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

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Presentation transcript:

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,

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

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

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

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

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

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

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

Today ’ s Plans 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

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

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

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

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

How to Evaluate Unfavorable Favorable

Access Barriers to Access Open Access

Flexibility Off the shelf Customized to my work force and company culture

Value Out of reach/Irrelevant Affordable/Valuable

Ease of Administration High-touch Turnkey

How to Evaluate = BUY IT! This is probably a best-in-class plan = 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

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