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Comprehensive, Yet Competetively Priced “Secondary Insurance’ to Help Employees Pay for High Deductible / Out-of-Pocket Healthcare Expenses HR Specialty.

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Presentation on theme: "Comprehensive, Yet Competetively Priced “Secondary Insurance’ to Help Employees Pay for High Deductible / Out-of-Pocket Healthcare Expenses HR Specialty."— Presentation transcript:

1 Comprehensive, Yet Competetively Priced “Secondary Insurance’ to Help Employees Pay for High Deductible / Out-of-Pocket Healthcare Expenses HR Specialty Products & Services Catalogue Executive Summary A No Frills Distillation of Vendor’s Marketing Collateral Thomas A Ference President & CEO Human Resources Mining & Distribution Co Locating, Validating and Accelerating HR Innovation Office: Cell: Fax: Website:

2 Gap Filler - Secondary Insurance With traditional group health insurance premiums rising, both employers and employees are increasingly selecting high dollar deductible plan options thereby leaving employees exposed for paying first-dollar inpatient and outpatient healthcare expenses. This secondary insurance coverage fills that gap Coverage can typically be purchased at premium rates that in combination are less expensive than if the same or lesser coverage had been purchased under the group policy to cover the same expenses (e.g =3).

3 Gap Filler - Secondary Insurance In-patient coverage for hospital room, surgery, physicians, etc. can be purchased in optional maximum amounts ranging from $500 to $10,000 Coverage for services rendered in various out-patient facilities like emergency room, MRI facility, physician’s office, etc. can be purchased in optional amounts ranging from 40% to70% of the chosen inpatient maximum. This insurance plan can be paid for by the employer, employee or a combination. After a covered claim has been processed by the group carrier, the bill is paid directly by the secondary carrier through a coordination effort with the provider based on the employees’ ID cards

4 The “Secondary” Concept Secondary Insurance High Deductible Plan Two plans can be more cost effective than one Pair a High Deductible Major Medical Plan with Secondary Insurance

5 SSS Gap Plan Design Out-Of-Pocket Maximum Inpatient BenefitOutpatient Benefit 5000 Major Medical 5000 Gap Pays $5, Employee $1,500 Deductible Gap Pays $3, Employee $1,500 Deductible 1000 Painting The Picture Current Plan Secondary Gap Filler Plan

6 Claim Examples

7 Annual Cost Savings Example - 50 employees Current GroupNew GroupGap Filler / Secondary New Group + Gap Filler $1000 Deductible, 100% thereafter $4000 Deductible 70% /30% to $6350 OOP Gap $6350 Inpatient and $4000 Outpatient $458,280$306,480$89, 148$395, 628 $62,652 / 14% Annual Savings from Combining Plans + Better Benefits Price Differential

8 Next Steps This product/service is contained in the HR Specialty Products & Services Catalogue™ Operational level details about this particular service provider can be obtained in conference with the vendor The HR Mining &Distribution Co. is an independent and contracted representative of the vendor Upon your request, we will arrange for an introduction that can range from a simple, quick conference call to a services overview / system demo Tom Ference (Chicagoland area) or Thank you for your potential interest in this fresh thinking


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