The Death of the 100% Hsa

[HealthGuy]

I doubt very much that the 100% HSA is going away. Maybe with 3rd world carriers like American Community, World, or American Republic. This sounds like crappy information to me.

 

[scagnt83]

I wouldnt doubt it.
Especially if underwriters are telling people this; they can be an excellent source of information

 

[ABC]

Seems to me then that it is all relative. If you have an HSA plan that costs $150.00 per month and a traditional plan that costs you $200.00 per month and they both go up 30% in price then it would be relative with the HSA still being competitive????

Now if the monthly premium were the same for an HSA as a good traditional plan, wouldn't it make sense to have the traditional plan? Then I could see why you could see the death of the HSA. Am I seeing this correct here or what?

You thinking from an Individual health policy standpoint with group you are pooling the preium together for the entire group.

If you have a group of 20 on a 100% hsa plan and the annual premium is $100,000. If someone meets there OOP they will contiune to have claims that they might be on the elective side. So on this example if you have one employee that gets a $42,000 hip replacement that could be consider elective. Possible life style change to lose weight might help.
They have now spent $42,000 of the $100,000 on just one claim.

I doubt very much that the 100% HSA is going away. Maybe with 3rd world carriers like American Community, World, or American Republic. This sounds like crappy information to me.

They will be priced out of the market. The companies that you mentioned might not even be in business in 2 years let alone taking risk on group. These small regional companies are still losing money. I know for a fact AC 100% hsa block has crushed them.




If you are not writing a lot of group business and you come across that 9 life group that wants a group HSA plan. I highly recommend looking at the 80% co insurance. It tougher to sell but that group will have a much better chance of getting a single digit rate increase down the road.

 

[somarco]

Must remind self this is the "group" forum . . .

Yep, pricing differential on group HSA vs copay plans makes it so much easier to go ahead and write the copay. I have pitched the group HSA until I am blue but the client is willing to spend 10% more for the copay.

Said it before. Someone is wrong on the pricing spread. Can't say if it is individual major med or group, but one of the actuaries is off.

As for your lead in comment, I don't know how the carriers are seeing enough HSA biz to arrive at that conclusion. If they are selling large group, 200+ lives, then probably so. But the small, pooled cases are not scrambling for HSA plans.

 

[moonlightandmargaritas]

If they are selling large group, 200+ lives, then probably so. But the small, pooled cases are not scrambling for HSA plans.

Never having worked in the large group arena, how many lives before it makes sense to self-insure and stop-loss?

 

[ABC]

Never having worked in the large group arena, how many lives before it makes sense to self-insure and stop-loss?

I have seen groups as small as 30 lives go self funded.

I am still a rookie at the self funded game but that is where I want to be.

Most cases that I am seeing are 300+.

On the other side you can find groups that are 500 lives that are fully insured.

 

[0b1kanobee]

I need some clarification on the title of this thread...

Does the words "100% HSA" as this thread is titled refer to the amount the insurance company pays after the deductible is met?

 

[moonlightandmargaritas]

I need some clarification on the title of this thread...

Does the words "100% HSA" as this thread is titled refer to the amount the insurance company pays after the deductible is met?

Yes they do.

 

[somarco]

how many lives before it makes sense to self-insure and stop-loss?

IMO, 100 lives.

A few years ago there were TPA's in Tampa writing 10 lives on a self funded basis. When I was in the stop loss biz we had groups down to 25 lives.

At 100 the group starts to become credible. Most carriers consider 300 lives to be fully credible. Others use what they call "life years" at work from 1000 life years.

Translation, a 200 life case with 5 yrs claim experience would be considered credible as having 1000 life years.

 

[Alston]

I doubt very much that the 100% HSA is going away. Maybe with 3rd world carriers like American Community, World, or American Republic. This sounds like crappy information to me.

Anthem Blue Cross may be phasing out the 100% plans on the individual side in Connecticut. (I don't sell group so I don't know what they are doing in that area.) They introduced a few 80% plans this year and took away one or two of the 100% plans.