MERCER为美国保险业协会做的绝密HR分析报告vze.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 ConsultingAgendanThe EnvironmentnThe Catch-22nPaths Away from Traditional Delivery:Two CampsnOpportunities Along Path 2nThe AnswernAd
2、ditional Topics1Mercer Human Resource ConsultingAgendanThe EnvironmentMedical TrendsLegislationMarketplace ChangesPopulation DemographicsEmployer OutlooknThe Catch-22nPaths Away from Traditional Delivery:Two CampsnOpportunities Along Path 2nThe AnswernAdditional Topics2Mercer Human Resource Consulti
3、ngDouble-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 Plans3Mercer Human Resource ConsultingAnnual CPI Trend U.S.health care costs rise,despite conti
4、nuing economic recessionThe gap between CPI-U and medical care component is increasing4Mercer Human Resource ConsultingComparison of Overall Growth Cumulative medical care CPI 89%greater than overall CPI since 1967Data based on January 1 CPI values5Mercer Human Resource ConsultingEmployers Cost Incr
5、eases 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%16.7%17.1%12.1%10.1%8.0%-1.1%0.2%6.1%7.3%8.1%11.2%14.
6、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 Items6Mercer Human Resource ConsultingAggregate Health Care Spending(1980 2010)Government portion of payments increa
7、sing;total projected to be over$2 trillion by 2009Source:CMS7Mercer Human Resource ConsultingMedical TrendsnPop QuiznHow many years will it take gross medical costs to double,assuming no specific employer interventions or national health care?10 or more98765 or fewer8Mercer Human Resource Consulting
8、Medical TrendsResponses from a group of 25 actuaries who had time to get their calculators9Mercer Human Resource ConsultingLegislationnMedicare Prescription DrugsIf made into law,will have major impact on retiree benefits and strategiesInitial confusion aside,should have positive impact on retiree p
9、lansExpect 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 retiree liabilityoan ILP approachowont be exactly same number as FAS liabilityofunding in years 2
10、+would be limited to service costIRS weighing its options10Mercer Human Resource ConsultingProposals to Increase Coverage Among Early RetireesFew government programs except for financially indigentnCOBRA extensions and/or Medicare buy-insnProhibitions on post-retirement benefit reductionsnExpanded p
11、re-funding for retiree medicalStill few viable products for pre-65 in individual market that overcome access and affordability issues.11Mercer Human Resource ConsultingADEA IssuesImpact on retiree medical coveragenAge Discrimination in Employment Act(ADEA)prohibits discrimination against persons age
12、 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 test is satisfiedoPlan must provide equal benefits for older and younger workers,oroPlan must incur equal cost
13、s for older and younger workersnThird and Sixth Circuit Courts reach different conclusionsnEEOC reviewing ADEA regulations12Mercer Human Resource ConsultingMarketplace ChangesConsolidation of Major Health Care Carriers Employer options are greatly reduced,carriers have more cloutUnited HealthcareHea
14、lthSourceProvidentCIGNAEquicorMetrahealthUS HealthcareAetnaTakeCareFHPPacifiCareHealthSourceCIGNAAetna US HealthcareNYLCarePrudential HealthCareFHPPacifiCareProvidentTransamericaEquitableHCAMetropolitanPartnersAetnaGSDHPLincoln National HPsTakeCarePacifiCareHealth Plan of AmericaWellPoint/Blue Cross
15、 of CaliforniaHancockMass MutualTravelersUnited HealthcareAetnaPacifiCare Health SystemsWellPoint/BlueCross of CaliforniaCIGNABCBS of GeorgiaMultiple BCBS PlansFewerMajor BCBS13Mercer Human Resource ConsultingMarketplace Changes PBM consolidation continues;three major national PBMs remainCPIAPICPNRx
16、NetValue RxDiagnostekPerformHCSHPIDiagnostekValue RxRxNetColumbiaValue RxExpress ScriptsExpress ScriptsNPADPSExpress ScriptsPAIDMEDCOAdvanced ParadigmAdvanceMedcoIntegrated Prescription Solutions(IPS)PCSFoundationMerck-MedcoMerck-MedcoProadvantageSystemedParadigmMerck-MedcoMedcoAdvance PCSMajor Insu
17、rersMajorInsurersMPSPCSClinical Pharmacy Advantage14Mercer Human Resource ConsultingPopulation TrendsAging baby boomers will increase the elderly and near elderly populationsData Source:U.S.Census Bureau State Population ProjectionsBaby Boomers Year of Birth 1946 to 1964Source:U.S.Census Bureau as o
18、f January 2000U.S.Population,2000Projected PopulationMillions15Mercer Human Resource ConsultingNegative Tidal Wave of Available Talent Pool of“prime workers”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%5
19、0%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 30-44Aging“Baby boomers”ages 45-6916Mercer Human Resource ConsultingImpact of Demographics on Health Care Cost Cost increases with age0.000.501.001
20、.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 By Age and Gender17Mercer Human Resource ConsultingHealth Deterioration A cause and a consequence nWe eat too much-64.5%of adults overweightnPopulation with
21、 diabetes increased over 50%in last decade*Overweight is roughly 10 to 30 pounds over an ideal weight.Obesity is roughly 30 pounds over an ideal weightSource:National Health and Nutrition Examination Survey45.0%47.0%47.0%56.0%64.5%18Mercer Human Resource ConsultingIssues Facing Businesses The perfec
22、t storm nLow ambient inflation;high medical inflationnAdvances in medical technology likely to lead to higher costs,difficult decisionsnLegislative uncertaintynConsolidating medical delivery and financing systemnAn aging workforcenIncreased longevitynSlowing economynDisappearing over-funded pension
23、plansnFew,if any,obvious and easy alternatives to managing health care costs19Mercer Human Resource ConsultingEmployer OutlooknEnvironmental outlook spurring employer actionEmployers acutely aware of trendsnHeightened interest in cost saving strategies(active and retiree)nGreater emphasis on longer
24、term cost projections and on the“bottom line”nProjection results have induced“fight or flight”responses20Mercer Human Resource ConsultingRetiree Medical Coverage Employers continue to drop retiree medical coveragePercentage of EmployersOffering Coverage to Future RetireesBased on employers of 500 or
25、 more lives responding to the2001 Mercer/Foster Higgins Survey of Employer-Sponsored Health PlansnWhen coverage is offered,retiree premiums and out-of-pocket costs often increase21Mercer Human Resource ConsultingAgendanThe EnvironmentnThe Catch-22nPaths Away from Traditional Delivery:Two CampsnOppor
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