A Legislative Compromise May Still Happen For AHPs
reports that "The lack of consensus towards creating Association Health Plans (AHPs) could lead to a compromise legislation".
Some suggest that AHPs would give small businesses the health benefits purchasing power similar to large corporations.
Critics suggest that AHPs may lower health benefits costs for a few while dramatically increasing the cost for others. They suggest that AHPs would "cherry pick" the market and leave groups with higher than average claims in the regular insurance market.
As suggested in previous postings, the largest corporations in America (General Motors, Ford, Microsoft, Federal Express, IBM, etc.) still pay a substantial amount toward health benefits.
The real problem is the cost of health care. Once we get a handle on the cost of health care, the power of the entrepreneurial marketplace will provide affordable health benefits.
Appropriately Priced Health Insurance
The Portland Press Herald published an April 22nd, 2005 article titled "Should overweight people pay higher health insurance premiums
?" Fortunately, the point of the article is not to pick on obese people.
The article is really asking the question whether or not individuals who willingly make certain lifestyle choices should be charged higher health insurance premiums. These lifestyle choices would include being overweight, smoking, and alcohol/drug abuse.
The author suggests that the additional premium would serve as an incentive for individuals that participate in harmful behaviors to change course and properly maintain their health.
Individual Health Insurance Can Be Excellent Choice For Some
Prior to leaving a "corporate" job, most entrepreneurs and self employed people consider the loss of health insurance as a big hurdle to overcome. However, in the right circumstances, individual health insurance has some excellent advantages.
Individual health insurance coverage can be customized to a specific situation. Take a minute to read an article in the Milwaukee Journal Sentinel
about how a Wisconsin entrepreneur provides health insurance for his family.
The future of health insurance is not your $250 and $500 individual deductibles. The future of health insurance is a high deductible plan that covers the big health care bills that can bankrupt a family.
In order to fully take advantage of the tax and savings opportunities, high deductible health care plans will in many cases be paired with a Health Savings Account (HSA).
Consumer Driven Health Care Plans Lack Information
Employers who have established consumer driven health plans indicate that some of the information necessary to be an informed health care consumer is not yet available.
A recent survey by Segal, indicated that half of the companies surveyed feel their employees need access to additional information detailing the specific cost for doctors and hospitals.
More information is also needed about the quality and outcomes of health care procedures.
A copy of the actual survey can be viewed at Segal's website
Group Clients and Dual Choice Plans
What techniques are many of our clients using to control health insurance costs today?
Almost all of our client planning meetings include some discussions about health insurance alternatives such as Health Savings Accounts (HSAs) and Health Reimbursement Arrangements (HRAs). We anticipate that many of our clients will implement HSAs or HRAs over the next few years.
However, we still have many clients who just are not ready to make the “jump” to HSAs or HRAs. Many of these clients are implementing “dual choice” plans. The dual choice concept is really very simple.
In a dual choice plan, the employer establishes a “core” plan that may include an individual deductible of $1500, $2500, or $3000. This core plan, in most cases, still includes office visit copays, routine benefits, and a prescription card.
The second plan or “buy- up” option typically includes lower deductibles and out of pocket maximums. Individual deductibles of $250 or $500 are common in buy-up plans. Similar to the core plan, the buy-up plan has coverage for office visits, routine care and an Rx card.
Employees electing the buy-up option pay additional premiums and in return get an insurance plan with a lower deductible and maximum out of pocket amount. Employees who choose the core plan still have protection against large claims as well as help with the office visits and prescriptions.
From an employer’s perspective, they contribute the same amount of dollars regardless of what plan their employee chooses. Dual choice plans have been well received by both our employers and their employees.