Presentation on theme: "Why Implement An International Medical Benefits Program in Your Plan? Jerry D. Turney President The Consolidated Marketing Group, LLC."— Presentation transcript:
Why Implement An International Medical Benefits Program in Your Plan? Jerry D. Turney President The Consolidated Marketing Group, LLC
2 The Medical Care Dynamic is Changing: By 2050, more than 50% of people living in the USA will be of direct ethnic origin Approximately 45.5 million Hispanics and 15.2 million Asians currently live in the USA. In recent surveys, 54.1% of Hispanics and 56.8% of American Asians said they would consider the option of going overseas for medical care. International travel for medical care has become an accepted alternative to US care.
3 Advantages For Self Insured Employers Claims cost savings of 50% to 80% on major procedures Reduce Specific and Aggregate Stop Loss Claims and Premiums Increased benefits for employees and dependents while reducing overall health plan costs Provides culturally desirable care for ethnic employees and their families Employers see this as an alternative solution rather then shifting costs to employees
4 Advantages for Employees Money-saving alternative to US-based care with no compromise in quality of care received Plan design can include No deductible; No coinsurance; No copays and No Out-Of-Pocket Travel Expenses Employee freely chooses between USA Domestic Treatment and the International Medical Benefits Program International Program features treatment in culturally familiar surroundings for ethnic employees with reduced out-of-pocket costs
5 Why An International Care Program? #1-Quality of Care- Many international facilities are superior to U.S. Facilities when measured by common factors such as Infection Rates, Survival Rates and other common measures. The Medical Tourism Association has been working to develop common measures of quality of care and measures of outcomes so Employers and Consumers can make informed choices as to treatment strategies and the selection of treatment locations, domestic or international.
6 Why An International Care Program? #2-Treatments Available-It is not unusual for medical treatments to be available internationally that have not been approved within the USA due to our cumbersome bureaucratic approval processes. One example is Hip Resurfacing, often superior to Hip Replacement. This has been a routine procedure internationally for over 10 years. One consequence of this situation is that surgeons in India and other locations have a decade+ of experience when compared to USA domestic surgeons.
7 Why An International Care Program? #3- Cultural Factors- Many patients, given a choice, would prefer to have care in culturally familiar surroundings. Experience has shown that Employees in this category view the availability of a voluntary International Care Option as a highly desirable employee benefit and consider it the treatment option of choice. This choice of treatment benefits both the Employee and the Employer's health plan.
8 Why An International Care Program? #4- Economic Factors -It is not unusual for charges in top-rated international facilities to be a little as 30% of USA treatment costs. (The typical private room rate in a Mexico City first tier hospital is $250 per day!). In response to this pricing differential and to encourage the use of international facilities, many employers adapt their Plan Document to waive deductibles and coinsurance for international care and will assist with transportation costs on major procedures exceeding a predetermined cost threshold.
9 Types Of Available Programs #1 Embedded Informational Program providing general information on the International Medical Treatment Option but without the Personal Concierge services of a Facilitator. International Medical Options and Program Access Information is available via website with all travel and treatment procedures self- directed by the patient. Popular with Trade and Ethnic Affinity Groups as a value-added program embedded into the association dues.
10 Types Of Available Programs #2 Turn Key Program ready to install. Included are full Facilitator services with an emphasis on ease of installation and cost effectiveness. Conduct of Employee meetings and on-going communication are priorities. Facilitator is accessed by or toll free phone numbers. Adaptation of the Plan Document to provide incentives as well as annual utilization reporting is included. Full coordination with existing Plan Administrator and Agent/Consultant is provided. Assistance with MTP, LLC Managing General Underwriters in obtaining Medical Stop Loss assistance, as needed.
11 Types Of Available Programs #3 Full Custom Program to include historical claims analysis, custom design of suggested Plan Document revisions to provide treatment incentives, ongoing reporting of plan performance and coordination with Plan Administrator and Agent/consultant. Full support services for initial program installation and ongoing management. Coordination with the group's Medical Stop Loss carrier or assistance with MTP, LLC Managing Managing General Underwriters to obtain Medical Stop Loss assistance, as needed.
12 Contact List Jerry D. Turney- The Consolidated Marketing Group LLC Scottsdale, AZ Phone # Information on general plan designs and installation Thomas O'Hara- Surgical Trip LLC Radnor, PA Phone # Information or questions on all Facilitator-related processes and procedures. Thomas E. Mestmaker- Mestmaker & Associates Bakersfield, CA Phone # All plan design and installation Gordon Sympson- MTP LLC Nashville, TN Phone # Medical Stop Loss Managing General Underwriter (MGU) for Gerber Life, American Fidelity Life; Lloyds of London Correspondent.