a solution for creating a plan to controlling the cost of healthcare now and in the future!...

A solution for creating a plan to controlling the cost of healthcare now and in the future! Presented By Polestar Benefits, Inc. MEDICAL PLAN HRA ALTERNATIVE FUNDING HAPPY EMPLOYEES HAPPY EMPLOYER

Health insurance premiums continue to drive higher; Most employers are facing increases to premiums (per year) of 15% or more; 72% of companies are interested in offering custom plans if its costs decrease by 10% or more.

1 2 3 Capture premium savings by choosing an alternative medical plan with a higher deductible and/or coinsurance; Use the premium savings for reimbursement of claims costs. Establish a second plan* that reimburses employees for difference of deductible and/or coinsurance expenses from the current plan to the alternate plan; Alternate Plan Deductible $2000 The plan established to reimburse for expenses, in this is case, is as a Health Reimbursement Arrangement (HRA). More information available on what an HRA is at http://www.polestarbenefits.com/hra.htmlhttp://www.polestarbenefits.com/hra.html

1.The Reimbursement Plan for the employee is typically setup to keep the total benefits close to or the same as the prior plan year; 2.Reimbursements from the Plan are not taxable income to the employees; 3.If the employee makes premium contributions to the medical plan, the reduction of premium with the alternative medical plan is also a savings to the employee.

Current PlanNew Plan Office Co-Pay$20 Deductible$500$2000 Coinsurance20/40% Rx$15/$30/$50 ONLY the difference in the deductible was reimbursed!!!

Current PlanNew PlanSavings Employee Only $351.98$292.55$59.43 Employee/ Spouse $703.96$585.10$118.86 Employee/ Family $985.54$819.14$166.40 Employee/ Child $633.56$526.59$106.97

# EnrolledMonthly Savings Annual Savings Employee Only 12$59.43$8,557.92 Employee/ Spouse 6$59.43$4,278.96 Employee/ Family 9$59.43$6,418.44 Employee/ Child 5$59.43$3,565.80 TOTAL SAVINGS $22,821.12

2007 8.04% 2008 15.95% 2009 11.75% 2010 11.52%

Annual Premium Savings $22,821.12 Total Claims Reimbursed ($2202.10) Administration Fees($1200.00) TOTAL SAVINGS $19,419.02

Renewal PlanYear 1Year 2Year 3Year 4Year 5 $351.98$292.55$327.66$366.97$411.01$460.33 Plus the cost of claims

Consider a Value planInsurance carriers have been creating new plans that create additional premium discounts for removing copay for office visits (for example) and other items Increasing liability to the member. Take the same concept for creating premium savings, but fill the additional holes with a HRA. Copyright 201013

DEDUCTIBLE REIMBURSEMENT EMPLOYEE (Member) PAYSHRA REIMBURSES The first $500 of DEDUCTIBLE expenses (per individual). Once the member has met his/her DEDUCTIBLE responsibility, he/she will receive reimbursement for the next $4,500 of incurred DEDUCTIBLE expenses. FOR PROFSERVICE DEDUCTIBLE EXPENSES The first $25 of PROFSERVICE DEDUCTIBLE expenses (per individual). Once the member has met his/her DEDUCTIBLE responsibility, he/she will receive reimbursement for the remaining PROFSERVICE DEDUCTIBLE expenses. Layer 1 Layer 2

Producer/Agent Frequently Asked Questions - http://www.exchange.utah.gov/learn-more/producer-agent-faqs http://www.exchange.utah.gov/learn-more/producer-agent-faqs 1 - Do employers have to use a producer? During the limited launch, employers were required to designate a producer. Currently employers are not required to designate a producer, however they are highly encouraged to do so. 2 - Which producers are eligible to use the Exchange? In order to use the Exchange, producers must be licensed in Utah and appointed with all carriers participating in the Exchange. Refer to UCA 31A-30-209 for further details. 3 - How many carriers are participating in the defined contribution system? Three medical carriers (Regence Blue Cross Blue Shield, Select Health, United Health Care) are participating and two HSA vendors are participating. We expect to see an increased number of participants as we progress. 4 - How many employer groups can the Exchange support? There is no limit to the number of employer groups the exchange can support. 5 - Which employer groups are eligible to participate in the defined contribution system? What group size will the Exchange accommodate.? Beginning January 1, 2011 employers in Utah with group size 2-50 are eligible to enroll in the defined contribution system. 6 - How do producers start the employer enrollment process? The first step is for the employer to submit an Employer Application via the Utah Health Exchange. Refer to Enroll - Employer section of this website for further details. 7 - Why is my name / agency not showing up on the employer registration page? If your name or agency does not show up on the employer registration page then please verify that you are appointed with the Exchange carriers. If you need additional information about producer qualifications please contact the Utah Insurance Department.Utah Insurance Department. 8 - What is the broker commission rate on the Exchange? Brokers are paid $37.00 per employee per month. The $37.00 is included in employee's monthly premiums. This amount is disclosed on employer's invoice.

a solution for creating a plan to controlling the cost of healthcare now and in the future!...

Documents

reimbursement plan

alternative medical

prior plan year

employee family

employee child

employee spouse

incurred deductible

total savings