Benefit Alternatives
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Transcript of Benefit Alternatives
Benefit Alternatives
Pat HainesSVP, Benefits
• Defining the Need• The Economics of the BOP Plan• Public Exchange Basics• Available Resources
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Topical Overview
• Church Size• Congregational Resources• Growth in Part-time Ministry
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Defining the Need
• Current Demographics• Minimum vs. Maximum Participation• Average Cost of Coverage• Relationship between Dues and Cost
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The Economics of the BOP Traditional Plan
• Members participating in Traditional Medical Plan as a result of their employment with a church or employing organization:
• 11,575 Total Members
• 66% (7,659) are Teaching Elders
• 34% (3,916) are Lay employees
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Covered Population Demographics
• 18% (1,385) of Teaching Elders participate at the 2014 minimum of $42,000
• 62% (2,435) of Lay members participate at the 2014 minimum
• 33% (3,820) of all members participate at the 2014 minimum
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Participation at Minimum
• 1.9% (145) of Teaching Elders participate at the 2014 maximum of $124,000
• 1.5% (57) of Lay Members participate at the 2014 maximum
• 1.7% (202) of all Members participate at 2014 maximum
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Participation at Maximum
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Population by Salary
$42,000 and Under
$42,001 - $52,500
$52,501 - $63,000
$63,001 - $73,500
$73,501 - $84,000
$84,001 - $94,500
$94,501 - $104,500
$104,501 - $115,000
$115,001 - $124,000
Above $124,000
0
250
500
750
1,000
1,250
1,500
1,750
2,000
2,250
2,500
2,750
2,435
693
327181
109 60 27 15 12 57
1,385
1,866
1,542
1,173
679
417
252129 71
145
LAY TEACHING ELDER
2013 FTE SALARY
MEM
BER
COUN
T
80% of Lay members42% of Teaching Elders
1.8% of Lay members2.8% of Teaching Elders
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Average Medical Plan Costs
Per Family Unit
2012 2013
$7,200
$6,700
Members Covering at Least One Dependent
2012 2013
$13,000
$14,300Participating at Member-Only
=
+
2012 2013
$12,000
$13,000
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• The Value of Community Nature
• 2014 Minimum Dues $9,660 = 74% of $13,000 Average Cost
• 2014 Maximum Dues$28,520 = 219% of $13,000 Average Cost
Relationship Between Dues and Cost
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The Value of Community Nature
Relationship Between Dues and Cost
Average Cost$13,000
2014 2014 2014
$9,600
28520219% of Average Cost
74% of Average Cost
2014 Maximum Dues Participation Basis
2014 Minimum Dues Participation Basis
• Primary Objectives• Address Access and Affordability
• Approach• Individual Mandate• Uniform Coverage Standards• Premium Tax Credits
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The Affordable Care Act
• Exchange Essentials• State based• Designed for individuals and small businesses• Metallic plan options
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Public Exchanges: Accessible and Affordable Coverage as of 1/1/2014
• Core Functions• Consumer Assistance• Plan Management• Eligibility• Enrollment• Financial Management
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Public Exchanges: Accessible and Affordable Coverage
• Marketplace Decisions: • State Based: 17 (includes DC)
State operates all exchange activities• Federally Facilitated: 27
HHS operates• Partnership: 7
State operates activities for Plan Managementand/or consumer assistance
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Public Exchanges: Current State
Marketplace Decisions
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• Open Enrollment: October 2013 – March 2014• Enrollment statistics• Early concerns
• Systems issues• Consumer confusion• Narrow networks• Geographic (urban vs. rural) variability: choices
and cost
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Public Exchanges: Current State
• Plans Offered: Minimally, one silver and one gold
• Plan Types: HMO, PPO, High Deductible, provided they achieve actuarial value
• Distinguishing Product Characteristics: provider network, customer service, ancillary products
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Public Exchanges: How They Are Designed To Work
• Eligibility: 85% of those purchasing coverage on exchange will likely qualify • Household income < 400% of FPL ($95,400
family of four)• No access to “affordable” coverage through
employer• Impact
• Caps coverage cost (for 2nd lowest cost Silver Plan) at 2% - 9.5% of household income
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Public Exchanges: Premium Subsidy
• Enriches Silver Plan• Reduces out-of-pocket maximum• Converts Silver to Platinum for those earning
< 200% FPL ($47,700 for family of four)
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Public Exchanges: Cost-Sharing Subsidy
• Traditional Plan (23% effective salary) • Minimum Dues Basis ($42,000)
$805/month; $9,660/year
• Median Dues Basis ($54,500) $1,363/month; $16,350/year
• Maximum Dues Basis ($124,000) $2,377/month; $28,520/year
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Understanding the BOP Benchmarks
• Affiliated Benefits Program
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Understanding the BOP Benchmarks
Coverage Level Monthly Annual
Member Only $624 $7,488
Member + Covered Partner
$926 $11,112
Member + Child(ren) Only
$1,281 $15,372
Member + Family $1,668 $20,016
• Seminary Students
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Understanding the BOP Benchmarks
Coverage Level Monthly Annual
Member Only $458 $5,496
Member + Covered Partner
$702 $8,424
Member + Child(ren) Only
$702 $8,424
Member + Family $805 $9,660
• Medical Continuation Coverage
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Understanding the BOP Benchmarks
Coverage Level Monthly Annual
Member Only $733 $8,796
Member + Family $1,466 $17,592
• It All Starts Here
https://www.healthcare.gov/
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Public Exchanges: How To “Shop”
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Public Exchanges: Some Pricing Samples
LocationState/County
Demographics Plan Design
Monthly Cost
MonthlyABP
PA/Philadelphia Family of Four, Ages 54, 53, 21, &18Household Income: $54,000
PPO Gold$20 PCP $60 Specialist $10 Generic Rx
$1,634 (before credit)$695 (after credit)
$1,668
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Public Exchanges: Some Pricing Samples
LocationState/County
Demographics Plan Design
Monthly Cost
MonthlyMed
ContinuationFL/Palm Beach
Family of Two, Ages 61 & 63Household Income: $60,000
PPO Gold$30 PCP $60 Specialist $4 Generic Rx
$1,669 (before credit)$934 (after credit)
$1,466
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Public Exchanges: Some Pricing Samples
LocationState/County
Demographics Plan Design
Monthly Cost
MonthlySeminary
GA/Fulton Family of Four, Ages 38, 34, 6, & 4Household Income: $65,000
HMO Gold$20 PCP $50 Specialist $10 Generic Rx
$1,125 (before credit)$871 (after credit)
$805
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Public Exchanges: Some Pricing Samples
LocationState/County
Demographics Plan Design
Monthly Cost
Monthly Med
ContinuationCA/San Diego Family of Two,
Ages 64 & 59Household Income: $55,000
HMO Gold (Kaiser)$20 PCP $40 Specialist $5 Generic Rx
$1,829 (before credit)$900 (after credit)
$1,466
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Public Exchanges: Some Pricing Samples
LocationState/County
Demographics Plan Design Monthly Cost
Monthly ABP
CT/Hartford Family of Three, Ages 45, 13, &16Household Income: $45,000
PPO Silver Anthem$2,300 Ded.$30 PCPDed. applies to Specialist$15 Generic RX
$373 $1,281
• It All Starts Here
https://www.healthcare.gov/
• And Now Here
https://www.healthcare.gov/find-premium-estimates/
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Public Exchanges: Let’s “Shop”