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Issue: # 80July 3, 2012
 

july 4th   

  

Greetings!    

 

 

We've received many telephone calls and questions on the newly formed Health Insurance Cooperatives, which due to changes in state law are now available.  Like the Health Connector Exchange or Business Express before them, we hear a lot of talk and attention on these new plans and how there will be substantial premium savings, but is there really a material savings to recover?  Our conclusions are noted below.  

 

To date only two Cooperatives,  have been approved, The Retailers Association of Mass. and The Chamber of Commerce Plan.  Advantage Benefits has researched these programs at length.  This newsletter will focus on the Chamber of Commerce Plans. 

 

If you have a question, send an email to  Bill or Vanessa today.

 



Bill Randell CLU,CHFC,     

Vanessa Costa CLU,CHFC,

 

 

 

 

 

Chamber of Commerce Health Cooperative

  

 The Chamber of Commerce plans have three carriers to choose from:

  1. Harvard Pilgrim
  2. Fallon
  3. Health New England  

Please note that Health New England is only appropriate for employers in Western Massachusetts.   

 

Even with three carriers, there are a limited number of plan designs available.   

Harvard-Pilgrim offers NO traditional "co-payment" plans, but only high "deductible" plans starting at $1,500 for their traditional larger network and $1,000 for the smaller "Focus" network.  Similarily, Fallon has NO "co-payment" plans,  and deductible plans start at 1,000 for all three of their networks: Select, Direct and the newly formed Steward.

  

Why join?  There are discounts for these limited plans.  How much?    You can save 3% on the premium by going through the Chamber of Commerce versus going to the carrier direct.   This discount, however, comes with a cost: 

  1.  Annual membership fee:  
  2.  Monthly administration fee:   Harvard-Pilgrim charges $20 per month per subscriber.  A group of two employees will be charged $40 per month or $480 for the year!!Fallon varies the monthly fee by coverage (single is $5/month, employee/child is $9/month, employee/spouse is $10/month, family is$15 per month).  
  3. Wellness Program Penalty:    At the end of each calendar year subscribers who are active participants will be calculated.  Businesses that fall short of a 60% active participation threshold will be assessed a one time $100 charge for each covered employee short of the threshold in the calendar year. 

 

After the Annual Membership, monthly administration fee and any wellness penalties, how much of your 3% savings is left?  And that assumes you like one of these high deductible plans.    In addition, it also assumes that the rates are more competitive than Blue Cross or Tufts, which the Chamber of Commerce does not offer.  We do not see this being viable until the up front discount is more in thee 5-10% range.