HealthLeaders-InterStudy, a leading provider of healthcare market intelligence, reports that workers who cannot afford major medical plans, but need more coverage than a limited benefits plan are the target of CIGNA Healthcare's Fundamental Care. According to the latest Pennsylvania Health Plan Analysis report, this voluntary benefits plan is now available in Pennsylvania and will be available nationally in January.
"Voluntary benefit plans allow employers to offer a group plan that shifts most or all of the premium cost to the employees," states Chris Lewis, HealthLeaders-InterStudy market analyst. "This specific program is being marketed to companies of 51 or more employees looking to save 25 percent to 40 percent of the cost of traditional full-coverage plans."
Fundamental Care fills the gap between a traditional limited benefit plan targeted to low-wage, hourly and part-time workers and the comprehensive major medical plans usually offered to full-time and salaried employees. Fundamental Care covers a yearly maximum of $25,000 to $100,000 in medical expenses, with employers required to contribute at least 25 percent of the premium. It is also distinctively customizable, with options that enable employers to choose different coinsurance rates, different annual maximums and different benefit levels.
In general, limited benefits plans have attracted increased attention the past three to four years as the U.S. uninsured population has grown. During this time, two different approaches to limited benefits have emerged, one provides a limited amount of preventive care but does not cover catastrophic events, and another features a high deductible and covers only catastrophic illnesses.
Other news in the Pennsylvania healthcare market: * HMO and point-of-service plans in the Keystone state experienced a 9% decline in enrollment from January 2005 to January 2006, mirroring a nationwide shift to open access PPO products. * Pennsylvania giant Highmark will no longer compensate primary care physicians by capitation, switching to the fee-for-service system, which has become the preferred reimbursement method in the market. About Health Plan Analysis
Health Plan Analysis identifies key health plan trends, allowing healthcare businesses to create comprehensive strategic plans and sales strategies at state and local levels.
HealthLeaders-InterStudy, a company of Decision Resources, Inc., is the authoritative source for managed care data and analysis.
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