The rising
cost of major medical insurance is reaching crisis levels
-
Years ago, major medical insurance meant catastrophic coverage.
-
Today’s rich plans with low deductibles and co-pays are no
longer affordable
-
Reducing benefits (higher deductibles and co-pays) to reduce premiums
is the direction in which
the industry is headed
The
Med-Gap Card™ Administrative Package can be a part of a strategy
to:
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About
the Med-Gap Card™ Administrative Package
The Med-Gap Card™ is the latest innovation in our HRA / FSA /
DCA line-up. The card can be used worldwide wherever MasterCard®
is accepted to pay for qualifying medical and dependent care services.
It looks like a regular charge card, but this card is used to take funds
out of a Health Reimbursement Arrangement,Medical Flexible Spending
Account, and Dependent Care Account.
HRAs allow an employer to reimburse an employee for out-of-pocket medical
expenses on a tax-free basis. The employer makes a predetermined amount
available to each employee. The employee uses the money to pay for qualified
expenses. If the employee does not use the money, the employer may allow
the carryover of unused funds for future use. Funds used to pay for
qualified medical expenses are considered a business expense for tax
purposes for the employer.
FSAs allow the employee to set aside pre-tax dollars through payroll
deduction to pay for qualified medical expenses. Unused funds cannot
be carried over to the next year and are forfeited to the employer at
the end of the plan year.
The tax
advantage to the employee is immediate as opposed to filing on their
tax return at the end of the year. Because the FSA is considered an
employer sponsored health plan, for tax purposes, it is an employer
business expense.
DCAs allow you to set aside pre-tax dollars through payroll deductions
for eligible anticipated dependent care expenses such as child care
or a dependent parent. Unused funds cannot be carried over to the next
year and are forfeited to the employer at the end of the plan year.
Employees save on state income, federal income, and social security
taxes on up to $5,000 a year for qualified dependent care expenses.
Simply present the Med-Gap Card™ at the time of purchase of qualified
medical and dependent care services, and the payment will be deducted
directly from your HRA, FSA or DCA.
- No
more waiting for your reimbursement check to arrive.
- No
double out-of-pocket payments.
- Very
little paperwork. Just fax a receipt if requested.
- Check
your balances on the web 24 hours per day.
The Med-Gap Card™ can help offset or cushion the impact of benefit
changes. Employees will appreciate:
- Convenient
access to the funds when they need them
- First
dollar coverage for out-of-pocket expenses
- Tax
savings (for the employee and employer) for amounts sheltered under
an FSA and DCA
It's simple. You are self-funding the smaller bills and using the major
medical plan to cover costs above this. Self-funding makes it possible
for you to save money. Based on our research, 75% of people covered
by a typical PPO co-pay plan do not meet a $500 deductible, and 84%
of people covered by a typical PPO co-pay plan do not meet a $1,000
deductible. Our research tells us that on the average only 1 in 20 people
are hospitalized each year. Since the employer is self-funding the claims
under the deductible, the money that is not used, is not paid to the
insurance company and therefore saved by the employer.
The only task required of the employer is to set up a bank account for
eligible expense payments and fund the account
when notified by MasterCard®. (No pre-funding is necessary)
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Example:
Health Reimbursement Arrangement
Current
Plan – Traditional Major Medical Plan:
$500 Deductible | 20% to $1,000 | Doctor 15/25 | RX $5/20/35
|
|
Employer
Changes the Group Major Medical Plan Design
Goal:
Maximum Premium Reduction / Minimum Risk Increase
Deductible
$1,000 | 20% $1,000 | Doctor $50/50 | RX $15/35/75
Raising the doctor and prescription drug co-pays, adding
a prescription drug deductible or eliminating the doctor and
prescription drug benefit will normally result in a significant
premium reduction.
| |
Census |
Current
Premium |
Renewal
Premium |
Proposed
Premium |
| E |
73 |
$267.85 |
$433.72 |
$375.81 |
| E/S |
3 |
$601.29 |
$968.84 |
$854.31 |
| E/C |
7 |
$483.46 |
$789.41 |
$622.66 |
| F |
9 |
$800.46 |
$1301.46 |
$1111.74 |
| Renewal
Annual Premium |
$621,661.32 |
| Proposed
Annual Premium |
$535,696.08 |
| Premium
Savings |
$85,965.24 |
**Projected
Savings and *Projected Costs assume that half of the
Med-Gap™ Card amounts are dispersed. All Savings
Illustrations are based on the current census and the
current premium rates of the major medical remaining constant
for a 12 month period. Any changes in either of these two components
will result in a corresponding change in the savings illustration.
Set up Fee and Administration Fee will vary
by type of plan selected. |
The
employer decides on Med-Gap Card™ Amounts
| |
Census |
HRA
Amount |
| Employee |
73 |
$500 |
| E
+ Spouse |
3 |
$1,000 |
E
+ Children |
7 |
$1,000 |
| Family |
9 |
$1,000 |
| Total
Med-Gap Card™ Liability |
$55,500 |
| Set
Up Fee |
$300 |
| Annual
Admin. Fee ($9 per employee per month) |
$9,936 |
| |
|
| Proposed
Annual Premium |
$535,696.08 |
| |
|
| Maximum
Plan Cost |
$601,432.08 |
| |
|
| Guaranteed
Savings |
$20,229.24 |
| |
|
| Projected
Plan Cost* |
$573,682.00 |
| |
|
| Projected
Savings** |
$47,979.24 |
|
The
Med-Gap Card™ – the Smart Choice!
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