With all of the uncertainties related to ObamaCare (The Patient Protection and Affordability Act) many employers are making drastic changes now to weather the storm that is coming in January of 2014. Some employers like AT&T and Caterpiller have made public statements that they will drop coverage entirely and pay the penalty while others are looking for creative strategies to protect their employees from the predicted unaffordable medical premiums. Insurance carriers have been developing many new products to offset the reduction in benefits and to bridge the gap prior to meeting medical deductible and/or out of pocket maximums. Many insurance agents are creating unique strategies and most tenured agents agree that there is really no way to predict the future of healthcare so the best strategy is to plan for the worst.
One new product that has been gaining much interest this year is the GAP plan. This product can be offered on a voluntary or employer paid basis. The GAP plan reimburses the consumer or employee for out of pocket in and outpatient expenses. They are typically offered as indemnity plans so employees do not have to stay within a defined network of physicians or hospitals. Most GAP plans reimburse the insured for first dollar out of pocket medical expenses and do not have to coordinate with medical insurance. This is one way to bridge the bridge the “GAP” in coverage associated with high deductible medical plans.
Another popular program to reduce out of pocket cost and time spent waiting in the doctors office is the telephonic physician programs. This program gives the consumer a direct phone number to call a licensed physician for basic consultation and to refill basic prescriptions without having to visit the physician’s office. This program typically includes a prescription discount program to reduce the retail cost of many popular brand name medications. Again the goal is to provide the consumer or employee with a cost effective alternative to the tradition first dollar medical insurance plans that are becoming unaffordable for employer, employee and the individual consumer.
While many of us hope that Healthcare Reform will simply be repealed I recommend that employers plan for the worst and hope for the best.