![Page 13: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/13.jpg)
Reforms Effective Plan Years On/After 2014
• (NGF) Additional preventive care requirements for PY beginning on/after 9/24/14
• In accordance with new guidelines Issued by the United States Preventive Services Task Force (USPSTF), non-grandfathered plans will need to cover cancer medication preventive services without charge. The effective date Is based on when the USPSTF added the new requirement.
http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca.Implementation.faqs18.html
![Page 14: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/14.jpg)
Cadillac Plan Tax Beginning in 2018, ACA imposes a 40 percent excise tax on: • "Coverage providers:" for the sum of months in which the
aggregate value of employer sponsored health coverage for the employee exceeds: • 1/12 of $10,200 for single coverage and $27,500 for family (i.e.,
other than single) coverage • These amounts are to be adjusted automatically if health costs increase
by more than anticipated before 2018 • The thresholds are increased by Consumer Price Index + 1 in 2019, and
by CPI thereafter
• An employer may make an adjustment to reduce the cost of plans when calculating the tax if the employer's age and gender demographics are not representative of a national average
• No adjustment for high cost states
• The annual limit for retirees between ages 55 and 64, individuals engaged in certain high-risk professions (e.g., law enforcement professionals, EMTs. longshoremen, construction workers, and miners), and those employed to install electrical or telecommunication lines is increased to $11,850 for individual coverage and $30,950 for family coverage
![Page 15: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/15.jpg)
Cadillac Plan Tax Determined by the employer and assessed against "coverage providers”
• "Coverage providers" are defined to include the following:
• In the case of fully insured plans, the health Insurer
• In the case of HSA or medical savings account (MSA) contributions. the employer making the contributions
• In the case of a self-insured plan or flexible spending account (FSA), the person that administers the plan (e.g., the TPA)
• In many cases, employer-sponsored coverage will include both fully insured and self-insured contributions (it may also include HSA contributions)
![Page 16: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/16.jpg)
Cadillac Plan Tax • The coverage subject to the excise tax rule includes:
• The applicable premium (determined in accordance with COBRA rules) for all accident and health coverage provided by the employer, even if paid for with after-tax dollars by the employee (except vision only insurance, dental insurance, accident and disability insurance, long term care insurance, and after-tax funded hospital indemnity and/or specified disease coverage)
• Both non-elective and salary reduction contributions to a health FSA
• Employer contributions (presumably including salary reductions) to an HSA
![Page 17: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/17.jpg)
2014 Fall Health Care Symposium
![Page 18: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/18.jpg)
Group vs. Individual Coverage- Pros & Cons
Keep Group Plan
• Pros
• Employees can contribute on a pre-tax basis! • Pre-tax contributions reduce taxable income to the employee and
the employer
• The “net” cost of the employees portion is more favorable when paying with pre-tax contributions
• Group plans typically have lower out-of-pocket costs • Most group plans pay 100% after the deductible has been met
• Co-pays for Office Visits, Prescriptions etc. are typically lower vs. individual coverage
• Employee retention • Employees appreciate a comprehensive benefits package
• Recruiting • Benefits are one of the first things prospective employees will ask
about
![Page 19: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/19.jpg)
Group vs. Individual Coverage- Pros & Cons
Keep Group Plan (Cont.) • Cons
• Individual Rating • *Groups in the 2-50 market that renew 6/1/14 or later have the
ability to keep their “old” plan and composite rating methodology
• Individual rates are based on age, geographic location (by county) & tobacco use
• PPACA plans are individually rated which makes cost-sharing more challenging
• Employers have typically paid a flat percentage or dollar amount towards premiums
• Individual premiums make this more difficult: • Take an average of all the individual rates and create a composite rate? • Provide a flat-dollar amount to each person and have them pay the actual
difference based on their rate? • Provide a flat percentage to each person and have them pay the actual
difference based on their rate?
![Page 20: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/20.jpg)
Group vs. Individual Coverage- Pros & Cons
Keep Group Plan (Cont.)
• Cons
• Rates have increased significantly for many groups
• December renewals have average increases of 35% with many groups receiving 50% increases
• Subsides – By offering a group plan you essentially “lock-out” employees from Marketplace subsidies
• Subsides are income dependent and wont apply to all employees
![Page 21: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/21.jpg)
Group vs. Individual Coverage- Pros & Cons
Convert To Individual Plans
• Pros
• Employees can pick from a variety of plans • Carriers offer multiple plan designs within the 4 “metal-levels” of
Bronze, Silver, Gold & Platinum
• Some employees may receive subsidies • Subsides are based on household income as it relates to the
Federal Poverty Level (FPL)
• Households that are between 100%-400% of FPL will qualify for a subsidy
• Employer is removed from the decision making process • Employees make their own decisions based on individual needs
![Page 22: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/22.jpg)
Group vs. Individual Coverage- Pros & Cons
Convert To Individual Plans
• Cons
• Employees must pay for premiums with a post-tax dollar • A $300 premium may require an employee to “gross” $400 in
order to “net” $300
• Out-of-Pocket Costs • Plans range from $1650 per person up to $6350 per person for
deductibles, co-insurance and co-pays
• Out-of-Pocket will increase to $6550 per person for 2015
• Employer Contributions Towards Premiums • Technically not legal – Could be done through a “merit” raise but
should not be explicitly for individual health insurance
• Additional taxes for the Employer
• Additional taxes for the employee
• May eliminate subsidy based on increased compensation
![Page 23: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/23.jpg)
Group vs. Individual Coverage- Pros & Cons
Convert To Individual Plans- “On” or “Off” Marketplace
• Plans Are The Same!
• Plans purchased directly from the insurance carrier (i.e. Highmark, Capital etc.) are the exact same plans you can purchase through the Marketplace (www.healthcare.gov)
• Pricing for the plans are identical unless you qualify for a subsidy
• If you qualify for a subsidy & you want to apply that subsidy towards your premium you must purchase your individual plan through the Marketplace (web-site, phone or mail)
• Subsides are based on household income & household size
![Page 24: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/24.jpg)
Who’s Eligible?
• Tax Credits • $11,490 to $45,960 for individuals • $15,510 to $62,040 for a family of two • $19,530 to $78,120 for a family of three • $23,550 to $94,200 for a family of four • $27,570 to $110,280 for a family of five
• Reduced out-of-pocket costs
• $11,490 to $28,725 for individuals • $15,510 to $38,775 for a family of two • $19,530 to $48,825 for a family of three • $23,550 to $58,875 for a family of four • $27,570 to $68,925 for a family of five
Income
Level
Premium as a
Percent of Income Up to 133%
FPL 2% of income
133-150%
FPL 3 – 4% of income
150-200%
FPL 4 – 6.3% of income
200-250%
FPL 6.3 – 8.05% of income
250-300%
FPL 8.05 – 9.5% of income
300-400%
FPL 9.5% of income
![Page 25: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/25.jpg)
What are employers doing? • Few Groups Have Dropped Coverage
• Small group market
• Most renewing “as is” in pre-PPACA plans
• Carriers interpretation of “if you like your plan”
• Large group market
• Carriers providing offers “not to shop”
• Carriers concerned about groups moving to self-funded
• Small & Large Groups
• QHDHPs & HSAs
• Self Funding
![Page 26: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/26.jpg)
2014 Fall Health Care Symposium
![Page 27: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/27.jpg)
Self Funding vs. Fully Insured
• Employer assumes all or a portion of the risk for health benefits.
• Administrative Services Only (ASO) – an arrangement in which an organization funds its own benefit plan
• Administrative options available to employers choosing self-funding:
• Payment Arrangements
• Paying at the maximum funding level
• Pay claims as you go
![Page 28: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/28.jpg)
Self Funded Terms
• Administrative Fee:
• Fee charged for claims adjudication, billing, eligibility, customer service, plan document maintenance, access fees, managed care fees
• Setup Fee:
• One-time charge for the input of eligibility and benefits in order for the plan to be administered
• Expected Claims:
• Total claims underwriter expects you to have in one policy year, actuarially determined from your past claims experience
![Page 29: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/29.jpg)
Self Funded Terms
• Laser:
• A provision within the stop loss contract that excludes a member from the stop-loss insurance. All claims for that individual would be the responsibility of the employer
• Shock Claim: • A shock loss may be defined as an abnormally large and
unexpected claim.
• Could be the result of severe accident or serious illness
• Stop-Loss Insurance:
• Insurance purchased to protect the employer from a shock claim and/or unexpectedly high utilization
• Specific
• Aggregate
![Page 30: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/30.jpg)
Self Funding Advantages
• Flexibility in Plan Design
• Self-funded plan not bound by state mandates
• Risk Management effectiveness through Stop Loss Insurance
• Employer may choose the amount of risk to retain and the amount to be covered under stop loss protection. Under an insured arrangement, insurance company sets the pooling level.
![Page 31: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/31.jpg)
Self Funding Advantages
• Tax Savings
• No premium tax for the self-funded claim fund
• Transparency
• Know what you are paying for
• Margin • Insurance companies typically charge 3-10% for margin (for
fluctuations in claims) • Under self-funded arrangement, this component is eliminated
![Page 32: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/32.jpg)
Self Funding Disadvantages
• Risk Assumption
• Employer assumes risk between the normally anticipated claim level and Stop Loss Coverage level
• Lasers
• Under fully insured arrangement, this component is eliminated
• Fiduciary Responsibility
• Employer assumes risk
![Page 33: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/33.jpg)
Self Funding Options
• ASO Plans
• Potential for lasers
• Negotiating on a small premium
• Should have 300 employees or more
• Carrier Options for Small Groups
• Down to 20 enrolled (underwriting required)
• Level premiums
• No lasers
![Page 34: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/34.jpg)
Self Funding Options
• Consortium Model
• Level premiums
• No lasers
• Stop Loss Purchasing Power
• Medical Loss Ratio
• Captive Model
• Potential cash advantage
• Collateral required up-front
• Commitment to wellness
![Page 35: 2013 Fall Health Care Symposium PK Sy… · Understanding Obamacare •In order to insure the uninsured, we first have to un-insure the insured. •Next, we require the newly uninsured](https://reader035.fdocuments.net/reader035/viewer/2022071003/5fc0168cb23b4859cd472700/html5/thumbnails/35.jpg)
Questions?
•