of Consumer Centric Health Care. I make the distinction between Consumer Driven vs Consumer Centric because the plans we’ll be looking at encourage an insured to take at least some responsibility for their care. On the other hand, neither one would be HSA-compliant, so we’ll skip the CDHP label (at least for now).
My industry just loves acronyms: CDHP, HSA, HRA, PPO, you name it. Well, let’s add another one to that list: Self Directed Health Plan (SDHP). One of my carriers has just introduced one such, and it’s a pretty neat idea. They start with a high deductible group plan, and while they strip out the doctor’s visit co-pays, they leave intact the prescription drug card, as well as the co-insurance. The high deductible and absence of co-pays helps lower the cost dramatically.
“Well, Henry, what’s the big deal,” you may ask, “after all, we’ve seen low-end plans before.” What makes this one unique is that the carrier is paying the employee to stay healthy: the plan includes a Self Directed Account, funded solely by the insurer. That’s right, the carrier puts in $1,000 a year for each covered employee ($2,000 for families), to pay for routine and preventive care. Services such as annual physicals and immunizations get reimbursed directly by the carrier, but still count toward one’s annual deductible. Pretty cool.
A little bird tells me that one of our eastern seaboard states is working with an insurance company to develop and market a policy that’s also “out there:” all covered employees of companies that sign up for this coverage receive “executive series” medical exams. In fact, so do their covered spouses and children.
Once the employee’s (or family member’s) current health is assessed, they’re enrolled in a treatment plan (if applicable). They receive full policy benefits if they follow “doctors orders,” but receive a significantly lower level of benefits if they don’t. This will be very helpful for those with chronic conditions such as diabetes, Crohn’s, hypertension, etc.
The program is still in the planning stage, but the carrier, exam provider and re-insurer are all in place. So far, details are scarce, but I’ll pass them along as I learn of them.