Benefit Alternatives Pat Haines SVP, Benefits. Defining the Need The Economics of the BOP Plan Public Exchange Basics Available Resources 2 Topical Overview.

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Presentation transcript:

Benefit Alternatives Pat Haines SVP, Benefits

Defining the Need The Economics of the BOP Plan Public Exchange Basics Available Resources 2 Topical Overview

Church Size Congregational Resources Growth in Part-time Ministry 3 Defining the Need

Current Demographics Minimum vs. Maximum Participation Average Cost of Coverage Relationship between Dues and Cost 4 The Economics of the BOP Traditional Plan

Members participating in Traditional Medical Plan as a result of their employment with a church or employing organization: 11,575 Total Members 66% (7,659) are Teaching Elders 34% (3,916) are Lay employees 5 Covered Population Demographics

18% (1,385) of Teaching Elders participate at the 2014 minimum of $42,000 62% (2,435) of Lay members participate at the 2014 minimum 33% (3,820) of all members participate at the 2014 minimum 6 Participation at Minimum

1.9% (145) of Teaching Elders participate at the 2014 maximum of $124, % (57) of Lay Members participate at the 2014 maximum 1.7% (202) of all Members participate at 2014 maximum 7 Participation at Maximum

Population by Salary 8 80% of Lay members 42% of Teaching Elders 1.8% of Lay members 2.8% of Teaching Elders

Average Medical Plan Costs 9 Per Family Unit Members Covering at Least One DependentParticipating at Member-Only = +

The Value of Community NatureThe Value of Community Nature 2014 Minimum Dues $9,660 = 74% of $13,000 Average Cost 2014 Maximum Dues $28,520 = 219% of $13,000 Average Cost 10 Relationship Between Dues and Cost

The Value of Community Nature 11 Relationship Between Dues and Cost Average Cost $13, % of Average Cost 74% of Average Cost 2014 Maximum Dues Participation Basis 2014 Minimum Dues Participation Basis

Primary Objectives Address Access and Affordability Approach Individual Mandate Uniform Coverage Standards Premium Tax Credits 12 The Affordable Care Act

Exchange Essentials State based Designed for individuals and small businesses Metallic plan options 13 Public Exchanges: Accessible and Affordable Coverage as of 1/1/2014

Core Functions Consumer Assistance Plan Management Eligibility Enrollment Financial Management 14 Public Exchanges: Accessible and Affordable Coverage

Marketplace Decisions: State Based: 17 (includes DC) State operates all exchange activities Federally Facilitated: 27 HHS operates Partnership: 7 State operates activities for Plan Management and/or consumer assistance 15 Public Exchanges: Current State

Marketplace Decisions 16

Open Enrollment: October 2013 – March 2014 Enrollment statistics Early concerns Systems issues Consumer confusion Narrow networks Geographic (urban vs. rural) variability: choices and cost 17 Public Exchanges: Current State

Plans Offered: Minimally, one silver and one gold Plan Types: HMO, PPO, High Deductible, provided they achieve actuarial value Distinguishing Product Characteristics: provider network, customer service, ancillary products 18 Public Exchanges: How They Are Designed To Work

Eligibility: 85% of those purchasing coverage on exchange will likely qualify Household income < 400% of FPL ($95,400 family of four) No access to “affordable” coverage through employer Impact Caps coverage cost (for 2 nd lowest cost Silver Plan) at 2% - 9.5% of household income 19 Public Exchanges: Premium Subsidy

Enriches Silver Plan Reduces out-of-pocket maximum Converts Silver to Platinum for those earning < 200% FPL ($47,700 for family of four) 20 Public Exchanges: Cost-Sharing Subsidy

Traditional Plan (23% effective salary) Minimum Dues Basis ($42,000) $805/month; $9,660/year Median Dues Basis ($54,500) $1,363/month; $16,350/year Maximum Dues Basis ($124,000) $2,377/month; $28,520/year 21 Understanding the BOP Benchmarks

Affiliated Benefits Program 22 Understanding the BOP Benchmarks Coverage LevelMonthlyAnnual Member Only$624$7,488 Member + Covered Partner $926$11,112 Member + Child(ren) Only $1,281$15,372 Member + Family$1,668$20,016

Seminary Students 23 Understanding the BOP Benchmarks Coverage LevelMonthlyAnnual Member Only$458$5,496 Member + Covered Partner $702$8,424 Member + Child(ren) Only $702$8,424 Member + Family$805$9,660

Medical Continuation Coverage 24 Understanding the BOP Benchmarks Coverage LevelMonthlyAnnual Member Only$733$8,796 Member + Family$1,466$17,592

It All Starts Here 25 Public Exchanges: How To “Shop”

26 Public Exchanges: Some Pricing Samples Location State/County DemographicsPlan Design Monthly Cost Monthly ABP PA/PhiladelphiaFamily of Four, Ages 54, 53, 21, &18 Household Income: $54,000 PPO Gold $20 PCP $60 Specialist $10 Generic Rx $1,634 (before credit) $695 (after credit) $1,668

27 Public Exchanges: Some Pricing Samples Location State/County DemographicsPlan Design Monthly Cost Monthly Med Continuation FL/Palm Beach Family of Two, Ages 61 & 63 Household Income: $60,000 PPO Gold $30 PCP $60 Specialist $4 Generic Rx $1,669 (before credit) $934 (after credit) $1,466

28 Public Exchanges: Some Pricing Samples Location State/County DemographicsPlan Design Monthly Cost Monthly Seminary GA/FultonFamily of Four, Ages 38, 34, 6, & 4 Household Income: $65,000 HMO Gold $20 PCP $50 Specialist $10 Generic Rx $1,125 (before credit) $871 (after credit) $805

29 Public Exchanges: Some Pricing Samples Location State/County DemographicsPlan Design Monthly Cost Monthly Med Continuation CA/San DiegoFamily of Two, Ages 64 & 59 Household Income: $55,000 HMO Gold (Kaiser) $20 PCP $40 Specialist $5 Generic Rx $1,829 (before credit) $900 (after credit) $1,466

30 Public Exchanges: Some Pricing Samples Location State/County DemographicsPlan DesignMonthly Cost Monthly ABP CT/HartfordFamily of Three, Ages 45, 13, &16 Household Income: $45,000 PPO Silver Anthem $2,300 Ded. $30 PCP Ded. applies to Specialist $15 Generic RX $373$1,281

It All Starts Here And Now Here estimates/ 31 Public Exchanges: Let’s “Shop”