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What Do We Really Know About Consumer-Driven Health Plans?

Health & Benefits Perspectives

How Does Your Retirement Program Stack Up? – 2010, Integrated retirement financial management benchmarking data

5/20/2010 Meeting Presentations

Worksite Wellness Council of Rhode Island

FAQs On The COBRA Premium Reduction Extension Provisions

RIBGH Meeting Presentations

Current Care - Resources and Information

Health Reform Resources

Mercer's 2009 National Survey of Employer-Sponsored Health Plans

Deep workforce and benefit cuts show signs of moderating in the last half of 2009, Mercer global survey shows

The Conference Board Employee Health Care Conference "Workforce Health 2010: New Deal, New Dividend"

Benefits in Crisis - Weathering Economic Climate Change

Practical advice: What you need to know about 2009 H1N1 virus

The Health Information Technology for Economic and Clinical Health Act (HITECH Act)

2nd Annual Healthcare Summit was another great success!

"Key Issues in Analyzing Major Health Insurance Proposals"

Issued by the U.S. Congressional Budget Office in December 2008
 
Mercer's - 2008 National Survey of Employer-Sponsored Health Plans
 
Mercer's - 2009 Survey - Leading through unprecedented times
 
Health Care Debate 2008 Election
 
Health Care Reform Listening Tour Comes to Providence
 
Presentations from 2nd Annual RIBGH Summit
 
Ted Almon Recognized by American Hospital Association
 
Taming cost increases with an HSA and wellness programs
 
Your first 100 days as Chief Human Resource Officer: Make a good first impression for lasting success
 
Curbing obesity, smoking doesn't save money
 
Pinpointing employers' health costs
 
Mercer web briefing recordings - Free to RIBGH Members
 
Webcast titled "Managing Health Care Costs in New England"
 
Mercer's National Survey of Employer-Sponsered Health Plans
 
Mercer 2007/2008 Compensation Planning: Americas Overview
 
HR Transformation v2.0:
It's All About the Business

 
A Step-by-Step Approach to Introducing Health Savings Accounts (HSAs)
 
Employer-Based Health Insurance in Rhode Island
 
Purchaser Guide to Value-Driven Health Care
 
Coordinated Health Planning Advisory Committee
 
National Survey of Employer-Sponsored Health Plans 2006
 

   • Global Risk Alert
 
Contributions Welcome
We welcome contributions to this page. If you have an article or link which might be of interest to RIBGH members or site visitors, please contact us for more information on how you can contribute resources to our web site.
 
Information Links
Kaiser Family Foundation, "How Private Health Coverage Works: A Primer 2008 Update"
The Commonwealth Fund, "States' Roles in Shaping High Performance Health Systems"
Kaiser Family Foundation - Employer Health Benefits 2007 - Annual Survey
Mercer Web Briefings - Free to RIBGH members
Rhode Island Office of the Health Insurance Commissioner (OHIC)
U.S. Department of Labor Site: Health Plans and Benefits Section
www.healthcareitnews.com
International Foundation of Employee Benefit Plans
www.advocacysolutionsllc.com
Snapshots: Health Care Costs - a series of online publications written by Kaiser Family Foundation staff that use charts, data and analysis to provide insight into the political and policy debates about the cost of health care in the United States.
The publications are designed to encourage an informed policy dis-
cussion as leaders in Washington and across the country weigh strategies for controlling the rising cost of health care for people, businesses and government alike. www.kff.org/insurance/snapshot/
E-mail Newsletter Sign Up

8/2010 - Employee Benefit Research Institute

What Do We Really Know About Consumer Driven Health Plans?

6/2010 - Health & Benefits Perspectives

mercer

Health care reform - Impact on employer-sponsored plans begins to emerge. This perspective reviews some of the issues that are emerging as employers decide how to move forward with compliance. To view complete perspective, click here.

Health care reform and total health management: strategic opportunities to manage cost and compliance. This perspective identifies some of the PPACA provisions that affect employer-sponsored health strategies designed to change behavoirs and, as a result, improve quality and control costs. To view complete perspective, click here.

6/2010 - How Does Your Retirement Program Stack Up? – 2010, Integrated retirement financial management benchmarking data

This Mercer report provides a comprehensive review of total and industry group benchmark data from a broad range of perspectives and financial effects. Mercer aims to provide a deeper understanding of the competitive landscape of retirement benefits while also offering insights to help companies manage these programs using the three policy levers of Mercer’s Integrated Retirement Financial Management framework – design, contributions and investment. For complete report, click here.

2010 RI Breastfeeding Friendly Workplace Award

The 2010 Rhode Island Breastfeeding Friendly Workplace Award application deadline is fast approaching and has just been extended from May 15th to May 31st. Details about applying for the award are posted online at the following link:

Businesses and organizations supporting breastfeeding employees can apply
for recognition at the bronze, silver, or gold level. Awardees will be
recognized by the Rhode Island Department of Health and the Rhode Island
Breastfeeding Coalition, the joint award sponsors.

Any questions can be directed to Kathy Moren at 401-884-8273.

5/20/2010 Meeting Presentations

Making It Work:  Health Reform in Rhode Island Public Forum Information

Mercer slide presentation

Worksite Wellness Council of Rhode Island

The Worksite Wellness Council of Rhode Island is dedicated to improving the health of working Rhode Islanders. To that end, the council works to identify and advance evidence-based worksite wellness programs and measure their local impacts.

For the latest information on the Worksite Wellness Council of Rhode Island's initiatives, resources, and events, please check out their website at www.wwcri.org.

April 2010 - FAQs On The COBRA Premium Reduction Extension Provisions

FAQs on the COBRA Premium Reduction Extension Provisions Related To The Continuing Extension Act Of 2010

Link to United States Department of Labor Federal webpage.

12/11/2009 - RIBGH Meeting Presentations

We are excited about the recent RIBGH/Worksite Wellness Council of Rhode Island affiliation. Several of the presentations from the December 11th meeting, which focused on creating a worksite culture of wellness with a return and on health care reform are listed below:

meeting sponsored by:

The Broker and Consultant Advisory Committee recently created a toolkit for employers. It is a guide to assist employers who want to sign up their employees to participate in the Health Information Exchange which is called Currentcare.

Section 1

Section 2

Section 3

Section 4

7/21/2010 Mercer Update - How to keep grandfathered status under health care reform rules

GRIST Report: Health care reform changes preparations for 2011 open enrollment

High-Risk Pool Provisions under the National Health Reform Law

5/17 - New Guidance Released on Small Business Health Care Tax Credit

5/11/2010 - Mercer GRIST Alert: Regulators clarify mandate to offer coverage for children under age 26

Group health plans must make coverage available to eligible employees’ children until age 26 for plan years beginning on or after Sept. 23, 2010, although grandfathered plans may restrict this coverage until 2014 to children who aren’t eligible for another employer’s health plan (GRIST #20100081, April 5, 2010). Just-released guidance clarifies the scope of a plan’s obligation, identifies eligible children and available coverage, and creates a special enrollment period for children who previously lost or were denied coverage due to age:

  • A plan can’t charge more or vary benefit options based on a child’s age. § No factors other than exceeding age 26 may be used to restrict a child’s eligibility for coverage. For example, plans cannot impose eligibility criteria, such as student status, marital status, residence with the employee or financial dependence on the employee, on children under age 26.
  • Plans will not have to extend coverage to the spouse or child of an adult child under age 26.
  • Employers must provide notice and give children under age 26 who previously lost coverage (including children with COBRA coverage) or who were denied coverage due to age at least 30 days to enroll in any plan or benefit option for which the employee-parent is eligible. This special enrollment right extends to the child’s employee-parent. Upcoming annual enrollment periods generally will satisfy this obligation as long as employee communications are updated accordingly.
  • A grandfathered plan cannot restrict coverage merely because an eligible employee’s child has access to coverage through the other parent’s employer.
  • Changing plan terms to extend coverage to children under age 26 will not affect a plan’s grandfathered status – even if the plan extends coverage before it legally must to do so.

The regulations will apply for plan years beginning on or after Sept. 23, 2010. Recent IRS guidance relaxes the rules for children’s tax-free employer-provided coverage through the end of the year in which a child turns 26 (GRIST Alert, 27 Apr 2010).

GRIST is prepared by Mercer’s Washington Resource Group. For more information, contact WRG at +1 202 263 3950.


4/5/2010 - Summary of the Health Reform Law

Kaiser Family Foundation has developed a detailed summary of the new health reform law, breaking out its key provisions by topic. The summary reflects the provisions of the Patient Protection and Affordable Care Act, which President Obama signed March 23, as well as provisions of the Health Care & Education Reconciliation Act, which the President signed March 30. A separate timeline highlights the implementation dates for various elements of the new law, including more than a dozen key provisions scheduled to take effect this year.


3/25/2010 -Below provides a quick overview of the key elements of this reform bill  from Mercer Legislative Attorneys 

 
 Key points:
  • Health care reform with major implications for employers has passed Congress, with a package of fixes heading for Senate action. By a 219-212 vote, House Democrats March 21 muscled through the Senate-passed bill (HR 3590) and approved 220-211 a budget reconciliation package (HR 4872) modifying the bill. The Senate is expected to take up the reconciliation package within days. Final provisions of the health reform legislation won’t be certain until the budget reconciliation package receives Senate approval (which could result in additional changes) and the President’s signature.
  • The bills contain many provisions that take effect over time. Our initial focus for our clients will likely be changes to dependent eligibility rules and retiree drug subsidy program (if applicable to you) and then we can explore the larger list of reforms and how they impact your costs and programs.
  •  Immediate effect on employers: Specifically, employers will face new sources of cost increases as soon as the third or fourth quarter of 2010. A few highlights include:
    • More dependent children will be eligible to enroll in plans that have an anniversary date six months following the bill’s enactment.
    • Employers that have received tax-free Medicare Part D retiree drug subsidies will face an immediate, significant accounting impact when President Obama signs the bill, and a significant cost increase when that tax change is actually implemented in 2013.
Other major provisions in the bill include:
  • Provides coverage to an estimated 32 million Americans by expanding existing programs, making health care more affordable and changing the insurance market
    • Expanding eligibility for Medicaid
    • Implementing an individual mandate
    • Implementing an employer “shared responsibility” provision to provide affordable coverage to full-time employees
    • Eliminating underwriting provisions, such as pre-existing condition exclusions, that deny coverage
    • Increasing dependent eligibility to age 26, as early as plan years beginning on or after six months following the President’s signing the reconciliation measure
    • Providing federal funding to help low-income individuals afford coverage
    • Small business tax credits
    • Introducing a free choice voucher for certain low income employees whose employers charge more than 8-9.8% of family income
  • Requirements for employers include:
    • Offer “affordable” coverage to full-time employees or pay a penalty
    • Pay an excise tax on high cost coverage exceeding $10,200 for singles and $27,500 for families. A higher threshold, $11,850 and $30,950, is set for retirees and employees in certain high-risk professions. (Slated to take effect in 2013, this excise tax would be delayed to 2018 by the reconciliation bill). Other adjustments are allowed for older workforce or a higher percentage of women.  The threshold will be set at CPI + 1% and then changed to CPI alone in 2020 
    • Auto-enrollment of new hires for employers with 200 or more full-time equivalent employees
    • Maximum of 90 day waiting period
    • Expanding eligibility for dependents up to age 26
    • Compliance with plan design standards that preclude cost sharing for preventive care and eliminate annual and lifetime maximums
    • Increasing wellness incentives to 30% of premium
    • W-2 reporting of health coverage beginning in 2011
    • $2,500 cap on FSAs
    • Access to a reinsurance pool for early retiree programs
    • Prohibition of  discrimination in favor of highly-paid employees under insured plans, effectively eliminating executive insured coverage
  • Changes to Medicare and retiree medical plans include:
    • Reducing and gradually eliminating the Part D donut hole
    • Reducing Medicare provider funding for both Medicare Advantage plans and provider payments
    • Elimination of tax-free treatment of Medicare Part D drug subsidy that may result in immediate accounting impact for many of our clients although the tax changes would not take effect until later
  • Introduces a new HHS role in overseeing health plan rates
  • Expands fraud and abuse programs for Medicare and Medicaid 
  •  Increases Medicaid provider payment by 20%
  • Introduces an exchange for individuals and small employers
  •  Introduces the CLASS Act program of voluntary, payroll deduction funded long-term care
  • Sources of funding include:
    • Industry fees on insurers, pharmaceutical companies and manufacturers
    • Group health plan fees 
    • Increased Medicare taxes for high earners
    • Reductions for Medicare Advantage plans and Medicare provider payments
    • Penalties for employers who do not offer affordable coverage
    • Penalties for individuals who do not elect coverage
    • Excise tax on “high cost” coverage
    • Elimination of tax-free treatment of Medicare Part D drug subsidy  

3/23/10 - How Health Care Reform Legislation Could Affect You

2/23/10 – New Comparison of U.S. House, Senate and President’s Health Care Reform Proposals

1/5/2010 - Key employer elements in House and Senate health care reform bills - View Publication

RIBGH would like to provide our members with a centralized resource link to information on health care reform proposals under consideration by Congress and President Obama's priority issues to be addressed by health care reform. A recent report on the impact of health care reform on small businesses is also included for your information and well as other resource information. Please check here for periodic updates.

11/09/2009 - Health Reform Survey Results - Executive Summary

Additional Resources:

11/18/2009
Mercer's 2009 National Survey of Employer-Sponsored Health Plans

Dear RIBGH Members,
 
Mercer is pleased to send you the results of Mercer's 2009 National Survey of Employer-Sponsored Health Plans, provided in the attached news release.
 
In addition, we're able to provide you with results for New England, which represents the responses of 175 New England-area employers.  Please see the bullets below.
 
I would be happy to speak with you about these survey results as well as what we are seeing with our clients locally. Please contact me directly at 401-752-8664 or via response to this message

Selected results for New England:

Total health benefit cost for active employees increased 6.4% in 2009, to an average of $10,403 per employee. 
Asked about their 2010 costs, respondents estimated that if they made no changes to their current plan, cost would rise by 10.6%.  However, they expect to lower their cost increase to 6.8% by making changes to plan design and/or plan vendors.
44% of respondents will shift cost to their employees in 2010 by raising deductibles, copays/coinsurance or out-of-pocket maximums.  In addition, 37% will increase employees’ share of the premium contribution, and 17% will increase employee cost-sharing some other way.
  • 25% of respondents offered a consumer-directed health plan with an account feature (an HSA or HRA) in 2009, and 30% say they are very likely to offer one in 2010 (including those that already offer a CDHP).
  • 85% of all employees covered in respondents’ health plans are enrolled in PPO/POS plans, 54% in HMOs, 25% in CDHPs, and 5% in traditional indemnity plans.
  • The average employee contribution amount for employee-only coverage is $121 monthly for a PPO/POS plan, $104 monthly for an HMO and $72 monthly for a CDHP.

Nationally, PPO deductibles rose sharply in 2009, with the average individual deductible for in-network services reaching nearly $1,100 (but just $511 for employers with 500 or more employees).  Regionally, employers in the northeast reported an average deductible of $1,122 (but just $395 for employers with 500 or more employees).

Christopher R. Coté, Principal
Mercer | 10 Weybossett Street, Providence, RI 02903
One State Street, Hartford, CT 06103 | Cell 401-265-8798 |

View Survey Results

The Conference Board Employee Health Care Conference "Workforce Health 2010: New Deal, New Dividend"

February 25-26 (New York City), Event Details

sponsored by:

Deep workforce and benefit cuts show signs of moderating in the last half of 2009, Mercer global survey shows

Benefits in Crisis - Weathering Economic Climate Change

Benefits in Crisis - Weathering Economic Climate Change is a new white paper produced by Towers Perrin which is based on the results of an online pulse survey conducted in February with just under 500 HR and benefits executives to determine the impact of the recession on benefit plans.

The results found, not surprisingly, that employers are continuing to pursue fairly aggressive measures to manage health care costs. Just over half are increasing employee cost sharing through higher contributions or benefit design changes (for example, tighter provisions in prescription drug plans). While a third have already set up health savings or health reimbursement accounts, a roughly similar number are planning to introduce them in the next two years or are considering doing so. Retiree medical plans, account based plans and workforce health are also covered in detail.

Link to Towers Perrin site and the white paper.

Provided by:

The Health Information Technology for Economic and Clinical Health Act (HITECH Act): implications for the adoption of health information technology, HIPAA, and privacy and security issues

The HITECH Act of the American Recovery and Reinvestment Act imposes more stringent regulatory requirements under the security and privacy rules of HIPAA, increases civil penalties for a violation of HIPAA, provides funding for hospitals and physicians for the adoption of health information technology, and requires notification to patients of a security breach. These broad new requirements will necessitate compliance by covered entities, business associates and related vendors in the health care industry.

Click here to read the full article on the Nixon Peabody website.

2nd Annual Healthcare Summit was another great success!

Summit Presentations Available Now!

"Key Issues in Analyzing Major Health Insurance Proposals" Issued by the U.S. Congressional Budget Office in December 2008

As noted in the summary of this report "Concerns about the number of people who are uninsured and about the rising costs of health insurance and health care have given rise to proposals that would substantially modify the U.S. health insurance system. The complexities of the health insurance and health care systems pose a major challenge for the design of such proposals and inevitably raise questions about their likely impact. To assist the Congress in its upcoming deliberations, this report seeks to provide useful background information as well as well as insights into how the Congressional Budget Office (CBO) would estimate the effects of such proposals on the federal budget, the number of people who have health insurance coverage, and spending for health care."

To view this entire publication, click here.

Mercer's - 2008 National Survey of Employer-Sponsored Health Plans
RESULTS JUST RELEASED

On November 19th, Mercer released results of the 2008 National Survey of Employer-Sponsored Health Plans, reporting results on a national probability sample of public and private employers with at least 10 employees. Nearly 2900 employers completed the survey. Results for New England, which represent the responses of 162 employers from Rhode Island, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont are highlighted in the following press release.

To view this New England area's highlighted results, click here.

Nationally, PPO deductibles rose sharly in 2008, with the median individual deductible for in-network services reaching $1000. Regionally, employers in the Northeast reported a median deductible of $500.

For a complete impact analysis of this startling trend, please review the following article, click here.

Health Care Debate 2008
Making sense of the health care debate in the 2008 presidential election - A Health & Benefits Pespective from Mercer, click here for details.
Health Care Reform Listening Tour Comes to Providence

On September 26th, the Campaign for an American Solution - a non-partisan, educational initiative of America's Health Insurance Plans - sponsored a Providence health care reform roundtable discussion with Rhode Island business leaders, labor representatives, and local working families.  You can watch a video of the roundtable discussion available online at:
http://www.americanhealthsolution.org/providence/

You can also share your concerns about our health care system and learn more about the Campaign for an American Solution's efforts by visiting www.americanhealthsolution.org.

Presentation from 2nd Annual RIBGH Summit

Our 2nd Annual RIBGH Heathcare Summit was held on September 19, 32008. Here are some of the presentations that were covered.

Ted Almon Recognized by American Hospital Association

The American Hospital Association (AHA), in partnership with the Hospital Association of Rhode Island (HARI), has honored Ted Almon, trustee, Women & Infants Hospital Foundation, with the Partnership for Action Grassroots Champion Award. As a 2008 Grassroots Champion, Ted is being recognized for his exceptional leadership in generating grassroots and community activity in support of the hospital mission.

The award was created to recognize hospital leaders who most effectively educate elected officials on how major issues affect hospitals’ vital role in the community, have done an exemplary job in broadening the base of community support, and is a tireless advocate for hospitals and patients. The award is presented annually to one individual from each state. Winners are chosen by the state association and were recognized at a special Breakfast of Grassroots Champions at the AHA Annual Membership Meeting.

Ted is the president and chief executive officer of Claflin, a leading regional independent health care equipment and product distributor. He is also a member of the Legislative Affairs and Public Policy Committee of the Rhode Island Business Group on Health. Over the years, Ted has served on countless health care taskforces, study groups and panels on both the state and national level. Congratulations, Ted, from all of us at RIBGH on this well-deserved honor in recognition of your commitment to improving health care in Rhode Island!

claflin

Taming cost increases with an HSA and wellness programs

by: Amy Gallagher, RIBGH member

In 2005, the Preservation Society of Newport County, also known as the Newport Mansions, was at a crossroads. The nonprofit organization paid 87% of the health care premium for its 87 full-time employees. Premium increases had run 25% to 30% for five consecutive years. When forecasting projected that health care costs would double by 2009, the organization knew it was time to make significant changes. Click here for the entire article.

Valuable Resources Presented by:

Your first 100 days as Chief Human Resource Officer: Make a good first impression for lasting success

This is a unique opportunity . one you will never have the chance to do over. How can you make the most of it? We suggest you spend these critical first 100 days at the strategic level, focused on the development of connected strategies for both the organization's workforce and the HR function itself. Click here for entire article.

States extend age of children entitled to dependent health coverage:

One strategy many states are using to address the problem of the uninsured is extending the age of children eligible for dependent coverage under insured group health and HMO plans. Some states are also applying this coverage requirement to stand-alone dental and vision plans, as well as to insurance policies and contracts issued in another state that cover state residents. For employers, these extension mandates raise several issues related to benefit cost and taxation, compliance, notice, and COBRA. This Update explores those issues. Click here for entire article.

Engaging employees to drive global business success:

Over the last two decades, employers’ needs and interests have moved from creating conditions and programs that result in employees who are merely “satisfied” with pay, benefits and working conditions, to employees who are “committed” to the organization and not considering a move, to those who are genuinely “engaged” in the work and mission of the organization. Click here for entire article.

Improving the value and cost of US health benefits: Could shifts in the employer role provide the solution?

This Perspective examines the history of employer-sponsored health coverage
and its current environment. Along with reviewing the different changes that
employers are debating, we discuss the health policy and insurance market
developments needed for significant shifts in the role employers play. In
addition, we offer practical considerations for employers contemplating
near-term change. Click here for the entire article.

Managing details, deadlines for health plan disclosures

Employers sponsoring health and welfare benefit plans face a dizzying array of required disclosures under ERISA: summary plan descriptions (SPDs), summaries of material modifications or reductions (SMMs or SMRs), and summary annual reports (SARs). Each of these disclosures has to contain different details and meet different distribution deadlines. Failure to meet these requirements exposes employers to a variety of risks, including courtassessed fines and liability for unintended benefits. This Update summarizes what each disclosure must contain and when it must be distributed. For complete update, click here.

Curbing obesity, smoking doesn't save money
 
Preventing obesity and smoking can save lives, but it doesn't save money, researchers reported yesterday.
By Maria Cheng - Associated Press
Providence Journal 2/5/08

London - Preventing obesity and smoking can save lives, but it doesn't save money, researchers reported yesterday.

It cost more to care for healthy people who live years longer, according to a Dutch study that counters the common perception that preventing obesity would save governments millions of dollars. "It was a small surprise." Said Pieter van Baal, an economist at the Netherlands' National Institute for Public Health and the Environment, who led the study. "But it also makes sense. If you live longer, then you cost the health system more."

In a paper published online yesterday in the Public Library of Science Medicine journal, Butch researchers found that the health costs of thin and healthy people in adulthood are more expensive that those of either fat people or smokers.

Van Baal and colleagues created a model to simulate lifetime health costs for three groups of 1,000 people: the "healthy living" group (thin and non-smoking), obese people, and smokers. The model relied on "cost of illness" data and disease prevalence in the Netherlands in 2003. The researchers found tht from age 20 - 56, obese people racked up the most expensive health costs. But because both the smokers and the obese people died sooner than the healthy group, it cost less to treat them in the long run.

On average, healthy people lived 84 years. Smokers lived about 77 years and obese people lived about 80 years. Smokers and obese people tended to have more heart disease than healthy people. Cancer incidence, except for lung cancer, was the same in all three groups. Obese people had the most diabetes and healthy people had the most strokes. Ultimately, the thin and healthy group cost the most, about $417,000 from age 20 on.

The cost of care for obese people was $371,000 and for smokers, about $326,000.

The results counter the perception that preventing obesity will save health systems worldwide millions of dollars.

"This throws a bucket of cold water onto the idea that obesity is going to cost trillions of dollars," said Patrick Basham, a professor of health politics at Johns Hopkins University who was unconnected to the study. He said that government projections about obesity costs are frequently based on guesswork, political agendas and changing science.

Obesity experts said that fighting the epidemic is about more than just saving money. "The benefits of obesity prevention may not be seen immediately in terms of cost savings in tomorrow's budget, but there are long-term gains." Said Neville Rigby, spokesperson for the International Association for the study of obesity. "These are often immeasurable when it comes to people living longer and healthier lives."

The study did not take into account other potential costs of obesity and smoking, such as lost economic productivity or social costs.

Pinpointing employers' health costs
 
On average, employers in Rhode Island spend $10,300 per worker last year, with limited competition among insurers boosting the cost, a survey says.
Journal Staff Report
Providence Journal 2/5/08

The average annual cost for group medical and dental benefits in Rhode Island last year was $10,300, according to a new survey by a benefits consulting firm based in Wakefield.
The survey by Bluff Head Enterprises, its sixth annual, was based on the responses of 58 Rhode Island-area employers representing more than 80,000 worker.

The survey also found that the 2007 annual cost for a single-person health plan was $5,124, more than $300 above the national average, and the average annual cost for family health coverage was $13,596. Since more Rhode Islanders elect family coverage than singe-person plans, the average per-employee cost for health insurance in $2007 reached $10,300.

Sam Slade, founder and president of Bluff Head, said the richness of Rhkode Island health plans compared with those in other states and limited competition among health insurers were key contributors to higher-than-average costs.

"Rhode Island is a bit of an anomaly. Survey respondents acknowledge that the lack of competition has a negative impact on price, yet they also openly admit to an aversion to new plans that might have a smaller network of providers than Blue Cross or United," Slade said.
Another contradiction, according to Slade, is the desire to achieve lower costs, but an attachment to older, richer plan designs. "Everyone's calling for less-expensive health insurance, but we in R.I. have also been somewhat more reluctant than folks in other parts of the country to adopt cost shifting design features which reduce premium rates.
Slade said the failure of health insurers such as Aetna, Cigna, Harvard-pilgrim and Tufts to break into the local market has limited competition.

The Bluff Head survey documents an average employee contribution of $1,631 per year toward the cost of employer-sponsored medical coverage. The average private-sector employee contribution was $1,740 for last year while the average public-sector employee contribution was $1,238.

Private sector employees continue to make higher health-care premium contribution than public employees but, according to Slade, this gap is narrowing. "it's clear that the State of Rhode Island is aggressively negotiating for employee contributions on health insurance from state employees," said Slade.

When it comes to squeezing more savings out of Rhode Island's health-care system, he said, reducing reimbursement rates for physicians was not a viable option. "Our insurers have been successful in negotiating relatively low reimbursement rates for participating physicians," said Slade. "I think most Rhode Islanders would be surprised to learn that R.I. health-care providers are paid, on average, less than in Rhode Island or Massachusetts."

Slade cited the recently created Health Pact Plan that offers higher benefits for Rhode Islanders agreeing to live healthier lives as a positive step in the effort to reduce health-care costs. Established by Christopher Kohler, Rhode Island's insurance commissioner, Health Pact offers premium reductions of up to 20 percent for participants.

Mercer web briefing recordings - Free to RIBGH Members
 
Free to all RIBGH Members, Mercer holds regular live web briefings on a wide range of HR topics. You can also view and listen to recorded versions of all of these sessions.

Click here

Webcast titled "Managing Health Care Costs in New England"
 
Managing Health Care Costs in New England, including MA, NH, VT, RI, CT, and ME. Staying Below the Health Care Cost Curve; Key Findings That Can Help You Gain Control.

In this Webcast series, we will explore local results of our health benefit cost research, including:   

  • A detailed review of region-specific health care costs and utilization  
  • Statistics, such as cost per employee, prescription costs, length of   hospital stay, disease prevalence, episode costs and risk profiles and  more
  • Comparison of local data against other regions and national norms
  • Primary cost drivers and how to reign in increases  
  • Outliers -- what they mean and what to do about them  
  • Regional best practices in delivering value and controlling costs

Register Now
Mercer's National Survey of Employer-Sponsored Health Plans
 
Presented at RIBGH 9/21/07 Health Summit Meeting

Click here to download highlights of this report in PDF format

Mercer

About this survey:

  • Largest, most comprehensive annual survey
  • Established in 1986, national probability sample used since 1993
  • Almost 3000 employers participated in 2006:
       -- 154 employers in New England
       -- 86 with 500+ employees
       -- 10 in Rhode Island
  • All employers with 10 or more employees are surveyed
  • Size groups examined separately in this report include:
       -- Small employers: 10 - 499 employees
       -- Large employers: 500+ employees
       -- Jumbo employers: 20,000+ employees

Topics addressed include:

  • Average change in total health benefit cost from 1990 to 2007
  • Total health benefit cost by employer size for 2006
  • Upward and downward pressures on cost in 2006
  • Cost jumps for smaller employers
  • Cost shifting trends
  • Cost sharing in 2006: employee contribution percentages, monthly rates
  • Trends in prescription drug benefit cost increases
  • Growth of consumer-directed health plans (CDHP)
  • Plans offered by area employers; percentage of employees enrolled in plans
  • Employees' use of care management programs
  • Growth of HSA-based CDHPs versus HRA-based plans
  • Average cost per employee compared for CDHPs, HMOs, other plans
  • Medical plan choices employers say they are likely to offer five years from now
  • Prevalence of retirees medical plans
  • Emerging strategies and outlook for 2007 - 2008

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Mercer 2007/2008 Compensation Planning: Americas Overview

Click here to download highlights of this report in PDF format

Mercer

   

SEPTEMBER 2007 -- This report covers pay trends and practices for 70 countries, based on a survey with 884 participants in Canada, the U.S., and Latin America. Topics addressed include: economic trends impacting base pay in the Americas, planned base pay increases, top rewards challenges facing HR, average 2007 base salary increases, short-term incentive payout, alignment of rewards strategy to business strategy, total rewards communication vehicles, and more.

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HR Transformation v2.0: It's All About the Business

Click here to download this white paper (PDF) from Mercer Health & Benefits

"Mercer's 2006 Global HR Transformation Study garnered nearly 1,400 responses across Asia, Australia, Europe, Latin America, New Zealand and North America. For purposes of the study, HR transformation is defined as the process of recreating or reinventing the HR function -- such as re-engineering, restructuring, implementing new systems or a new HR service delivery model, outsourcing or co-sourcing -- with the specific intent of enhancing HR’s contribution to the business."

"Mercer's study confirms, unequivocally, that HR transformation is alive and well around
the world. Half of the 2006 respondents said they are currently in the midst of an HR transformation, while 12 percent had completed one within the past year, and another
10 percent plan to begin a transformation within the next year. However, based on the 2006 study findings as well as Mercer’s work with leading organizations globally, it is clear that a
second wave of transformation is now under way. This new wave -- let’s call it Transfor- mation v2.0 -- differs significantly from the initial wave."

"Transformation v1.0, which started about 10 years ago, focused largely on operational excellence and improved HR service delivery through process and technological enhance-
ments. At the same time, it opened the door to a more strategic role for HR -- one that has
not yet fully materialized. In Transformation v2.0, HR is challenged to deliver on those strategic expectations -- to make the human capital strategies a reality. HR can do so
through a disciplined focus on business."

"Through this paper, Mercer examines both versions of HR transformation and answer
some critical questions:

  • Is HR making progress -- and in the right direction?
  • Where hasn't HR made progress and why?
  • How is HR transformation similar and different around the world?
  • How can organizations position themselves for success in the next wave of
    HR transformation?
  • What will the successful HR function of the future look like?"

     

Click here to read this informative and challenging white paper, which has been posted to our site with the permission of Mercer Health & Benefits.

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A Step-by-Step Approach to Introducing Health Savings Accounts

Click here to download this article (PDF) by J. Michael Vittoria, Member of RIBGH
Board of Directors

"Many employers are now looking to high-deductible health plans (HDHPs) paired with health savings accounts (HSAs) as a potential solution to rising health insurance costs. However, marketing a new plan to employees who are used to a traditional preferred provider organi-
zation (PPO) requires careful planning and extensive communications. This author recounts how one manufacturer introduced HSAs and enjoyed significant cost savings."  

This article will appear in the September issue of Benefits & Compensation Digest. It is posted here with permission from the publisher, the International Foundation of Employee Benefit Plans. Learn more about the IFEBP at their website: www.ifebp.org

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PowerPoint Presentations - 5/10/07 RIBGH Meeting

"Employer-Based Health Insurance in Rhode Island" - Christopher F. Koller, Rhode Island Insurance Commissioner
 

"Coordinated Health Planning Advisory Committee " - Terri Wetle, Ph.D., Committee Chair and Associate Dean of Medicine for Public Health, Brown University

If you missed this meeting, or if you wish to review the information which was provided at the meeting, use the links above to download the PowerPoint presentations.
 
If you do not have Microsoft PowerPoint software on your computer, you can get PowerPoint Viewer 2007 free from the Microsoft site. Go to http://www.microsoft.com/downloads/ and then search on "PowerPoint Viewer".

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Purchaser Guide to Value-Driven Health Care

 Click Here to Download Purchaser Guide (PDF)

To help employers embrace the four cornerstones of value-driven health care as outlined by Secretary of Health and Human Services (HHS) Michael Leavitt in November 2006, the Partnership for Value-Driven Health Care has developed a "Purchaser Guide to Value-Driven Health Care." This resource will help guide purchasers of health care as they implement the four cornerstone actions of better health care - utilize health information technology, measure and publish quality, measure and publish price information, and create positive incentives for high quality, efficient care.
 
Organizations interested in joining the value-driven health care initiative should consider signing the HHS statement of support.

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National Survey of Employer-Sponsored Health Plans 2006

 Mercer News Release on Employer-Sponsored Health Plans 2006 (PDF)
 Survey of Employer-Sponsored Health Plans 2006 -- Charts (PDF)

 
Some highlights of this survey are presented below. For more details, use the links above to download press release and charts.

Rhode Island Employers (10 surveyed employers)

  • Total health benefit cost for active employees increased 4.1% in 2006 to an average of $8,905 per employee. After making changes to plan design and/or plan vendors, employers expect a change in the total cost per employee for 2007 of +5.6%.
     
  • The average employee contribution amount for employee-only coverage is $82 monthly for a PPO.
     
  • 95% of employees covered by employer plans are enrolled in PPOs. Less than 1% are enrolled in HMOs, 4% in POS plans, 0% in traditional indemnity plans and 1% in CDHPs.

Northeast region employers (with 10 or more employees)

  • Total health benefit cost for active employees increased 6.3% in 2006 to an average of $8,180 per employee. After making changes to plan design and/or plan vendors, employers expect a change in the total cost per employee for 2007 of +6.8%.
     
  • The average employee contribution amount for employee-only coverage is $96 monthly for a PPO and $97 monthly for an HMO.
     
  • 50% of employees covered by employer plans are enrolled in PPOs, 29% in HMOs, 16% in POS plans, 3% in traditional indemnity plans, and 2% in CDHPs.

U.S. employers (with 10 or more employees)

  • Total health benefit cost for active employees increased 6.1% in 2006 to an average of $7,523 per employee. After making changes to plan design and/or plan vendors, employers expect a change in the total cost per employee for 2007 of +6.1%.
     
  • The average employee contribution amount for employee-only coverage is $98 monthly for a PPO and $95 monthly for an HMO.
     
  • 61% of employees covered by employer plans are enrolled in PPOs, 24% in HMOs, 9% in POS plans, 3% in traditional indemnity plans, and 3% in CDHPs.

Download the press release (PDF) for more details. For interpretation and observations of survey, contact: Deborah Wozniak in the Mercer Health & Benefits office at (617) 450-6399.

The U.S. employer and region data above and in the press release was collected through a stratified random sample and has been weighted to reflect the results of all employers in the country. The state data above represents only the employers who responded.

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Avian Flu:  Preparing for a Pandemic

 Mercer Perspective: Easing the Avian Flu's Impact on Employee Welfare
      and Productivity (PDF)

This Perspective centers on workforce concerns -- issues related to the health, safety and welfare of employees.

Before, during, and after an avian flu outbreak, human resource managers, and the
protocols they put in place, will play a critical role in maintaining their organizations' ability
to function effectively.

 Mercer Avian Flu Preparedness Survey Report

The results of this Mercer Survey provide a multidimensional insight into how different ndustries, regions and countries are planning for a pandemic. Mercer believes that this data will provide companies with the capacity to benchmark their capability to respond to a major pandemic crisis and develop appropriate business continuity planning strategies.

 Mercer Review of Insured and Self Insured Benefits (PDF)

In the event of a pandemic, organizations need to have confidence in the benefits package adequacy for their staff. This article identifies and explores 5 steps that organizations should include in their avian flu preparedness plan: 
  • Define yourorganization's benefits objectives
  • Identify the current benefits package
  • Understand the benefits and their limitations
  • Gap analysis
  • Solutions and implementation
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 Marsh Global Risk Alert on Avian Flu (PDF)
(This is a large file and may take a few moments to download.)

Businesses would be well-advised to ensure their emergency-response and business-continuity plans are up-to-date and include specific planning for dealing with a pandemic. This Risk Alert aims to:
 

  • Provide background information on avian flu and human influenza pandemics;
  • Discuss corporate preparedness and business-continuity management (BCM)
    through the lens of a pandemic;
  • Highlight the international implications of a pandemic; and
  • Outline some of the potential insurance coverage issues related to pandemics.
Other Avian Flu Information Resources for Businesses

 Business Checklist developed by CDC and Dept.of Homeland Security (PDF)
 Letter to Business Leaders from US Secretaries Chertoff, Leavitt, Gutierrez (PDF)

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Employer-Sponsored Health Plans: Highlights of Mercer Survey

 Mercer National Survey of Employer-Sponsored Health Plans 2005 (PDF)

This report contains highlights from the survey results, including Rhode Island employers, Northeast region employers, and U.S. employers
 

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CEO Compensation: Mercer Human Resource Consulting Survey

 Mercer 2005 CEO Compensation Survey (PDF)

Lastest proxies show CEO pay and corporate performance are closely aligned amid intensifying pressure for responsible executive pay
 
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