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1、RichBaileyFSA MAAA FCARichmond VA IsitTimeforEmployerstoMoveAwayFromtheTraditionalWaysofProvidingEmployeeBenefits November3 2004 1 Agenda TheEnvironmentTheCatch 22PathsAwayfromTraditionalDelivery TwoCampsOpportunitiesAlongPath2TheAnswerAdditionalTopics 2 Agenda TheEnvironmentMedicalTrendsLegislation
2、MarketplaceChangesPopulationDemographicsEmployerOutlookTheCatch 22PathsAwayfromTraditionalDelivery TwoCampsOpportunitiesAlongPath2TheAnswerAdditionalTopics 3 Double DigitIncreaseforSecondYearinaRowPeremployeecostsinexcessof 5 600peryear 4 AnnualCPITrendU S healthcarecostsrise despitecontinuingeconom
3、icrecession ThegapbetweenCPI Uandmedicalcarecomponentisincreasing 5 ComparisonofOverallGrowthCumulativemedicalcareCPI89 greaterthanoverallCPIsince1967 DatabasedonJanuary1CPIvalues 6 Employers CostIncreasesOut PaceOtherIndicatorsLargestincreasesince1990 allemployers 7 AggregateHealthCareSpending 1980
4、 2010 Governmentportionofpaymentsincreasing totalprojectedtobeover 2trillionby2009 Source CMS 8 MedicalTrends PopQuizHowmanyyearswillittakegrossmedicalcoststodouble assumingnospecificemployerinterventionsornationalhealthcare 10ormore98765orfewer 9 MedicalTrendsResponsesfromagroupof25actuarieswhohadt
5、imetogettheircalculators 10 Legislation MedicarePrescriptionDrugsIfmadeintolaw willhavemajorimpactonretireebenefitsandstrategiesInitialconfusionaside shouldhavepositiveimpactonretireeplansExpectcostshiftingtonegativelyimpactactiveplansEEOCProposedchangesinADEAregulationsClinevs GeneralDynamicsWellsF
6、argocaseAppearstoallowpre funding andtax deductibility ofentireretireeliabilityanILPapproachwon tbeexactlysamenumberasFASliabilityfundinginyears2 wouldbelimitedtoservicecostIRSweighingitsoptions 11 ProposalstoIncreaseCoverageAmongEarlyRetireesFewgovernmentprogramsexceptforfinanciallyindigent COBRAex
7、tensionsand orMedicarebuy insProhibitionsonpost retirementbenefitreductionsExpandedpre fundingforretireemedical Stillfewviableproductsforpre 65inindividualmarketthatovercomeaccessandaffordabilityissues 12 ADEAIssuesImpactonretireemedicalcoverage AgeDiscriminationinEmploymentAct ADEA prohibitsdiscrim
8、inationagainstpersonsage40orolderintermsandconditionsofemploymentAge baseddistinctionsinemployeebenefitplansarepermissibleonlyif Aspecificstatutoryexceptionapplies orEqualbenefit equalcosttestissatisfiedPlanmustprovideequalbenefitsforolderandyoungerworkers orPlanmustincurequalcostsforolderandyounger
9、workersThirdandSixthCircuitCourtsreachdifferentconclusionsEEOCreviewingADEAregulations 13 MarketplaceChangesConsolidationofMajorHealthCareCarriersEmployeroptionsaregreatlyreduced carriershavemoreclout 14 MarketplaceChangesPBMconsolidationcontinues threemajornationalPBMsremain 15 PopulationTrendsAgin
10、gbabyboomerswillincreasetheelderlyandnearelderlypopulations 16 NegativeTidalWaveofAvailableTalentPoolof primeworkers willbedecreasing 17 ImpactofDemographicsonHealthCareCostCostincreaseswithage 18 HealthDeteriorationAcauseandaconsequence Weeattoomuch 64 5 ofadultsoverweight Populationwithdiabetesinc
11、reasedover50 inlastdecade Overweightisroughly10to30poundsoveranidealweight Obesityisroughly30poundsoveranidealweightSource NationalHealthandNutritionExaminationSurvey 45 0 47 0 47 0 56 0 64 5 19 IssuesFacingBusinessesTheperfectstorm Lowambientinflation highmedicalinflationAdvancesinmedicaltechnology
12、likelytoleadtohighercosts difficultdecisionsLegislativeuncertaintyConsolidatingmedicaldeliveryandfinancingsystemAnagingworkforceIncreasedlongevitySlowingeconomyDisappearingover fundedpensionplansFew ifany obviousandeasyalternativestomanaginghealthcarecosts 20 EmployerOutlook Environmentaloutlookspur
13、ringemployeractionEmployersacutelyawareoftrendsHeightenedinterestincostsavingstrategies activeandretiree Greateremphasisonlongertermcostprojectionsandonthe bottomline Projectionresultshaveinduced fightorflight responses 21 RetireeMedicalCoverageEmployerscontinuetodropretireemedicalcoverage 22 Agenda
14、 TheEnvironmentTheCatch 22PathsAwayfromTraditionalDelivery TwoCampsOpportunitiesAlongPath2TheAnswerAdditionalTopics 23 TheCatch 22 Reducingemployercosttypicallyimpliesincreasingemployee retireecostEventuallyrunsagainstemployer ssensibilitiesregardingfairness paternalism ifpresent andtheconceptofbene
15、fitsgenerallyExample FAS106 Lowermyliabilitiessignificantlybutdon tdoanythingharshtoourretirees theywon tacceptit Totheextentthatretireesrepresentthebulkoftheliability thisisaverydifficultpropositionOpportunitiesexisttochangeeligibility design etc forfutureretireesIfwedon ttakecostoutofthesystem eit
16、hertheemployerortheemployees retireeswillpaytheincreases 24 Agenda TheEnvironmentTheCatch 22PathsAwayfromTraditionalDelivery TwoCampsOpportunitiesAlongPath2TheAnswerAdditionalTopics 25 PathsAwayfromTraditionalDelivery TwoCamps EmployersthatbecomemoreinvolvedinChangingemployeebehaviorChangingproviderbehaviorChangingprovidersthattheyworkwithChangingthelawsEmployersthatreducetheirinvolvementbyIncreasingemployeeresponsibilityLimitingemployercostLimitingemployerrisk 26 EmployersBecomingMoreInvolved C
