solutions
What is subsidy %? - correct answer ✔✔[total ER contribution] / [total cost of plan]
What happens if the ER pays full-cost of plan chosen by EEs? - correct answer ✔✔1. non-contributory
plan
2. ER subsidy is 100%
3. deferred benefit to plan
4. EE's view any choice they make as free
what factor would cause an EE to chose one plan over the other? - correct answer ✔✔1. provider
network features
2. cost-sharing features
3. non-price competition - can cause ER cost to increase
What happens if the ER pays less than 100% of the cost of the plan? - correct answer ✔✔1. contributory
financing
2. ER subsidy is less than 100%
3. defined contribution approach to plan design
4. 'price' becomes an issue for EEs in plan
5. subsidy % can influence EE choice and plan cost for ER
What should subsidy % be determined for? - correct answer ✔✔1. family vs. single
2. different salary levels
3. different plan options
What is a LDHP? - correct answer ✔✔low deductible Health plan
, has low coinsurance, deductibles, and OOP max.
doesn't give EE incentive to behave as a traditional consumer
What is the triple tax advantage? - correct answer ✔✔1. ER contributions to fund HSA are not taxed to
EEs
2. EEs can make contributions with pre-tax $
3. HSA contribution limit
4. tax free investment income
5. funds can be used for qualified unreimbursed med. exps.
6. any unused contributions can be carried forward without limit
What is the HSA contribution limit for EEs? ERs? - correct answer ✔✔$3850
$7750
What is the reasonable goal for Healthcare cost containment? - correct answer ✔✔reduce the growth in
HCC to an acceptable level for an ER
What are the broad strategies to achieve HCCC? - correct answer ✔✔1. reduce freq.
2. reduce severity
3. change 'mix' of services - substitute a less costly service for a more costly service
What are ways within strategy #1 of achieving HCCC? - correct answer ✔✔1. control demand for HCGS
2. control supply of services given by providers
3. top-down strategy
What are ways to control demand for HCGS? - correct answer ✔✔1. implement a wellness program