Detailed Overview

What haven’t you tried? – BeniComp® Advantage!

You’ve increased employee contributions, raised copays and coinsurance, required generic prescriptions, implemented wellness awareness campaigns, what next? We all have tried to shift the cost of health care with plan design changes and by having our employees share in the cost. It simply has not worked. The cost of health care continues to escalate at an alarming rate and eat at our profits and our ability to invest in our companies and employees.

You will never impact the cause of a claim by merely shifting the cost of a claim.

Sources suggest that up to 70% of illnesses are lifestyle related. If many illnesses are lifestyle driven, then why not focus on the cause of the problem, lifestyle choices. The only way to truly reduce costs is to reduce claims. BeniComp® Advantage (BCA) is designed to affect the root cause of escalating health care costs – utilization of medical services. Employees who follow healthy lifestyles incur fewer claims and fewer claims mean lower health care costs. Unlike traditional disease management and wellness tools, employers benefit from BCA now! Employees benefit when they change behaviors.

BeniComp® Advantage works in conjunction with a high deductible health plan and is the first plan that rewards employees for managing their own health. If an employee maintains or improves their health, BeniComp® Advantage offers a financial reward. For those employees who choose not to modify their lifestyle, they do not receive these rewards and will incur higher out of pocket cost.

Either way, costs are allocated more fairly between employees with high and low utilization patterns, a much better way to share health care costs. BCA is voluntary – employees who do not participate simply have a higher deductible.

When employees see the rewards offered through the BeniComp® Advantage plan, they are encouraged to make positive lifestyle changes. Improving ones lifestyle provides a direct financial benefit that reinforces positive lifestyle choices. Employers save now by shifting costs and continue to save by changing trends.

BeniComp® Advantage is a fully insured supplemental product that supplements your current health plan. As a national health care solutions provider, we are prepared to administer your entire plan, offering a full administrative solution or work with your current administrator/carrier provided they qualify.

This insured product is a supplemental program that allows you, as the employer, to reward your employees based on their healthy life choices and to impact the long-term health trend by addressing escalating medical costs at its root … the cause of the claim. This program is structured to comply with all non-discrimination and employment law, including HIPAA.

 

Here’s How It Works

As seen with the sweeping move to high deductible plans, the creation of the Health Savings Accounts, Health Reimbursement Accounts and other Consumer Driven Plans, everyone is looking for a solution to help control cost. The BeniComp® Advantage plan does shift cost, but only to those who have lifestyles that threaten controlled premiums for the rest of the population.

It also gets to the root of the problem, utilization through lifestyle. Using BeniComp® Advantage, the base medical plan is the same for all employees. BeniComp® Advantage overlays the base medical plan with a policy that reimburses portions of an employees base plan deductible.

The BeniComp® Advantage Model

A Second Policy is Issued

Separate Fully Insured BeniComp® Advantage Policy

This example assumes that the base medical deductible is $500/$1,000 for the employee/family. When adding the Advantage product, the base medical plan deductible is increased by $2,000 making the deductible $2,500/$5,000 per employee/family. Employees can qualify for credits worth $500 each for the lifestyle choices shown. Employees, based on results from a medical screening, can qualify for any or all of the available credits by demonstrating appropriate body mass, blood pressure, and cholesterol levels, as well as non-tobacco use.

Each category met would translate to a $500 credit towards the $2,500 deductible illustrated ($4,000 toward the $5,000 family deductible), bringing employees who meet all four categories back to the original $500/$1,000 deductible. The range for each criterion can be set as generous or as tight as desired, allowing the employees to ease into this change and modify their lifestyles.

 

Employee #1 (example)

Employee #1 has qualified for all 4 categories; therefore, this employee receives a $2,000/$4,000 credit toward their deductible. They are still responsible for the $500/$1,000 base deductible amount.

BeniComp® Supplemental Policy

* Coinsurance may apply

 

Employee #2 (example)

Employee #2 has qualified for 2 of the 4 credits; therefore, this employee receives a $1,000/$2,000 credit toward their deductible and is responsible for a $1,500/$3,000.

BeniComp® Supplemental Policy

* Coinsurance may apply

Deductible reimbursements will begin after the employee has funded their portion of the deductible. 

Employers realize immediate savings in the following ways:

  • 12 – 18% net savings realized (includes cost of program)
  • Specific/aggregate premium reductions
  • Unearned credits shift claims cost to higher utilizers of the plan
  • Employees with few credits may be motivated to consider other coverage options
  • Increase ROI on Disease and Large Case Management due to early notification
  • 90% participation in voluntary wellness screenings, including a blood draw
  • Critical notifications to employees of potential serious conditions

Future Savings include:

  • Healthy lifestyles reduce claims experience
  • Cancer and respiratory risk reduced
  • Diabetes and heart disease risk reduced
  • Fewer sick days

Who is BeniComp®?

BeniComp® Group, Inc. developed the BeniComp® Advantage program and is an administrative partner offering an array of customized group health plan solutions to employers. BeniComp® is the administrator for the medical book of business for two national insurance companies: Government Personal Mutual Insurance Company and Assurity Life Insurance Company. BeniComp® is a national provider of health care solutions, uniquely positioned to administer both self-funded and fully insured health policies. BeniComp® has been in business since 1962 and is the administrator of over 550 employers nationwide.

Ready to take the next step in controlling your health care and improving the lifestyle of your employees? Call us at 260.482.7400 or toll free at 800.837.7400.

 

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Benicomp Advantage

8310 Clinton Park Drive
Ft.Wayne, IN 46825


info@benicompadvantage.com


Toll Free:  800-837-7400
Fax: (260) 469-2984

Toll free: 800-837-7400

8310 Clinton Park Drive
Ft.Wayne, IN 46825
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