Self Insured Employer Health Plans

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Self-insured Coverage in Employer-sponsored Health Insurance for the Private Sector, 2000 and 2010

Author :
Publisher :
ISBN 13 :
Total Pages : 4 pages
Book Rating : 4.:/5 (815 download)

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Book Synopsis Self-insured Coverage in Employer-sponsored Health Insurance for the Private Sector, 2000 and 2010 by :

Download or read book Self-insured Coverage in Employer-sponsored Health Insurance for the Private Sector, 2000 and 2010 written by and published by . This book was released on 2011 with total page 4 pages. Available in PDF, EPUB and Kindle. Book excerpt: Employers that offer health insurance to their employees can provide that coverage either through self-insured plans or through fully-insured plans purchased from an insurance company. When an employer chooses to self-insure coverage, it generally takes on the financial risk associated with paying the plan's costs although employers with such plans commonly purchase stop-loss coverage to limit their financial exposure. Employers that sponsor fully-insured plans generally pay premiums to an insurer and the insurer bears the financial risk. Self-insured and fully-insured coverage are not treated the same way under the law. State laws that regulate fully-insured employer-sponsored plans usually do not apply to self-insured plans. And some provisions of the federal Patient Protection and Affordable Care Act of 2010 pertain to fully-insured plans but not to self-insured plans. Larger firms often offer a choice of health plans with different benefits and costs to their employees--the options may include both self-insured and fully-insured plans. For example, a self-insured Preferred Provider Organization (PPO) may be offered at all sites nationwide while different fully-insured Health Maintenance Organizations (HMOs) are offered at various work locations in different states. This Statistical Brief is limited to an analysis of enrollment in self-insured health insurance plans. Of the total 56.1 million employees with employer-sponsored coverage in the private sector in 2010, 32.3 million were enrolled in plans that were self-insured by their employers. The Brief discusses self-insurance enrollment rates for small versus large employers and across industry groups in 2010, and changes since 2000, for private sector firms. This analysis is based on estimates from the Insurance Component of the Medical Expenditure Panel Survey (MEPS-IC). Only comparisons with a statistically significant difference at the 0.05 percent significance level are noted in the text.

Self-insurance and Health Benefits

Author : United States. Congress. House. Committee on Small Business. Subcommittee on Health and Technology
Publisher :
ISBN 13 :
Total Pages : 96 pages
Book Rating : 4.:/5 (319 download)

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Book Synopsis Self-insurance and Health Benefits by : United States. Congress. House. Committee on Small Business. Subcommittee on Health and Technology

Download or read book Self-insurance and Health Benefits written by United States. Congress. House. Committee on Small Business. Subcommittee on Health and Technology and published by . This book was released on 2014 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Self-insured Employer Health Plans

Author : Gregory Acs
Publisher :
ISBN 13 :
Total Pages : 278 pages
Book Rating : 4.:/5 (559 download)

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Book Synopsis Self-insured Employer Health Plans by : Gregory Acs

Download or read book Self-insured Employer Health Plans written by Gregory Acs and published by . This book was released on 1996 with total page 278 pages. Available in PDF, EPUB and Kindle. Book excerpt: Data from three recent surveys indicate that about 40 percent of workers with employment-based health insurance are enrolled in plans that their employers self-insure. Despite the considerable differences between federal regulation of these self-insured plans and state regulation of employer plans purchased from an insurance company, the authors find striking similarities in the populations they serve, the benefits they offer, and their premium costs. Implications for health policy are discussed.

Self-Insured Health Plans

Author : Paul Fronstin
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (137 download)

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Book Synopsis Self-Insured Health Plans by : Paul Fronstin

Download or read book Self-Insured Health Plans written by Paul Fronstin and published by . This book was released on 2012 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper examines recent trends in self-insurance. Data come from the Medical Expenditure Panel Survey (MEPS) and are presented by establishment size among private-sector employers. State-level data are also presented, along with the correlation between state mandates and the prevalence of self-insurance. Offering a self-insured plan means the employer assumes the financial risk related to offering health insurance (as opposed to a fully insured plan, where the insurance company assumes the risk). Large employers are much more likely to offer health benefits on a self-insured basis than small employers. However, there is speculation that passage of the Patient Protection and Affordable Care Act of 2010 (PPACA) will result in an increasing number of smaller employers offering self-insured plans. Employers think that components of PPACA, such as the strict grandfathering requirements; the minimum-creditable-coverage requirement; the breadth of essential health benefits; taxes on insurers, medical-device manufacturers, and pharmaceutical companies; affordability requirements; and reinsurance fees will all drive up the cost of health coverage. Small employers concerned about the rising cost of providing health coverage may view self-insurance as a more attractive means to mitigate any expected cost increases. Some key findings include the following: The percentage of workers in private-sector self-insured health plans has been increasing. In 2011, 58.5 percent of workers with health coverage were in self-insured plans, up from 40.9 percent in 1998. Large employers (with 1,000 or more workers) have driven the upward trend in overall self-insurance. The percentage of workers in self-insured plans in firms with fewer than 50 employees has been close to 12 percent in most years examined. The prevalence in self-insured plans varies by state, with Massachusetts having the third-highest prevalence of self-insurance in the small-group market (behind Hawaii and Alaska). Overall, 58.5 percent of workers were in self-insured plans in 2011, but the percentage ranged by state, from a low of 30.5 percent to a high of 73.8 percent. Massachusetts, the only state to have enacted health reform similar to PPACA, has seen an increase in the percentage of workers in self-insured plans among all firm-size cohorts, except among workers in firms with fewer than 50 employees. The PDF for the above title, published in the November 2012 issue of EBRI Notes, also contains the fulltext of another November 2012 EBRI Notes article abstracted on SSRN: “All or Nothing? An Expanded Perspective on Retirement Readiness.”

Private Health Insurance

Author : Ross Harold Arnett
Publisher :
ISBN 13 :
Total Pages : 12 pages
Book Rating : 4.3/5 (2 download)

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Book Synopsis Private Health Insurance by : Ross Harold Arnett

Download or read book Private Health Insurance written by Ross Harold Arnett and published by . This book was released on 1984 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care ACT (ACA)

Author : Suzanne M. Kirchhoff
Publisher : CreateSpace
ISBN 13 : 9781508902300
Total Pages : 32 pages
Book Rating : 4.9/5 (23 download)

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Book Synopsis Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care ACT (ACA) by : Suzanne M. Kirchhoff

Download or read book Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care ACT (ACA) written by Suzanne M. Kirchhoff and published by CreateSpace. This book was released on 2015-06-26 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: The 2010 Patient Protection and Affordable Care Act (ACA, P.L. 111-148) requires certain health insurers to provide consumer rebates if they do not meet a set financial target known as a medical loss ratio (MLR). At its most basic, a MLR measures the share of health care premium dollars spent on medical benefits, as opposed to company expenses such as overhead or profits. For example, if an insurer collects $100,000 in premiums and spends $85,000 on medical care, the MLR is 85%. In general, the higher the MLR, the more value a policyholder receives for his or her premium dollar. The ACA requires an annual, minimum 80% MLR for individual and small group insurance plans, and an annual, minimum 85% MLR for large group plans. Congress imposed the MLR to provide "greater transparency and accountability around the expenditures made by health insurers and to help bring down the cost of health care."

Health Benefits Coverage Under Federal Law--.

Author :
Publisher :
ISBN 13 :
Total Pages : 108 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis Health Benefits Coverage Under Federal Law--. by :

Download or read book Health Benefits Coverage Under Federal Law--. written by and published by . This book was released on 2010 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Self-Insured Health Plans

Author : Paul Fronstin
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (137 download)

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Book Synopsis Self-Insured Health Plans by : Paul Fronstin

Download or read book Self-Insured Health Plans written by Paul Fronstin and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper examines recent trends in self-insurance. Data come from the Medical Expenditure Panel Survey (MEPS) and are presented by establishment size among only private-sector employers. State-level data are also presented. In 2013, 37.6 percent of private-sector establishments self-insured at least one of their health plans, up from 26.5 percent in 1999. All of the growth in self-insurance in recent years has been confined to larger firms. In 2013, 83.9 percent of employers with 500 or more employees self-insured at least one health plan, up from 66.2 percent in 1999. The percentage of employers offering a self-insured health plan with fewer than 100 employees has bounced around between 10.7 percent and 14.7 percent between 1996 and 2013. Furthermore, the percentage of employers offering a self-insured health plan with 100-499 employees fell from 35.3 percent in 1996 to 25 percent in 2006, and has been between 25.2 percent and 29.2 percent since. Large employers (with 1,000 or more workers) have driven the upward trend in overall self-insurance. Understanding the trend in self-insurance for employers with 50 or more workers and those with fewer than 50 workers is important because the employer mandate in the Patient Protection and Affordable Care Act (PPACA) affects only employers with at least 50 workers. To the degree small employers are concerned about the rising cost of providing health coverage, self-insurance may become a more attractive means to mitigate any expected regulatory cost increases. However, as of 2013, there is no evidence that smaller firms were increasingly self-insuring their health plans. In 2013, 64.6 percent of firms with 50 or more employees offered at least one self-insured plan, compared with 13.2 percent among firms with fewer than 50 employees. This analysis finds that the percentage of workers in self-insured plans has been increasing. In 2013, 58.2 percent of workers with health coverage were in self-insured plans, up from 40.9 percent in 1998. The percentage of workers in self-insured plans in firms with fewer than 50 employees has been close to 12 percent in most years examined in this analysis. The estimates in this analysis should serve as a baseline to gauge the potential impact of rising health insurance costs on self-insurance in the future.

Self-Insured Health Plans

Author : Paul Fronstin
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (137 download)

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Book Synopsis Self-Insured Health Plans by : Paul Fronstin

Download or read book Self-Insured Health Plans written by Paul Fronstin and published by . This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper examines 1996-2015 trends in self-insured health plans among private-sector establishments offering health plans and among their covered workers, with a particular focus on 2013 to 2015, so as to assess whether the Affordable Care Act (ACA) might have affected these trends. The data come from the Medical Expenditure Panel Survey Insurance Component (MEPS-IC). Since the passage of the ACA, some commentators have speculated that an increasing number of small and midsized employers would convert their health plans from fully insured to self-insured plans. The rationale has appeared to be that several of the key ACA components -- creditable coverage, affordability, essential benefits, and various taxes and fees -- would drive up the cost of health coverage, thus possibly making self-insurance (which is viewed by many as generally less expensive than fully-insured alternatives) a more attractive option for many employers. The percentage of private-sector establishments offering health plans at least one of which is self-insured has increased from 28.5 percent in 1996 to 39 percent in 2015 (36.8 percent increase). Between 2013 and 2015, the percentages of establishments offering health plans with at least one self-insured plan has increased for midsized establishments from 25.3 percent to 30.1 percent (a 19 percent increase); for small establishments from 13.3 percent to 14.2 percent (a 7 percent increase); and has decreased from 83.9 percent to 80.4 percent for large establishments (a 4 percent decrease). Similarly, the percentage of health-plan-covered workers enrolled in self-insured health plans has increased from 58.2 percent to 60 percent (a 3 percent increase) from 2013 to 2015. The largest increases in self-insured plan coverage among covered workers have occurred in establishments with 25-99 employees and with 100-999 employees. These data are consistent with the perspective set forth above that the ACA would cause more small and midsized employers to adopt self-insured plans.

The End of Employer-Provided Health Insurance

Author : Paul Zane Pilzer
Publisher : John Wiley & Sons
ISBN 13 : 1119012112
Total Pages : 288 pages
Book Rating : 4.1/5 (19 download)

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Book Synopsis The End of Employer-Provided Health Insurance by : Paul Zane Pilzer

Download or read book The End of Employer-Provided Health Insurance written by Paul Zane Pilzer and published by John Wiley & Sons. This book was released on 2014-11-17 with total page 288 pages. Available in PDF, EPUB and Kindle. Book excerpt: How to save 20 to 60 percent on health insurance! The End of Employer-Provided Health Insurance is a comprehensive guide to utilizing new individual health plans to save 20 to 60 percent on health insurance. This book is written to ensure that you, your family, and your company get your fair share of the trillions of dollars the U.S. government will spend subsidizing individual health insurance plans between now and 2025. You will learn how to navigate the Affordable Care Act to save money without sacrificing coverage, and how to choose the plan that offers exactly what you, your family and your company need. Over the next 10 years, 100 million Americans will move from employer-provided to individually purchased health insurance. The purpose of The End of Employer-Provided Health Insurance is to show you how to profit from this paradigm shift while helping you, your family, and your employees get better and safer health insurance at lower cost. It will help you save thousands of dollars per person each year and protect you from the greatest threat to your financial future—our nation's broken employer-provided health insurance system. We are at the beginning of a paradigm shift in the way businesses offer employee health benefits and the way Americans get health insurance—a shift from an employer-driven defined benefit model to an individual-driven defined contribution model. This parallels a similar shift in employer-provided retirement benefits that took place two to three decades ago from defined benefit to defined contribution retirement plans. Written by a world-renowned economist and New York Times best-selling author, this insightful guide explains how individual health insurance offers more to employees than employer-provided plans. Using the techniques outlined in this book, you and your employer will save money on health insurance by migrating from employer-provided health insurance coverage to employer-funded individual plans at a total cost that is 20 percent to 60 percent lower for the same coverage. That's $4,000 to $12,000 in savings per year for a family of four for the same hospitals, same doctors, and same prescriptions.

Coverage Matters

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309076099
Total Pages : 204 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Coverage Matters by : Institute of Medicine

Download or read book Coverage Matters written by Institute of Medicine and published by National Academies Press. This book was released on 2001-10-27 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.

Employment and Health Benefits

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309048273
Total Pages : 381 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Employment and Health Benefits by : Institute of Medicine

Download or read book Employment and Health Benefits written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 381 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.

An Employee's Guide to Health Benefits Under COBRA

Author :
Publisher :
ISBN 13 :
Total Pages : 36 pages
Book Rating : 4.:/5 (11 download)

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Book Synopsis An Employee's Guide to Health Benefits Under COBRA by :

Download or read book An Employee's Guide to Health Benefits Under COBRA written by and published by . This book was released on 2010 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Care Without Coverage

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309083435
Total Pages : 213 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Care Without Coverage by : Institute of Medicine

Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Self-funding Health Benefit Plans

Author : John C. Garner
Publisher :
ISBN 13 : 9780891547563
Total Pages : 264 pages
Book Rating : 4.5/5 (475 download)

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Book Synopsis Self-funding Health Benefit Plans by : John C. Garner

Download or read book Self-funding Health Benefit Plans written by John C. Garner and published by . This book was released on 2015-10 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Employer Self-insured Health Plans--

Author : Ohio. Department of Insurance
Publisher :
ISBN 13 :
Total Pages : 6 pages
Book Rating : 4.:/5 (591 download)

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Book Synopsis Employer Self-insured Health Plans-- by : Ohio. Department of Insurance

Download or read book Employer Self-insured Health Plans-- written by Ohio. Department of Insurance and published by . This book was released on 2001 with total page 6 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Self-Insured Health Insurance Coverage

Author : Bernadette Fernandez
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (15 download)

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Book Synopsis Self-Insured Health Insurance Coverage by : Bernadette Fernandez

Download or read book Self-Insured Health Insurance Coverage written by Bernadette Fernandez and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This report provides background information on private health insurance coverage, state and federal regulation of private coverage, and self-insured health plans. It includes data on the prevalence of self-insurance and discusses the employer decision to self-insure. Lastly, it describes selected private health insurance provisions under federal health reform, and application of such provisions on self-insured plans.