1. The “balanced benefits” model: strategic employee
benefits design in the brave new world of healthcare
reform

2. Healthcare reform and you
• Healthcare reform isn’t coming, it’s already underway
• Simplified enrollment, guaranteed issue
• New distribution outlets for employers, individuals
• Substitution of technology to guide decision-making
• 80 - 85% of premium must be used for healthcare
• Mandated benefits
• Penalties for noncompliance
• McKinsey – at least 30% of employers are likely to drop their
sponsored health insurance plans in 2014
• Unhappy employees
• Unhappy employers
• Constantly shifting deadlines and regulations

3. The facts
• Cost of providing benefits to employees has skyrocketed,
primarily due to major medical coverage
• Average health insurance premium for family coverage in 2002
was $8,003
• Average health insurance premium for family coverage in 2012
is $15,745
• Average employer contribution in 2002 - $5,866
• Average employer contribution in 2012 - $11,429
• Between deductibles, co-pays and other out of pocket costs
an employee can easily spent $5,000 or more despite having
insurance coverage

4. The responses
• Reactive, not proactive
• Higher deductibles
• Higher co-pays
• Tiered drug formularies
• Step therapy
• “Consumer driven” plans
• Pure costs-shifting – pay more but don’t get more
• Strategy doesn’t address another, just as pressing set of
concerns

5. The missing link
• Employers and employees understandably focus on the cost
of health insurance and medical care when an employee
becomes ill
• It’s in the news, they see those dollars go out the door
• Premiums, co-pays, deductibles
• But that’s only half the equation
• What about mortgage or rent?
• What about car payments?
• College tuition?
• Groceries and utility bills?
• Income replacement is as important as health insurance

6. A health plan is not enough
• Employees need access to a portfolio of products that
address financial risk
• Section 125 plans and HSAs to use pre-tax dollars to pay for
unreimbursed healthcare expenses
• Gap plans
• Life insurance
• Short term disability
• Accidental injury
• Critical illnesses
• LIMRA 2011 Survey – one third of employers plan to offer
new voluntary benefits to replace existing employer paid and
contributory benefit

7. Helping a client choose
• Dozens of carriers
• Hundreds of products
• Everyone will tell you that they’re the best
• Wouldn’t it be nice to have an expert
• Knows the carriers
• Knows the products
• Can design a voluntary benefits package specifically tailored to
compliment and work in tandem with your sponsored benefits
• Successfully communicate the true value of your benefits
program to the workforce

8. We can help
• Unique understanding of the need for an integrated benefits
strategy
• Knowledge of health plans and voluntary benefits
• Understand the role both play in meeting business needs
• Unique collaborative and consultative outlook
• Not about cost shifting
• Emphasis on design
• Work to balance employer and employee interests
• A true partner

9. For more information
Marty Matthiesen, Senior Account Executive
(972) 532-2120
Marty.Matthiesen@ntalife.com