2016 Insurance Plans Survey: Health and Prescription Drugs

Transcription

1 2016 Insurance Plans Survey: Health and Prescription Drugs Welcome to MRA's 2016 Insurance Plans Survey! Thank you for taking part in this survey on health insurance plans and prescription drugs. Key dates to remember are: SURVEY DEADLINE: July 15, 2016 REPORT PUBLISHED: October 2016 MRA members receive the PDF report FREE with participation. THINGS TO REMEMBER as you complete the survey: NOTE: If your company's Health & Prescription Drug Plan is organization-wide, please complete the survey only once. If the company's insurance plan is different for each location, please complete a separate survey for each location. At the end of the survey you will be given the opportunity to open an additional survey to report on another location. Repeat this process until all locations have been submitted. If your company's Health & Prescription Drug benefits are significantly different between employee groups, please complete the survey for the group that includes the vast majority of your company's employees. You can stop your survey at any time by selecting "Save Temporarily" to pick up at a later time. After submitting the survey, you will be able to print and/or save your responses for your records. Once submitted, changes cannot be made. Survey announcements will be ed to your organization's designated Survey Contact. Only one Internet Browser window should be open when completing the survey. If you would like to prepare your answers beforehand, click here to print the survey. MRA's Survey Department is here to help! Contact us at ext or surveys@mranet.org. PARTICIPATING COMPANY DEMOGRAPHICS 1 Company Information: For your convenience we ve pre-populated some of the fields. You may change them if needed. Please fill in your name, phone # and so that we may contact you if we

2 have questions regarding your submission. Company Name Address City State Zip Code Questionnaire completed by Phone # Ext # 2 Choose your final report format: The final report will be ed / mailed to the survey contact designated by your company. Free easy-to-use bookmarked PDF (available 2-3 weeks earlier than paper) Paper copies are available for $125 CW SHRM member participant PDF for $250 3 Location of organizational unit reported in this questionnaire: Please report on one state/region at a time. Complete a separate questionnaire for each subsidiary, division or facility located in one of the different locations listed below. At the end of the survey you will be given the opportunity to open an additional survey to report on another state/region. Please continue in this manner until you have completed submitting data for all your states/regions. Wisconsin Minnesota Illinois Iowa 4 What is your company s primary industry? Manufacturing Service / Non-Manufacturing Financial / Insurance / Real Estate

3 Government / Education / Non-profit Health Care Other 5 Size of organizational unit reported in this questionnaire: This is the employment group in which your survey data will be compiled. If your company s health and prescription drug plan is organization-wide, please indicate here the number of people employed by the organization as a whole. If the company s insurance plan is different for different locations, please complete a separate survey for each location and indicate here the number of people employed at this location. Less than 25 employees 25 to 49 employees 50 to 99 employees 100 to 499 employees 500 to 999 employees 1,000 employees or more MEDICAL PLAN OVERVIEW Answer the following questions for employees who work at least 30 hours per week or 130 hours or more per month. Part-time employees will be addressed in a separate set of questions later in the survey. 6 Does your company offer a medical insurance plan to employees? Checking No indicates there is no medical insurance benefit offered to any employee. Yes No 7 What is the total number of active employees who are ELIGIBLE for medical insurance at your company or at this location? 8 What is the total number of active employees who are ENROLLED in the medical insurance plan at your company or at this location?

4 9 Are medical insurance benefits for any hourly employees in your company determined through collective bargaining? Yes No 10 What is the funding method used for your company s medical insurance plan? Fully-insured only Self-insured (self-funded) only Self-insured with stop-loss insurance 11 If your company purchases stop-loss coverage, what is the type? Specific stop-loss coverage only Aggregate stop-loss coverage only Both specific and aggregate stop-loss coverage COST STRATEGIES 12 At your most recent plan renewal, what was the INITIAL proposed percentage increase or decrease (prior to any plan or carrier changes) and the FINAL increase or decrease in total premiums as of your most recent plan renewal? Enter numbers only. Do not include the '%' sign. Please enter 25 percent as '25', not '0.25'. NOTE: If your plan is self-insured, indicate the percentage increase in COBRA premiums. Initial % Final % 13 What percent (%) of Total Gross Payroll did your company s medical, dental, vision and prescription drug plans represent in 2015?

5 Include the TOTAL premium - both employer and employee contributions. Enter numbers only. Do not include the '%' sign. Please enter 25 percent as '25', not '0.25'. 14 Did your medical insurance costs rise at the most recent plan renewal? Yes No 15 Did your company pass on the cost increase to employees? Yes, we passed on the entire cost of the increase Yes, but we absorbed some of the increase (less than half) Yes, but we absorbed most of the increase (more than half) Yes, but we shared the cost increase 50/50 with participants No, we absorbed all of the increase 16 Does your company currently employ any of the following strategies to control participation in your medical plan? Check all that apply and answer the follow-up question on incentive amounts / surcharges as applicable. DO NOT enter percents. Eligibility Audit - Performed internally Eligibility Audit - Outsourced to vendor Spousal Carve-Out (Spouses who are eligible for coverage from another plan must carry that coverage instead of your company s plan) Spousal Surcharge (Spouse with other plan coverage available pays more to remain on your plan) What is the dollar amount of the surcharge per month? Opt Out/Waiver for SINGLE coverage ( receives incentive pay to not enroll in company s medical plan) What is the dollar amount of the incentive per month? Opt Out/Waiver for FAMILY coverage ( receives incentive pay to not enroll in company s medical plan) What is the dollar amount of the incentive per month? Tobacco Use surcharge or incentive discount What is the dollar amount of the surcharge or incentive per month? Other; please specify:

6 17 What cost containment strategies, if any, has your company already implemented or plans to implement in the next 18 months to address medical care costs? Increase employee contributions to premium Cost containment strategy already implemented Plan to implement this cost containment strategy (next 18 months) Increase employee deductible Increase employee outof-pocket Increase prescription drug copay Increase copay for doctor visits Change provider or carrier Move to more narrow network plan design Move plan to the Public Marketplace Exchange Move plan to a Private Exchange/Defined Contribution Plan Provide cost and quality transparency to participants Eligibility audit Opt out/waiver

7 Spousal carve out Spousal surcharge Switch from fullyinsured plan to selfinsured plan, or vice versa Drop coverage No cost containment strategies taken 18 What wellness strategies, if any, has your company already implemented or plans to implement in the next 18 months to address medical care costs? Health risk assessments Wellness strategy already implemented Plan to implement this wellness strategy (next 18 months) Biometric Screenings (blood pressure, weight, cholesterol, etc.) Classes/Lunch & Learns Health coaches Online health information Incentive campaigns

8 Smoking/Tobacco cessation resources Weight Loss management On site fitness facility On site nurse or medical professional Other No wellness strategies taken MEDICAL PLANS 19 What is the effective date of the annual plan year? January 1 February 1 March 1 April 1 May 1 June 1 July 1 August 1 September 1 October 1 November 1 December 1 Other: 20 What is the total number of plans offered to active employees? One medical plan A choice of 2 medical plans A choice of 3 or more medical plans

9 21 Indicate the type(s) of plan(s) offered. Note: CDHP/HDHP are defined as: 1. Health plans with a deductible of at least $1,300 for single coverage and $2,600 for family coverage offered with an HRA (Health Reimbursement Arrangement) or 2. High deductible health plans that meet the requirements to allow an enrollee to establish and contribute to an HSA (Health Savings Account). Please select all that apply. PPO (Preferred Provider Organization) without an HRA or HSA POS (Point of Service plan) without an HRA or HSA HMO (Health Maintenance Organization) without an HRA or HSA Narrow Network - sometimes known as an ACO (Accountable Care Organization) plan CDHP/HDHP with Savings Option (Consumer Directed Health Plan / High Deductible Health Plan. If you have an HRA and/or HSA select this option.) 22 Check all premium tiers that apply to your PPO plan: Family 23 What are contributions to your PPO Plan based on? Dollar Amount or Percent of Premium Self-Insured Organization's COBRA Premium Small Employer Age-Rated Bands Years of Service Wellness-Based Percent of Salary 24 PPO PLAN Indicate the MONTHLY premium amount. Total premium includes BOTH the company and employee contributions to premium If your company offers more than one plan of this type, answer the following for the plan that has the highest level of enrollment. If you have additional plans that you d like to report on, you will be given the opportunity to do so immediately upon completion of this survey.

10 - If self-insured, report COBRA premium - If a small employer with age-rated bands, report the premium for typical/representative employee and/or family - If years of service, percent of salary or wellness-based, report the premium for typical/representative employee and/or family Total Monthly Premium ($), including both EMPLOYER and EMPLOYEE amounts $ Amount paid by EMPLOYEE Family $ Amount paid by EMPLOYER 25 Please select those services that require a copay, and enter the corresponding copay amount. Primary Care Physician Specialty Care Physician Urgent Care Emergency Room No copay for any of these 26 Enter the annual plan in-network deductible. If a health reimbursement plan is applicable, INCLUDE the impact of HRA contributions toward deductibles. For example: Plan deductible $2,000/single, less $500 HRA reimbursement = $1,500 net plan deductible (Enter this amount). Family 27 Enter the coinsurance percentage for in-network: Total must = 100% NOTE: Typically the employee portion is lower than the insurance portion. % Pays (lower %) % Insurance Pays (higher %) 28

11 Check all of the tier levels in the PPO prescription drug plan: For the purpose of this survey, we are only collecting data on tiers 1, 2 & 3. Check all that apply. Tier 1 - Generic Tier 2 - Preferred Tier 3 - Non-Preferred 29 Indicate the design of your prescription drug plan. Copay only Copay only after medical plan deductible is met Copay only after prescription drug plan deductible is met Copay only after medical plan deductible and coinsurance are met 100% covered after medical plan annual deductible is met 100% covered after coinsurance and annual deductible are met Some tiers with copays and some tiers with coinsurance Other 30 Enter the employee copay, deductible and/or coinsurance for each tier: Tier 1 - Generic Tier 2 - Preferred Tier 3 - Non- Preferred Copay $ Prescription Plan Only Deductible $ Medical Plan Only Deductible $ Coinsurance % Other (specify) 31 Check all premium tiers that apply to your POS plan: Family 32 What are contributions to your POS Plan based on?

12 Dollar Amount or Percent of Premium Self-Insured Organization's COBRA Premium Small Employer Age-Rated Bands Years of Service Wellness-Based Percent of Salary 33 POS PLAN Indicate the MONTHLY premium amount. Total premium includes BOTH the company and employee contributions to premium If your company offers more than one plan of this type, answer the following for the plan that has the highest level of enrollment. If you have additional plans that you d like to report on, you will be given the opportunity at the end of the survey to do so. - If self-insured, report COBRA premium - If a small employer with age-rated bands, report the premium for typical/representative employee and/or family - If years of service, percent of salary or wellness-based, report the premium for typical/representative employee and/or family Total Monthly Premium ($), including both EMPLOYER and EMPLOYEE amounts $ Amount paid by EMPLOYEE Family $ Amount paid by EMPLOYER 34 Please select those services that require a copay, and enter the corresponding copay amount. Primary Care Physician Specialty Care Physician Urgent Care Emergency Room No copay for any of the above 35 Enter the annual plan in-network deductible. If a health reimbursement plan is applicable, INCLUDE the impact of HRA contributions toward deductibles. For example: Plan deductible $2,000/single, less $500 HRA reimbursement = $1,500 net plan deductible (Enter this amount).

13 Family 36 Enter the coinsurance percentage for in-network: Total must = 100% NOTE: Typically the employee portion is lower than the insurance portion. % Pays (lower %) % Insurance Pays (higher %) 37 Check all of the tier levels in the POS prescription drug plan: For the purpose of this survey, we are only collecting data on tiers 1, 2 & 3. Check all that apply. Tier 1 - Generic Tier 2 - Preferred Tier 3 - Non-Preferred 38 Indicate the design of your prescription drug plan. Copay only Copay only after medical plan deductible is met Copay only after prescription drug plan deductible is met Copay only after medical plan deductible and coinsurance are met 100% covered after medical plan annual deductible is met 100% covered after coinsurance and annual deductible are met Some tiers with copays and some tiers with coinsurance Other 39 Enter the employee copay, deductible and/or coinsurance for each tier. Copay $ Prescription Plan Only Deductible $ Medical Plan Only Deductible $ Coinsurance % Other (specify)

14 Tier 1 - Generic Tier 2 - Preferred Tier 3 - Non- Preferred 40 Check all premium tiers that apply to your HMO plan: Family 41 What are contributions to your HMO Plan based on? Dollar Amount or Percent of Premium Self-Insured Organization's COBRA Premium Small Employer Age-Rated Bands Years of Service Wellness-Based Percent of Salary 42 HMO PLAN Indicate the MONTHLY amount for each tier. Total premium includes BOTH the company and employee contributions to premium If your company offers more than one plan of this type, answer the following for the plan that has the highest level of enrollment. If you have additional plans that you d like to report on, you will be given the opportunity at the end of the survey to do so. - If self-insured, report COBRA premium - If a small employer with age-rated bands, report the premium for typical/representative employee and/or family - If years of service, percent of salary or wellness-based, report the premium for typical/representative employee and/or family Total Monthly Premium ($), including both EMPLOYER and EMPLOYEE amounts $ Amount paid by EMPLOYEE Family $ Amount paid by EMPLOYER 43

15 Please select those services that require a copay, and enter the corresponding copay amount. Primary Care Physician Specialty Care Physician Urgent Care Emergency Room No copay for any of the above 44 Enter the annual plan in-network deductible. If a health reimbursement plan is applicable, INCLUDE the impact of HRA contributions toward deductibles. For example: Plan deductible $2,000/single, less $500 HRA reimbursement = $1,500 net plan deductible (Enter this amount). Family 45 Enter the coinsurance percentage for in-network: Total must = 100% NOTE: Typically the employee portion is lower than the insurance portion. % Pays (lower %) % Insurance Pays (higher %) 46 Indicate the design of your prescription drug plan. Copay only Copay only after medical plan deductible is met Copay only after prescription drug plan deductible is met Copay only after medical plan deductible and coinsurance are met 100% covered after medical plan annual deductible is met 100% covered after coinsurance and annual deductible are met Some tiers with copays and some tiers with coinsurance Other

16 47 Check all of the tier levels in the HMO prescription drug plan: For the purpose of this survey, we are only collecting data on tiers 1, 2 & 3. Check all that apply. Tier 1 - Generic Tier 2 - Preferred Tier 3 - Non-Preferred 48 Enter the employee copay, deductible and/or coinsurance for each tier. Tier 1 Generic Tier 2 Preferred Tier 3 Nonpreferred Copay $ Prescription Plan Only Deductible $ Medical Plan Only Deductible $ Coinsurance % Other (specify) 49 Check all premium tiers that apply to your Narrow Network (ACO) plan: Family 50 What are contributions to your Narrow Network (ACO) Plan based on? Dollar Amount or Percent of Premium Self-Insured Organization's COBRA Premium Small Employer Age-Rated Bands Years of Service Wellness-Based Percent of Salary 51

17 NARROW NETWORK (ACO) PLAN Indicate the MONTHLY premium amount : Total premium includes BOTH the company and employee contributions to premium If your company offers more than one plan of this type, answer the following for the plan that has the highest level of enrollment. If you have additional plans that you d like to report on, you will be given the opportunity at the end of the survey to do so. - If self-insured, report COBRA premium - If a small employer with age-rated bands, report the premium for typical/representative employee and/or family - If years of service, percent of salary or wellness-based, report the premium for typical/representative employee and/or family Total Monthly Premium ($), including both EMPLOYER and EMPLOYEE amounts $ Amount paid by EMPLOYEE Family $ Amount paid by EMPLOYER 52 Please select those services that require a copay, and enter the corresponding copay amount. Primary Care Physician Specialty Care Physician Urgent Care Emergency Room No copay for any of the above 53 Enter the annual plan in-network deductible. If a health reimbursement plan is applicable, INCLUDE the impact of HRA contributions toward deductibles. For example: Plan deductible $2,000/single, less $500 HRA reimbursement = $1,500 net plan deductible (Enter this amount). Family 54 Enter the coinsurance percentage for in-network: Total must = 100% NOTE: Typically the employee portion is lower than the insurance portion.

18 % Pays (lower %) % Insurance Pays (higher %) 55 Check all of the tier levels in the Narrow Network (ACO) prescription drug plan: For the purpose of this survey, we are only collecting data on tiers 1, 2 & 3. Check all that apply. Tier 1 - Generic Tier 2 - Preferred Tier 3 - Non-Preferred 56 Indicate the design of your prescription drug plan. Copay only Copay only after medical plan deductible is met Copay only after prescription drug plan deductible is met Copay only after medical plan deductible and coinsurance are met 100% covered after medical plan annual deductible is met 100% covered after coinsurance and annual deductible are met Some tiers with copays and some tiers with coinsurance Other 57 Enter the employee copay, deductible and/or coinsurance for each tier. Tier 1 - Generic Tier 2 - Preferred Tier 3 - Non- Preferred Copay $ Prescription Plan Only Deductible $ Medical Plan Only Deductible $ Coinsurance % Other (specify) CDHP/HDHP with SAVINGS OPTION

19 58 Check all premium tiers that apply to your CDHP/HDHP plan: Family 59 What are contributions to your CDHP/HDHP Plan based on? Dollar Amount or Percent of Premium Self-Insured Organization's COBRA Premium Small Employer Age-Rated Bands Years of Service Wellness-Based Percent of Salary 60 CDHP/HDHP PLAN Indicate the MONTHLY amount for each tier: Total premium includes BOTH the company and employee contributions to premium If your company offers more than one plan of this type, answer the following for the plan that has the highest level of enrollment. If you have additional plans that you d like to report on, you will be given the opportunity at the end of the survey to do so. - If self-insured, report COBRA premium - If a small employer with age-rated bands, report the premium for typical/representative employee and/or family - If years of service, percent of salary or wellness-based, report the premium for typical/representative employee and/or family Total Monthly Premium ($), including both EMPLOYER and EMPLOYEE amounts $ Amount paid by EMPLOYEE Family $ Amount paid by EMPLOYER 61 Please select those services that require a copay, and enter the corresponding copay amount. Primary Care Physician Specialty Care Physician Urgent Care Emergency Room

20 No copay for any of the above 62 Enter the annual plan in-network deductible. If a health reimbursement plan is applicable, INCLUDE the impact of HRA contributions toward deductibles. For example: Plan deductible $2,000/single, less $500 HRA reimbursement = $1,500 net plan deductible (Enter this amount). Family 63 Enter the coinsurance percentage for in-network: Total must = 100% NOTE: Typically the employee portion is lower than the insurance portion. % Pays (lower %) % Insurance Pays (higher %) 64 Check all of the tier levels in the CDHP/HDHP prescription drug plan: For the purpose of this survey, we are only collecting data on tiers 1, 2 & 3. Check all that apply. Tier 1 - Generic Tier 2 - Preferred Tier 3 - Non-Preferred 65 Indicate the design of your prescription drug plan. Copay only Copay only after medical plan deductible is met Copay only after prescription drug plan deductible is met Copay only after medical plan deductible and coinsurance are met 100% covered after medical plan annual deductible is met 100% covered after coinsurance and annual deductible are met

21 Some tiers with copays and some tiers with coinsurance Other 66 Enter the employee copay, deductible and/or coinsurance for each tier. Tier 1 - Generic Tier 2 - Preferred Tier 3 - Non- Preferred Copay $ Prescription Plan Only Deductible $ Medical Plan Only Deductible $ Coinsurance % Other (specify) 67 Does this plan include: A HRA Health Reimbursement Arrangement (HRA) A Health Savings Account (HSA) Both of the above None of the above HEALTH REIMBURSEMENT ACCOUNT (HRA) 68 What is the company s annual HRA reimbursement allowance per participant? Include total reimbursements for all that apply (copays, deductibles, and coinsurance). Family 69 If the costs are split by the company and the employee, what portion does the employee pay? pays first, HRA pays second HRA pays first, employee pays second

22 Stacked plan employee pays first portion, HRA pays second, employee pays final portion Stacked plan HRA pays first portion, employee pays second, HRA pays final portion 70 Does your HRA offer a rollover of unused funds? Yes No 71 What is the maximum dollar amount that can be rolled over in your HRA? $ Family $ HEALTH SAVINGS ACCOUNT (HSA) 72 Does your company contribute to the employee s HSA account? Yes No 73 Enter the company s annual contribution to the employee s HSA: Family PART-TIME EMPLOYEES 74 Does your company offer medical plan coverage to part-time employees (employees who work less than 30 hours a week)? Yes

23 No 75 What percent of premiums do part-time employees pay in comparison to full-time employees? Higher percentage of premium than full-time employees Same premium as full-time employees 76 Do you plan to continue offering employer-sponsored medical insurance in 2017? Yes, we are likely to continue offering employer-sponsored medical insurance coverage No, we are very to somewhat likely, to drop coverage No, we are planning to terminate coverage completely No, we have already dropped coverage Unsure 77 Thinking about the costs and features related to a medical plan, what do you think are the three most important considerations for employees? What is most important to them? Select three from the list below. Whether or not their primary care physician is in/out of network Whether or not their specialty physician/s is in/out of network Whether or not their preferred hospital system is in/out of network The amount the employee contributes to the monthly premium The amount the employee pays for the deductible The employee s share of the co-pay for doctor visits The employee s share of copay for prescription drugs Number of hours worked to qualify for health insurance Other (Specify:) PATIENT PROTECTION & AFFORDABLE CARE ACT (ACA/HEALTH CARE REFORM) 78 Has your organization enrolled its employees into the Public Marketplace Exchange or into a Private Exchange?

24 Yes, we have enrolled our employees into the Public Marketplace Exchange Yes, we have enrolled our employees into a Private Exchange No, but enrolling employees into the Public Marketplace Exchange may be considered in the future No, but enrolling employees into a Private Exchange may be considered in the future No, we have no intentions of taking this action at this time Unsure 79 Which standard measurement period is being used to determine who is a full-time employee? 3 month look back period 6 month look back period 9 month look back period 12 month look back period Monthly Measurement Method Undetermined at this time Do not know Does not apply, we have less than 50 employees 80 In what area do you or your organization have the least level of understanding or knowledge? Public Marketplace Exchange Private Exchanges/Defined contribution plans Employer Shared Responsibility (a.k.a. Pay or Play ) Measurement periods Reporting requirements Wellness programs 81 From which source is your organization seeking advice regarding health care reform? Check all that apply Insurance broker Insurance carrier Independent consulting services Law firm Internal personnel Outside presentations, webinars, etc. None

25 82 Is your organization planning to sustain an employment level under the 50 employee threshold to remain a small employer? Yes, we have taken this action Yes, we are planning this action in the upcoming year No, we are a large employer (50+ employees) and this does not impact us No, we are a small employer (49 or less employees) and we currently have no plans to take this action Unsure 83 Is your organization planning to limit hours so fewer employees would qualify as full-time in regard to medical insurance eligibility? Yes, we have already taken this action Yes, we are planning this action in the upcoming year No, we currently have no plans to take this action Unsure 84 Which safe harbor method is your company utilizing to determine affordability of your lowest cost plan? W2 method, 9.66% of employee wage Rate of pay, 9.66% of monthly wage Federal Poverty Level, 9.66% of single FPL Undetermined at this time Do not know Does not apply, we have less than 50 employees 85 Congratulations! You have reached the end of the survey. Before you go, please share with us any comments you may have about the survey, its content, or other questions you would like to have included. When finished, please click the "Submit Survey" button to complete your submission.