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EMPLOYEE BENEFIT SERVICES F. Darrell Lindsey Insurance Services Employee Benefit Systems DIVISION provides specific products and special services to various healthcare payers and healthcare providers. Gaining a competitive advantage today is more difficult than ever. That is why more small businesses are joining together as Industry Association Groups, mid-size to large organizations, are outsourcing various business functions to proven experts like F. D. Lindsey Insurance Services, allowing the Business Owner to benefit from the latest and most successful self-funded, or risk transfer benefits management techniques with Employment Based programs such as; HRA’s (Health Reimbursement Arrangements), MSA’s (Medical Savings Accounts), FSA’s (Flexible Spending Accounts), and the NEW HSA’S (Health Savings Accounts). These Individual TAX incentive health care savings plans, for the payment of health costs not covered under Commercial insurance programs provided by the Business Owner, can help ease the pain when employer’s begin to follow what is being called CDH (Consumer Driven Healthcare) or CDP (Consumer Driven Plans). CDH – Consumer Driven Healthcare is based on a “reversal” of the trend that the Business Owner is responsible for providing “cradle to grave” health insurance coverage. This is motivated by a realization that, in 1960 the consumer (the employee/individual) paid for nearly 60% of their own healthcare directly; the government paid for about 20%; and health insurance paid for 20%. Bu 1980 consumers/employees were only paying for 28% of their own health care costs; the government was up to 40%; and the Health Insurance program was up to 32%. In 2000, the consumer/employee was now only paying 15% (com-pared with 60% in 1960); the government was paying 45% (including Medicare, etc., which was not counted in 1960 so not an accurate percentage by comparison); and the Health Insurance Industry was paying 40%. The actual 40% for the Health Insurance Industry jumps to 75% if Medicare and Medicaid are removed from the total calculation and the under age 60 employer/employee Business Owner group is separated. As consumer driven Health Care, as being demanded by employee/ consumers in their fight to gain control over costs and Doctor/Hospital choice, and by necessity as Business Owners attempt to control costs by reducing benefits or requiring the employee to pay a greater share of the insurance premium. To offset the pain of all parties, making available to all employees the TAX Incentive plans available for individuals to pay for DEDUCTIBLE, HRA’s, MFSA’s, HCRA’s, MSA’s, and HSA’s, as authorized under ERISA and the IRS, will be important to offer and have available. The effort currently be Business Owners large and small is to develop a program under new CDP (Consumer Driven Plans) which “combine” a High Deductible Insurance Company Group Health Policy with a “Healthcare Spending Account” HSA that is funded by the Business Owner or jointly funded by the employer and the employee. The tax DEDUCTIBLE Healthcare Spending Account can be activated the moment the insured has a qualified medical cost, thus providing the first dollar coverage that employees have come to expect. HOWEVER, for the program to WORK, there is usually a gap between the actual medical expenses paid by the Health Spending Account as a limit, and the expenses paid under the Business Owners health insurance policy, which must be paid and satisfied by the employee. At some companies the gap may be small, $120 or $250, at others it may be $1,000 or more. | |
