A solution for creating a plan to controlling the cost of healthcare now and in the future! Presented By Polestar Benefits, Inc. Alternative Funding MEDICAL PLAN HRA ALTERNATIVE FUNDING HAPPY EMPLOYEES HAPPY EMPLOYER
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A solution for creating a plan to controlling the cost of
healthcare now and in the future! Presented By Polestar Benefits,
Inc. MEDICAL PLAN HRA ALTERNATIVE FUNDING HAPPY EMPLOYEES HAPPY
EMPLOYER
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Health insurance premiums continue to drive higher; Most
employers are facing increases to premiums (per year) of 15% or
more; 72% of companies are interested in offering custom plans if
its costs decrease by 10% or more.
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1 2 3 Capture premium savings by choosing an alternative
medical plan with a higher deductible and/or coinsurance; Use the
premium savings for reimbursement of claims costs. Establish a
second plan* that reimburses employees for difference of deductible
and/or coinsurance expenses from the current plan to the alternate
plan; Alternate Plan Deductible $2000 The plan established to
reimburse for expenses, in this is case, is as a Health
Reimbursement Arrangement (HRA). More information available on what
an HRA is at
http://www.polestarbenefits.com/hra.htmlhttp://www.polestarbenefits.com/hra.html
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1.The Reimbursement Plan for the employee is typically setup to
keep the total benefits close to or the same as the prior plan
year; 2.Reimbursements from the Plan are not taxable income to the
employees; 3.If the employee makes premium contributions to the
medical plan, the reduction of premium with the alternative medical
plan is also a savings to the employee.
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Current PlanNew Plan Office Co-Pay$20 Deductible$500$2000
Coinsurance20/40% Rx$15/$30/$50 ONLY the difference in the
deductible was reimbursed!!!
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Current PlanNew PlanSavings Employee Only $351.98$292.55$59.43
Employee/ Spouse $703.96$585.10$118.86 Employee/ Family
$985.54$819.14$166.40 Employee/ Child $633.56$526.59$106.97
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# EnrolledMonthly Savings Annual Savings Employee Only
12$59.43$8,557.92 Employee/ Spouse 6$59.43$4,278.96 Employee/
Family 9$59.43$6,418.44 Employee/ Child 5$59.43$3,565.80 TOTAL
SAVINGS $22,821.12
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2007 8.04% 2008 15.95% 2009 11.75% 2010 11.52%
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Annual Premium Savings $22,821.12 Total Claims Reimbursed
($2202.10) Administration Fees($1200.00) TOTAL SAVINGS
$19,419.02
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Renewal PlanYear 1Year 2Year 3Year 4Year 5
$351.98$292.55$327.66$366.97$411.01$460.33 Plus the cost of
claims
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Consider a Value planInsurance carriers have been creating new
plans that create additional premium discounts for removing copay
for office visits (for example) and other items Increasing
liability to the member. Take the same concept for creating premium
savings, but fill the additional holes with a HRA. Copyright
201013
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DEDUCTIBLE REIMBURSEMENT EMPLOYEE (Member) PAYSHRA REIMBURSES
The first $500 of DEDUCTIBLE expenses (per individual). Once the
member has met his/her DEDUCTIBLE responsibility, he/she will
receive reimbursement for the next $4,500 of incurred DEDUCTIBLE
expenses. FOR PROFSERVICE DEDUCTIBLE EXPENSES The first $25 of
PROFSERVICE DEDUCTIBLE expenses (per individual). Once the member
has met his/her DEDUCTIBLE responsibility, he/she will receive
reimbursement for the remaining PROFSERVICE DEDUCTIBLE expenses.
Layer 1 Layer 2
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Producer/Agent Frequently Asked Questions -
http://www.exchange.utah.gov/learn-more/producer-agent-faqs
http://www.exchange.utah.gov/learn-more/producer-agent-faqs 1 - Do
employers have to use a producer? During the limited launch,
employers were required to designate a producer. Currently
employers are not required to designate a producer, however they
are highly encouraged to do so. 2 - Which producers are eligible to
use the Exchange? In order to use the Exchange, producers must be
licensed in Utah and appointed with all carriers participating in
the Exchange. Refer to UCA 31A-30-209 for further details. 3 - How
many carriers are participating in the defined contribution system?
Three medical carriers (Regence Blue Cross Blue Shield, Select
Health, United Health Care) are participating and two HSA vendors
are participating. We expect to see an increased number of
participants as we progress. 4 - How many employer groups can the
Exchange support? There is no limit to the number of employer
groups the exchange can support. 5 - Which employer groups are
eligible to participate in the defined contribution system? What
group size will the Exchange accommodate.? Beginning January 1,
2011 employers in Utah with group size 2-50 are eligible to enroll
in the defined contribution system. 6 - How do producers start the
employer enrollment process? The first step is for the employer to
submit an Employer Application via the Utah Health Exchange. Refer
to Enroll - Employer section of this website for further details. 7
- Why is my name / agency not showing up on the employer
registration page? If your name or agency does not show up on the
employer registration page then please verify that you are
appointed with the Exchange carriers. If you need additional
information about producer qualifications please contact the Utah
Insurance Department.Utah Insurance Department. 8 - What is the
broker commission rate on the Exchange? Brokers are paid $37.00 per
employee per month. The $37.00 is included in employee's monthly
premiums. This amount is disclosed on employer's invoice.
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Polestar Benefits, Inc. Toll Free: (855) 222-3358
http://www.linkedin.com/in/tysonfuehrer www.polestarbenefits.com
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