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| 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.
Benefit
Plan Structure Prior to BeniComp® Advantage |
Employee
Deductible at $500 |
Core
Medical Plan |
|
The
BeniComp® Advantage Model
A Second Policy is Issued |
Revised
Core Medical Plan |
Employee
Deductible at $2,500 |
Employer
Payment
(Core Plan) |
Separate Fully Insured BeniComp® Advantage
Policy
Body
Mass Index |
Blood
Pressure |
Tobacco
Non-Use |
Cholesterol
Level |
Deductible
Reimbursement Policy
Employees earn $500-$2,000 |
Unearned
credits = employer savings! |
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 |
EMPLOYEE |
Core
Medical Plan
Base Deductible at $2,500 |
BeniComp
Advantage Plan |
| Body
Mass Index Credit $500* |
| Non-tobacco
Use Credit $500* |
| Blood
Pressure Credit $500* |
| Cholesterol
Credit $500* |
Net
Employee Responsibility $500 |
|
FAMILY |
Core
Medical Plan
Base Deductible at $5,000 |
BeniComp
Advantage Plan |
| Body
Mass Index Credit $1,000* |
| Non-tobacco
Use Credit $1,000* |
| Blood
Pressure Credit $1,000* |
| Cholesterol
Credit $1,000* |
Net
Employee Responsibility $1,000 |
|
*
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 |
EMPLOYEE |
Core
Medical Plan
Base Deductible at $2,500 |
BeniComp
Advantage Plan |
| Body
Mass Index Credit $0* |
| Non-tobacco
Use Credit $0* |
| Blood
Pressure Credit $500* |
| Cholesterol
Credit $500* |
Net
Employee Responsibility $1,500 |
|
FAMILY |
Core
Medical Plan
Base Deductible at $5,000 |
BeniComp
Advantage Plan |
| Body
Mass Index Credit $0* |
| Non-tobacco
Use Credit $0* |
| Blood
Pressure Credit $1,000* |
| Cholesterol
Credit $1,000* |
Net
Employee Responsibility $3,000 |
|
| *
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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