MERCER为美国保险业协会做的绝密HR分析报告(1).pptx
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1、Rich Bailey FSA,MAAA,FCARichmond,VAIs it Time for Employers to Move Away From the Traditional Ways of Providing Employee Benefits?November 3,2004Mercer Human Resource Consulting2021/9/111AgendanThe EnvironmentnThe Catch-22nPaths Away from Traditional Delivery:Two CampsnOpportunities Along Path 2nThe
2、 AnswernAdditional TopicsMercer Human Resource Consulting2021/9/112AgendanThe EnvironmentMedical TrendsLegislationMarketplace ChangesPopulation DemographicsEmployer OutlooknThe Catch-22nPaths Away from Traditional Delivery:Two CampsnOpportunities Along Path 2nThe AnswernAdditional TopicsMercer Human
3、 Resource Consulting2021/9/113Double-Digit Increase for Second Year in a RowPer employee costs in excess of$5,600 per year-2.9%+6.2%+7.3%+8.1%+11.2%+14.7%Source:2002 Mercer/Foster Higgins National Survey of Employer-sponsored Health PlansMercer Human Resource Consulting2021/9/114Annual CPI Trend U.S
4、.health care costs rise,despite continuing economic recessionThe gap between CPI-U and medical care component is increasingMercer Human Resource Consulting2021/9/115Comparison of Overall Growth Cumulative medical care CPI 89%greater than overall CPI since 1967Data based on January 1 CPI valuesMercer
5、 Human Resource Consulting2021/9/116Employers Cost Increases Out-Pace Other Indicators Largest increase since 1990(all employers)Includes medical,dental and pharmacySource:2002 Mercer/Foster Higgins National Survey of Employer-sponsored Health PlansResults for Employers with 500 or more lives6.9%18.
6、6%16.7%17.1%12.1%10.1%8.0%-1.1%0.2%6.1%7.3%8.1%11.2%14.7%2.1%2.5%-2.00%0.00%2.00%4.00%6.00%8.00%10.00%12.00%14.00%16.00%18.00%20.00%1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002EmployersCPI-MedicalCPI-All ItemsMercer Human Resource Consulting2021/9/117Aggregate Heal
7、th Care Spending(1980 2010)Government portion of payments increasing;total projected to be over$2 trillion by 2009Source:CMSMercer Human Resource Consulting2021/9/118Medical TrendsnPop QuiznHow many years will it take gross medical costs to double,assuming no specific employer interventions or natio
8、nal health care?10 or more98765 or fewerMercer Human Resource Consulting2021/9/119Medical TrendsResponses from a group of 25 actuaries who had time to get their calculatorsMercer Human Resource Consulting2021/9/1110LegislationnMedicare Prescription DrugsIf made into law,will have major impact on ret
9、iree benefits and strategiesInitial confusion aside,should have positive impact on retiree plansExpect cost shifting to negatively impact active plansnEEOC Proposed changes in ADEA regulationsCline vs.General DynamicsnWells Fargo caseAppears to allow pre-funding(and tax-deductibility)of entire retir
10、ee liabilityoan ILP approachowont be exactly same number as FAS liabilityofunding in years 2+would be limited to service costIRS weighing its optionsMercer Human Resource Consulting2021/9/1111Proposals to Increase Coverage Among Early RetireesFew government programs except for financially indigentnC
11、OBRA extensions and/or Medicare buy-insnProhibitions on post-retirement benefit reductionsnExpanded pre-funding for retiree medicalStill few viable products for pre-65 in individual market that overcome access and affordability issues.Mercer Human Resource Consulting2021/9/1112ADEA IssuesImpact on r
12、etiree medical coveragenAge Discrimination in Employment Act(ADEA)prohibits discrimination against persons age 40 or older in terms and conditions of employmentnAge-based distinctions in employee benefit plans are permissible only if:A specific statutory exception applies,orEqual benefit/equal cost
13、test is satisfiedoPlan must provide equal benefits for older and younger workers,oroPlan must incur equal costs for older and younger workersnThird and Sixth Circuit Courts reach different conclusionsnEEOC reviewing ADEA regulationsMercer Human Resource Consulting2021/9/1113Marketplace ChangesConsol
14、idation of Major Health Care Carriers Employer options are greatly reduced,carriers have more cloutUnited HealthcareHealthSourceProvidentCIGNAEquicorMetrahealthUS HealthcareAetnaTakeCareFHPPacifiCareHealthSourceCIGNAAetna US HealthcareNYLCarePrudential HealthCareFHPPacifiCareProvidentTransamericaEqu
15、itableHCAMetropolitanPartnersAetnaGSDHPLincoln National HPsTakeCarePacifiCareHealth Plan of AmericaWellPoint/Blue Cross of CaliforniaHancockMass MutualTravelersUnited HealthcareAetnaPacifiCare Health SystemsWellPoint/BlueCross of CaliforniaCIGNABCBS of GeorgiaMultiple BCBS PlansFewerMajor BCBSMercer
16、 Human Resource Consulting2021/9/1114Marketplace Changes PBM consolidation continues;three major national PBMs remainCPIAPICPNRxNetValue RxDiagnostekPerformHCSHPIDiagnostekValue RxRxNetColumbiaValue RxExpress ScriptsExpress ScriptsNPADPSExpress ScriptsPAIDMEDCOAdvanced ParadigmAdvanceMedcoIntegrated
17、 Prescription Solutions(IPS)PCSFoundationMerck-MedcoMerck-MedcoProadvantageSystemedParadigmMerck-MedcoMedcoAdvance PCSMajor InsurersMajorInsurersMPSPCSClinical Pharmacy AdvantageMercer Human Resource Consulting2021/9/1115Population TrendsAging baby boomers will increase the elderly and near elderly
18、populationsData Source:U.S.Census Bureau State Population ProjectionsBaby Boomers Year of Birth 1946 to 1964Source:U.S.Census Bureau as of January 2000U.S.Population,2000Projected PopulationMillionsMercer Human Resource Consulting2021/9/1116Negative Tidal Wave of Available Talent Pool of“prime worke
19、rs”will be decreasing Source:DRI,World at Work Journal,fourth quarter 2001Percent Change in Population by Age Group,2000-10-20%-10%0%10%20%30%40%50%60%5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79The“Echo boom”ages 15-29Shrinking Pool of“Prime workers”ages 3
20、0-44Aging“Baby boomers”ages 45-69Mercer Human Resource Consulting2021/9/1117Impact of Demographics on Health Care Cost Cost increases with age0.000.501.001.502.002.503.0020-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-6465+AgeRelative Cost by AgeMaleFemaleAverage employer cost=1.0Relative Costs B
21、y Age and GenderMercer Human Resource Consulting2021/9/1118Health Deterioration A cause and a consequence nWe eat too much-64.5%of adults overweightnPopulation with diabetes increased over 50%in last decade*Overweight is roughly 10 to 30 pounds over an ideal weight.Obesity is roughly 30 pounds over
22、an ideal weightSource:National Health and Nutrition Examination Survey45.0%47.0%47.0%56.0%64.5%Mercer Human Resource Consulting2021/9/1119Issues Facing Businesses The perfect storm nLow ambient inflation;high medical inflationnAdvances in medical technology likely to lead to higher costs,difficult d
23、ecisionsnLegislative uncertaintynConsolidating medical delivery and financing systemnAn aging workforcenIncreased longevitynSlowing economynDisappearing over-funded pension plansnFew,if any,obvious and easy alternatives to managing health care costsMercer Human Resource Consulting2021/9/1120Employer
24、 OutlooknEnvironmental outlook spurring employer actionEmployers acutely aware of trendsnHeightened interest in cost saving strategies(active and retiree)nGreater emphasis on longer term cost projections and on the“bottom line”nProjection results have induced“fight or flight”responsesMercer Human Re
25、source Consulting2021/9/1121Retiree Medical Coverage Employers continue to drop retiree medical coveragePercentage of EmployersOffering Coverage to Future RetireesBased on employers of 500 or more lives responding to the2001 Mercer/Foster Higgins Survey of Employer-Sponsored Health PlansnWhen covera
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