1. The Insurance Dollar Breaking Down The Costs: Copays Deductibles Coinsurance Penn-Ohio Regional Health Care Alliance

2. The Insurance Dollar Cost Sharing Methods  Copay - Designed to offer reimbursement on high frequency/low severity costs.  Deductible - Designed to offer reimbursement on high severity/low frequency costs.  Coinsurance - Designed to maintain insured's "engagement" in costs. Penn-Ohio Regional Health Care Alliance

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17. Integrating Employee Engagement Through HRA's Employer offers "High" Deductible Plan with no employer funding of deductible. What Happens? Employer sees immediate cost savings. Employee see the actual costs of healthcare (becomes a gatekeeper) Employee bears the "first dollar" costs up to the deductible. With Coinsurance, "out of pocket" maximum is also important. Depending on market environment, may or may not be a competitive benefit package. Penn-Ohio Regional Health Care Alliance

18. The Insurance Dollar Integrating Employee Engagement Through HRA's Employer “funds” a portion of the deductible. What Happens? Employee sees the actual costs of healthcare (becomes a gatekeeper) Employee Rollovers have a “savings” effect on some employees (No “use it or lose” effect). Employer is in the insurance business (Takes Risk/Reward) Opportunity to build common goals. Penn-Ohio Regional Health Care Alliance

19. The Insurance Dollar Integrating Employee Engagement Through HRA's Employer “funds” a portion of the deductible. What Happens? Employee sees the actual costs of healthcare (becomes a gatekeeper) Employee Rollovers have a “savings” effect on some employees (No “use it or lose” effect). Employer is in the insurance business (Takes Risk/Reward) Opportunity to build common goals. Penn-Ohio Regional Health Care Alliance

20. The Insurance Dollar Integrating Employee Engagement Through HRA's Employer HRA funding affects more than the HRA Balance. 90/10 ER/EE Split – Does this put enough of the employee’s skin in the game to affect behavior? 50/50 ER/EE Split – 10/90 ER/EE Split – Does this offer enough of the Y/Y savings opportunity to affect behavior? Penn-Ohio Regional Health Care Alliance

21. The Insurance Dollar Open Dialogue Penn-Ohio Regional Health Care Alliance