In every group of employee and family members regardless of the number, rather you have 4 employees, 50 employees, or 500 employees. The Health Care Utilization remain about the same: 13% of consumers have no utilization of health care dollars

53.3% of consumers are  low utilizers using 10% of health care dollars

25% of consumers are medium utilizers  using 15% - 20% of health care dollars

8.7% of consumers are high utilizers using 70%+ of health care dollars. This small percentage of employees will not impact the potential savings to the plan.

The fact that health insurance is designed to protect against 2 different areas of exposure: 

Predictable costs are most efficiently funded and paid by the employer and consumer.  Purchasing insurance to cover predictable claims is not cost effective due to the additional expense associated with overhead, taxes, profit, and reserves. 

Unpredictable costs such as shock claims or catastrophic losses, are justifiably insured through an excess-loss contract with an insurance carrier.  Expenses are much lower for this type of coverage. Likewise, premiums are correspondingly less. 
Employee and Employer do not like changes, but the high cost of premium are forcing more company to review the premium financing options. Premium costs are going up faster than at any other time in 10 years. According to the William M. Mercer consulting firm, employers are looking at premium increases averaging double digits in the next few years. Even the federal government's health coverage is facing rate increases on the average of 13.3% with some of the more popular plans going up 20% or more. 

What is you can set up a plan to self fund the 91.3% of the small claims and save an average of 20% + from your current premium. 

Provide stop loss for the 8.7% high utilizers

Provide your employees the freedom of choice in doctors and treatments

Up to 100% coverage in the first layer of protection

Win - Win satuation - would you do it?

 

 

HEALTH STATUS: GOOD
Requiring periodic routine care 53.3% 

Low annual utilization

HEALTH STATUS: FAIR
Requiring episodic care
for non-chronic conditions 25%
Moderate annual utilization

HEALTH STATUS: POOR
Requiring chronic disease
       care and management 8.7%   
High annual utilization

2 Doctor office visits (in-network)
1 Urgent care visit (out-of-area)
0 Inpatient admissions
2 Prescriptions

6 Doctor office visits (in-network)
1 Emergency room visit
6 Prescriptions 
1 Physical exam

24 Doctor office visits (in-network)
2 Emergency room visits
2 Inpatient admissions (6 days)
72 Prescriptions (6 per month)

Sources: CMS Prescriptions based on $42 average charge for up to a 30-day generic prescription ($84 for 90-day supply); $75 average charge for up to a 30-day brand prescription ($150 for 90-day supply); 1:1 brand-to-generic prescription ratio; includes available 90-day supply by mail; other applicable prescription discounts are not included; other additional restrictions including, but not limited to, approved drug formularies, quarterly prescription limits, or prescription cost formulas may affect annual cost-sharing.

Breakdown of Health Care Dollars

Are you getting your money's worth?

Based on $9,276 Annual HMO Family Premium

Physician/Clinical  32 Cents $2968.32
Hospital  31 Cents $2875.56
Prescription Drugs 10 Cents $  927.60
Nursing/home Care   9 Cents $  834.84
Administration   7 Cents $  649.32
Other  11 Cents  $1020.36

  Sources CMS, Office of the Actuary, National Health Statistics Group 2002, Blue Cross and Blue Association research, 2002

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How do your company get started...in saving 15 - 50% of renewal premium?

Contact your broker about our online services
The employer decide on the funding level for claims under the high deductible plan.
The employer buys a high deductible plan from any insurance carrier through your licensed broker.
Mypaperlessoffice administers and processes claims under the carrier high deductible for the employer.
The employee gets a normal plan Office visit copays, Prescription copays and Coinsurance (Employer control the plan benefit design and funding level)
Mypaperlessoffice provide plan document, SPD, HIPAA and all administration via online system for the employer
Online enrollment or broker assisted enrollment
Claims are handle by MasterCard® and/or traditional Paper method depends on plan design
Mypaperlessoffice becomes the Service Center for EMPLOYERS, EMPLOYEES and PROVIDERS
Generic RX $10 copay plan available as well as other Gap coverage (Your broker can arrange the products for your employees)