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1、Alphabet Soup-THE ABCs OF FSAs,HSAs,HRAs A.I.M.s 2nd Annual Health Fair,The ABCs of FSA,HSAs,HRAs,How did we get here?Consumer Driven Health CareThe CDHC Tool BoxQ&A,The Reality Employers Face,3-4 years of double digit increasesFactors driving cost increases are manyPrescription Drug Costs RisingBab
2、y Boomers AgingMedical Technology AdvancingProvider Recontracting,Factors Driving National Increases,Sources:Pricewaterhouse,04/02,AAHP,.the average company pays 3%of revenue for health care benefits up 50%in five years,Health care as percent of revenue,CAGR=9%,Source:Hewitt Health Value Initiative;
3、United States Census;Bureau of Labor Statistics(2002 Productivity estimated based on first 3 Quarters),Health care costs are growing much faster than productivity(revenue per employee),Source:Hewitt Health Value Initiative;United States Census;Bureau of Labor Statistics(2002 Productivity estimated b
4、ased on first 3 Quarters),CAGR=3%,CAGR=10%,Healthcare increases are rapidly consuming the growth in household income,Annual increase in household income,Portion used to pay increases in healthcare premiums and out-of-pocket expenditures,*2002 estimate based on 2001 growthSource:U.S.Census Bureau,Kai
5、ser Family Foundation,UHC Analysis,100%=$2957,100%=$2293,100%=$1073,100%=$1093,What is a CDHC Plan?,ANY health plan,so far as itempowers patientsshares economic consequencesrewards good healthpromotes consumerismprovides health/healthcare toolsimproves healthcare quality,What a CDHC Plan DOES,Provid
6、es member with Targeted Incentives&Tools:to stay healthyto consume health care carefully to shop for health care prudentlyVaries member cost based on health care behaviorConsumer participates in small claims(controllable)Globally-effects utilization Rewards members,The Lingo,Consumer DrivenConsumer
7、DirectedDefined ContributionWrap Around Plan Health Reimbursement Arrangement,Health Reimbursement AccountPersonal Care AccountPersonal Medical FundPersonal Health FundHealth Savings Account,The CDHC Tool Box,High Deductible Health Plan(HDHP)Reduces insurance premiumCreates the“space”for the other t
8、ools to workFlexible Spending Account(FSA)Health Savings Account(HSA)Health Reimbursement Arrangement(HRA)Health,Fitness&Quality of Care Initiatives,Some Old,Flexible Spending Account(FSA):employee funds claims costs with pre-tax dollarsMedical Reimbursement AccountDependent Care AccountUse it or Lo
9、se it,Some New,HSA(Health Savings Account):Qualified Health Care Expenses(213d)Combination of employer/employee money.Unused balances vested May be used to fund health care post-retirementTrustee or custodian requiredContribution maximum=the lesser of annual HDHP deductible or:$2,600 Individual$5,15
10、0 Family,HSA DETAILS,Employer must purchase High Deductible Health Plan(HDHP)HDHP must have Minimum in-net annual deductible.Self-only:$1,000Family:$2,000 and Maximum in-net out-of-pocket costSelf-only:$5,000Family:$10,000,HSA,Deductible must apply to most covered services Preventative Services“Carv
11、e Out”Well patient evaluations&testsWell-child care/routine pre-natalImmunizationsSmoking cessation&weight loss programsPreventative drug therapies such as treatment of heart attack/stroke with ACE inhibitors,HSA Highlights,Automatic 100%vesting(employee owns)Triple Tax AdvantageFunded with pre-tax
12、dollarsGrows tax free(or value declines)Reimbursement for qualified expenses paid tax free,Possible Employer Concerns,HSA(Health Savings Account):Employer does not have control over plan specificscannot limit or direct use of HSA moneyEmployee has no access to uncontributed fundsvs.FSA&HRAEmployee c
13、an use account balance to pay for non-qualified expenses(Plasma TV)Employee pays State,Federal tax+10%penalty,Some New,HRA(Health Reimbursement Arrangement)Qualified Health Care ExpensesIRC 213d expenses onlyno non-qualified use permittedEmployer can further limit access to HRA funds Unused Funds ca
14、n be carried over“Use it or Keep it”Employee builds a benefit bankVesting provisions may vary with plan design,HRA,HRA(Health Reimbursement Arrangement)Employer funded only!Claims paid as incurred(not as funded)Employer can set parameters of the plan(control)Rollover%Vesting provisionsUnderlying med
15、ical plan specificsAmount of employer contribution flexible year-to-yearHRA/FSA integration common,Health,Fitness&Quality of Care,Fitness club subsidySmoking cessation&weight lossRich preventive care benefitsHealth risk assessmentsDisease management&lifestyle coachingProvider report cardsOnline 2nd opinions,Key to successful CDHC strategy,Organized Health Care Arrangement:Partnering Employer+Insurer+Consumer into single strategic initiativeHigh Deductible Health Plan(HDHP)FSA,HSA,HRAConsumer IncentivesHealth,Fitness&Quality of Care Tools,
