csaio6 / 09 - 2005 cern staff association 1 cern long-term care scheme conference of the staff...
DESCRIPTION
CSAIO6 / CERN Staff Association 3 CERN Health Insurance Scheme (1) l Nature of the CHIS n Funding of the CHIS u Contribution of active staff – share between Staff & Organisation : 4.02% & 6.35% of basic salary u Contribution of pensioners – share between pensioners & Organisation : 4.02% & 6.35% of the last indexed monthly basic salary u Contribution of spouses when they receive an income n External administrator (UNIQA) u Claims reimbursement u Daily administration of the CHIS servicesTRANSCRIPT
CSAIO6 / 09 - 2005 CERN Staff Association 1
CERN CERN Long-Term CareLong-Term Care
SchemeSchemeConference of the Staff AssociationsConference of the Staff Associations
of Internationals Organizations of Internationals Organizations 29-30 September 200529-30 September 2005
CSAIO6 / 09 - 2005 CERN Staff Association 2
ContentsContents CERN Health Insurance Scheme
Nature of the CHIS Basic principles of the CHIS Scheme administration & responsibilities
Long-Term Care Scheme Background of the LTC Actuarial studies (scheme choice) Nature of the LTC Actuarial scenarios (no LTC; with LTC) Financing of the LTC Benefits of the LTC Advantages of the LTC Some LTC statistics from 2001 - 2005 Some CHIS – LTC statistics from 1988 – 2004 The future of the LTC
Conclusions
CSAIO6 / 09 - 2005 CERN Staff Association 3
CERN Health Insurance Scheme (1)CERN Health Insurance Scheme (1)
Nature of the CHISFunding of the CHIS
Contribution of active staff – share between Staff & Organisation : 4.02% & 6.35% of basic salary
Contribution of pensioners – share between pensioners & Organisation : 4.02% & 6.35% of the last indexed monthly basic salary
Contribution of spouses when they receive an income
External administrator (UNIQA) Claims reimbursement Daily administration of the CHIS services
CSAIO6 / 09 - 2005 CERN Staff Association 4
CERN Health Insurance Scheme (2)CERN Health Insurance Scheme (2) Basic principles of the CHIS
Obligatory, everyone must participate
Contributions are based on salaries only, independent of age of beneficiariesand of number of beneficiariesin the household
All members of the family (spouse & dependent children are cover).
It is obligatory
It is a mutual scheme
CSAIO6 / 09 - 2005 CERN Staff Association 5
CERN Health Insurance Scheme (3)CERN Health Insurance Scheme (3) Freedom of choice of health
care providers & world-wide coverage
Responsibility of each CHIS memberthe level of reimbursementshall not exceed the level of contributions
Freedom of choice
Collective responsibility
CHIS = Insurance
CSAIO6 / 09 - 2005 CERN Staff Association 6
CERN CERN Health Insurance SchemeHealth Insurance Scheme (5) (5) Scheme administration & responsibilities
CERN has the full control of the scheme CERN monitors the scheme CERN lays down the policies & proposes modifications
as needed
UNIQA acts as a daily administrator of the scheme UNIQA implements the policies & applies the CHIS rules UNIQA produces statistics and gives feedback
CSAIO6 / 09 - 2005 CERN Staff Association 7
Long-Term Care schemeLong-Term Care scheme Background of the LTC
Before 2001 the CERN Staff Association worked to elaborate a LTC scheme and studied several scheme types
Several actuarial reviews to obtain a forecast & foresee the future evolution
In 2001 CERN set up a Long-Term Care scheme, which is part of the CHIS
The LTC scheme was set up as a result of the 2000 five yearly review
CSAIO6 / 09 - 2005 CERN Staff Association 8
LTC : LTC : Actuarial studiesActuarial studies Technical basis
Use available mortality tables for (non)dependents
Do not include (big) safety margins the insurance companies include
Aim at ~60% of standard full-board Swiss cost (100 CHF)
Three levels of dependency No adjustment foreseen for home care allowance
CSAIO6 / 09 - 2005 CERN Staff Association 9
LTC : LTC : Actuarial studiesActuarial studies Collective scheme versus individual commercial
proposal
CHF per monthFirst year
Guarantee Solidarity total Individual insurance
> 65 Y. old 1800 -600 1800 2400 to 4000
30 to 50 Y. 0 75 75 475 to 1160
51 to 64 Y. 775 300 1075 1200 to 2300
Regarding the CERN population this scheme is cheaper but the solidarity between the young and the old
generations is not fully warranty
CSAIO6 / 09 - 2005 CERN Staff Association 10
Long-Term Care scheme (1)Long-Term Care scheme (1) Nature of the LTC
All CHIS members are insured, regardless of their age and medical history
Three levels of dependency Low level Medium level High level
According to the member’s degree of
ability to perform some life essential
actions Getting up, sitting down, getting into bed Mobility Washing & grooming Dressing & undressing
Taking food & drink Going to the lavatory Coherence & ability to communicate Orientation in space & time
Not 3Not 4
Not 5
CSAIO6 / 09 - 2005 CERN Staff Association 11
LTC : LTC : Actuarial ScenariosActuarial Scenarios No LTC (only standard health coverage)
52 CHF per day for home care with 2580 CHF per year for paramedical expenses
Hospitalization cost 1000 CHF per day 100 days per year for dependant are spend in
hospital With LTC
85 CHF per day for home care Up to 2500 CHF per for paramedical expenses LTC scheme eliminates hospitalization cost
CSAIO6 / 09 - 2005 CERN Staff Association 12
LTC : LTC : Actuarial Studies resultsActuarial Studies resultsNo LTC (standard health coverage) With LTC18 cases / Year MCHF MCHF
Home care 0.36 5.88
Paramedical 0.05 0.54
Hospitalization 1.8
Total for the first year 2.21 6.42
231 cases after 20 Y - Total 302.86 186.80
Average / Year over 20 years
15.14 Paramedical: 3.73Home-care : 5.61Total : 9.34
40% CHIS reduction cost with the LTC scheme
CSAIO6 / 09 - 2005 CERN Staff Association 13
Long-Term Care scheme (2)Long-Term Care scheme (2) Financing of the LTC
Affiliation and contribution are compulsory for CHIS members
Increase by 0.6% of the CHIS rate contribution for all staff contributors
Enlargement of the basis of contribution for the pensioners (0.6% corresponds to 1.2% of pension)
Creation of a capitalized LTC Fund to pay the home care allowance
Staff members of the scheme are the single contributors
But the Organization is paying a contribution for pensioners
CSAIO6 / 09 - 2005 CERN Staff Association 14
Long-Term Care scheme (3)Long-Term Care scheme (3) Benefits
Low level Medium level High level
Medical treatment No change
Paramedical treatment
Up to1’000 CHF per month
Up to 1’500 CHF per month
Up to 2’500 CHF per
monthHome care* allowance
34 CHFper day
51 CHFper day
85 CHFper day
* Not paid during hospitalization
50% of standard full-board Swiss cost70% of standard full-board French cost
CSAIO6 / 09 - 2005 CERN Staff Association 15
Long-Term Care scheme (4) Long-Term Care scheme (4) Advantages of the LTC
Cost reduction of increase in hospital bills Authorize the improvement of the long-term
financial balance of the Organization’s health insurance scheme
Better cover for dependent persons Keep the CHIS equivalent to the LAMAL
scheme
CSAIO6 / 09 - 2005 CERN Staff Association 16
Long-Term Care scheme (5)Long-Term Care scheme (5) Some LTC Statistics from 2001 – 2004
Number of cases
Low level
Medium level
High level
Total Actuarial forecasts
before 2001 1612-2001 32 ~6012-2002 13 18 16 47 ~8812-2003 21 23 19 63 ~9512-2004 29 20 22 71 ~106
37 cases evaluated in 2003 / 20 cases evaluated in 2004
2026 : 243 cases foreseen (3.1% of CHIS members)
CSAIO6 / 09 - 2005 CERN Staff Association 17
Long-Term Care scheme (6)Long-Term Care scheme (6) Some LTC Statistics from 2001 – 2004
MCHF Contributions Payment Fund
before 2001 0 0.65 0
12-2001 5.60 0.80 4.8012-2002 5.90 1.40 11.7012-2003 6.10 1.50 15.5012-2004 6.20 1.64 22.10
Actuarial study 20 MCHF foreseen end of 2004
CSAIO6 / 09 - 2005 CERN Staff Association 18
Long-Term Care scheme (7)Long-Term Care scheme (7) Some LTC Statistics in 2004 by age & sex
0.6%25.0%5.0%3.4%1.7%0.7%0.2%0.3%0.2%0.4%0.4%soitau 31-12-2004
1186844179473769120314031105827558678nb d'assurés
711191613933223Total
22624532moyen Total
1134121M
1132411Fmoyen
20244221212grave Total
1414312111M
6111111Fgrave
2933866111faible Total
141325111M
1526151Ffaible
Total86-9081-8576-8071-7566-7061-6556-6031-3526-3019-25sexeniveau LTC
gpe agenombres
0.6%25.0%5.0%3.4%1.7%0.7%0.2%0.3%0.2%0.4%0.4%soitau 31-12-2004
1186844179473769120314031105827558678nb d'assurés
711191613933223Total
22624532moyen Total
1134121M
1132411Fmoyen
20244221212grave Total
1414312111M
6111111Fgrave
2933866111faible Total
141325111M
1526151Ffaible
Total86-9081-8576-8071-7566-7061-6556-6031-3526-3019-25sexeniveau LTC
gpe agenombres
CSAIO6 / 09 - 2005 CERN Staff Association 19
Long-Term Care scheme (8)Long-Term Care scheme (8) Some CHIS – LTC statistics from 1988 -2004
Evolution cost
Large increase for
hospitalization in 15 years
Evolution 1988-2004 des dépenses par groupes de prestations sur base 100 en 1988 pour les prestations versées par année
0
100
200
300
400
500
600
1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
indi
ces
médecinspharmaciessoins_analysesdentisteshosp 90%hosp 100%totalLTC
CSAIO6 / 09 - 2005 CERN Staff Association 20
Long-Term Care scheme (9) Long-Term Care scheme (9) The future of the LTC
Actuarial study in 2006 to review the scheme and take a decision on adapting the daily allowance
Looking for preferential providers in the field of nursing & home help in France
CSAIO6 / 09 - 2005 CERN Staff Association 21
Conclusions Conclusions The number of cases is in line with the forecast The LTC scheme meets needs. Some difficulties
reported in the assessment of low dependency level The current financing of the LTC scheme is sound
from an actuarial point of view. Adapt continuously the scheme to the future
evolution of society, also to keep the LTC and CHIS equivalent to the LAMAL Swiss health scheme
CSAIO6 / 09 - 2005 CERN Staff Association 22
END
I am at your disposal for questions
Joel LAHAYECERN Staff Association