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Medical Savings Accounts Actual Claims Experience And Charts
Actual Claims Experience
MSA
Employee #1 - 52 year old male (husband/wife coverage)
Total Claims $74,426.07
Employee #2 - 51 year old male (single coverage)
Total Claims $60,453.81
Employee #3 - 38 year old female (family coverage w/ 2 dependents)
Total Claims $44,909.51
TRADITIONAL PLAN
Employee #1 - 39 year old male (family coverage w/4 dependents)
Total Claims $29,841-85
Employee #2 - 61 year old male (husband/wife coverage)
Total Claims $30,715.47
Employee #3 - 45 year old female (husband/wife coverage)
Total Claims $31,138.59
POS
Employee #1 - 44 year old male (single coverage)
Total Claims $86,516.31
Employee #2 - 45 year old female (family coverage w/ 3 dependents)
Total Claims $27,827-54
Employee #3 - 45 year old (family coverage w/ 2 dependents)
Total Claims $11,766.73
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Chart One
Jersey City Management Employee Census (1997)
|
| | MSA
|
|---|
| Employee Only: | 49
| | Employee/Spouse: | 25
| | Employee/Family: | 43
| | Employee/Children: | 7
| | Total: | 124 (56 percent)
| | Traditional
|
|---|
| Employee Only: | 24
| | Employee/Spouse: | 24
| | Employee/Family: | 13
| | Employee/Children: | 2
| | Total: |
63 (29 percent)
| | Blue Choice (US)
|
|---|
| Employee Only: | 6
| | Employee/Spouse: | 3
| | Employee/Family: | 15
| | Employee/Children: | 3
| | Total: |
27 (12 percent)
| | HMO Blue
|
|---|
| Employee Only: | 2
| | Employee/Spouse: | 1
| | Employee/Family: | 3
| | Employee/Children: | 1
| | Total: | 7 (3 percent)
| 85 percent of employees chose either the MSA or traditional indemnity plan options. The
MSA was by far the most popular Plan with 56 percent of employees choosing it.
Chart Two
Jersey City's 1998 Health Care Renewal Rates*
Married Couple with Children
|
Traditional Plan | $11,568
| |
Preferred Provider Plan (PPO) | $6,702
| |
HMO** | NA
| |
Medical Savings Account (MSA)*** | $10,571
| |
MSA Savings vs. Traditional Plan | $997
|
| * | Pricing based on 3 years of actual Jersey City claims experience.
| | ** | HMO costs not included since price is not experience-based.
| | *** | Cost
includes both annual premiums and $1,800 MSA contribution.
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Chart Three
Jersey City's 1998 Health Care Renewal Rates*
Married Couple, No Children
| Traditional Plan | $9,896
| | Preferred Provider Plan (PPO) | $5,760
| | HMO** | NA
| | Medical Savings Account (MSA)*** | $8,773
| | MSA Savings vs. Traditional Plan | $1,123
|
| * | Pricing based on 3 years of actual Jersey City claims experience.
| | ** | HMO costs not included since price is not experience-based.
| | *** | Cost includes both annual premiums and $1,800 MSA contribution.
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Chart Four
Jersey City's 1998 Health Care Renewal Rates*
One-Parent Family
| Traditional Plan | $6,620
| | Preferred Provider Plan (PPO) | $3,822
| | HMO** | NA
| | Medical Savings Account (MSA)*** | $5,249
| | MSA Savings vs. Traditional Plan | $1,371
|
| * |
Pricing based on 3 years of actual Jersey City claims experience.
| | ** |
HMO costs not included since price is not experience-based. | | *** |
Cost
includes both annual premiums and $1,800 MSA contribution.
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Chart Five
Jersey City's 1998 Health Care Renewal Rates*
Single Individuals
| Traditional Plan | $4,537
| | Preferred Provider Plan (PPO) | $2,588
| | HMO** | NA
| | Medical Savings Account (MSA)*** | $3,535
| | MSA Savings vs. Traditional Plan | $1,002
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| * | Pricing based on 3 years of actual Jersey City claims experience.
| | ** | HMO costs not included since price is not experience-based.
| | *** | Cost includes both annual premiums and $1,400 MSA contribution.
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Medical Savings Accounts Do Not Promote Adverse Selection!
| Plan | Claims | Participants | Average Age | Average Claim | Average Number Covered
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|---|
| MSA | $637.822 | 117 | 42.5 | $5,451,48 | 2.2
| | Traditional | $437.017 | 65 |
42.5 | $6,723.33 | 2.2
| | POS | $117.748
| 25 |
41.5 | $4,708.92 |
2.4
| | HMO | N/A | 8 | 50 | N/A | 2.4
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MSA vs. Traditional Plan Out-of-Pocket Net Benefit
(For family of four @ 28 percent tax rate)
Family Medical Expenses
| 0
| $500
| $1000
| $1500
| $2000
| $2500
| $3000
| Traditional Plan Cost
| 0
| ($260)
| ($360)
| ($460)
| ($560)
| ($660)
| ($760)
| | MSA Cost
| +$1296
| +$796
| +$296
| ($204)
| ($704)
| ($704)
| ($704)
| | Net Benefit
| $1296
| $1056
| $656
| $256
| ($144)
| ($44)
| $56
|
Family Medical Expenses
| $3500
| $4000
| $4500
| $5000
| $5500
| $6000
| $6500
| Traditional Plan Cost
| ($860)
| ($960)
| ($1060)
| ($1160)
| ($1260)
| ($1360)
| ($1460)
| | MSA Cost
| ($704)
| ($704)
| ($704)
| ($704)
| ($704)
| ($704)
| ($704)
| | Net Benefit
| $156
| $256
| $356
| $456
| $556
| $656
| $756
|
Family Medical Expenses
| $7000
| $7500
| $8000
| $8500
| $9000
| $9500
| $10000
| Traditional Plan Cost
| ($1560)
| ($1660)
| ($1760)
| ($1800)
| ($1800)
| ($1800)
| ($1800)
| | MSA Cost
| ($704)
| ($704)
| ($704)
| ($704)
| ($704)
| ($704)
| ($704)
| | Net Benefit
| $856
| $956
| $1056
| $1096
| $1096
| $1096
| $1096
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