MERCER为美国保险业协会做的绝密HR分析报告

RichBaileyFSA,MAAA,FCARichmond,VAIsitTimeforEmployerstoMoveAwayFromtheTraditionalWaysofProvidingEmployeeBenefits?November3,2004MercerHumanResourceConsulting1AgendaTheEnvironmentTheCatch-22PathsAwayfromTraditionalDelivery:TwoCampsOpportunitiesAlongPath2TheAnswerAdditionalTopicsMercerHumanResourceConsulting2AgendaTheEnvironment–MedicalTrends–Legislation–MarketplaceChanges–PopulationDemographics–EmployerOutlookTheCatch-22PathsAwayfromTraditionalDelivery:TwoCampsOpportunitiesAlongPath2TheAnswerAdditionalTopicsMercerHumanResourceConsulting3Double-DigitIncreaseforSecondYearinaRowPeremployeecostsinexcessof$5,600peryear$3,703$3,594$3,817$4,097$4,430$4,924$5,646$0$1,000$2,000$3,000$4,000$5,000$6,0001996199719981999200020012002-2.9%+6.2%+7.3%+8.1%+11.2%+14.7%Source:2002Mercer/FosterHigginsNationalSurveyofEmployer-sponsoredHealthPlansMercerHumanResourceConsulting4AnnualCPITrendU.S.healthcarecostsrise,despitecontinuingeconomicrecession0%1%2%3%4%5%6%7%8%9%10%1990199119921993199419951996199719981999200020012002CPI-AllUrbanConsumersCPI-MedicalCareThegapbetweenCPI-Uandmedicalcarecomponentisincreasing1990199119921993199419951996199719981999200020012002CPI-MedicalCare9.0%8.7%7.4%5.9%4.8%4.5%3.5%2.8%3.2%3.5%3.9%4.6%4.7%CPIOverall5.4%4.2%3.0%3.0%2.6%2.8%3.0%2.3%1.6%2.2%3.3%2.8%1.5%RatioMC/Overall1.72.12.52.01.81.61.21.22.01.61.21.63.1Source:U.S.BureauofLaborStatisticsMercerHumanResourceConsulting5ComparisonofOverallGrowthCumulativemedicalcareCPI89%greaterthanoverallCPIsince1967DatabasedonJanuary1CPIvaluesCPIvs.CPIMedicalCare0100200300400196719691971197319751977197919811983198519871989199119931995199719992001YearStandardizedCostMedicalCareCPIOverallCPIMercerHumanResourceConsulting6Employers’CostIncreasesOut-PaceOtherIndicatorsLargestincreasesince1990(allemployers)Includesmedical,dentalandpharmacySource:2002Mercer/FosterHigginsNationalSurveyofEmployer-sponsoredHealthPlansResultsforEmployerswith500ormorelives6.9%18.6%16.7%17.1%12.1%10.1%8.0%-1.1%0.2%6.1%7.3%8.1%11.2%14.7%2.1%2.5%-2.00%0.00%2.00%4.00%6.00%8.00%10.00%12.00%14.00%16.00%18.00%20.00%1987198819891990199119921993199419951996199719981999200020012002EmployersCPI-MedicalCPI-AllItemsMercerHumanResourceConsulting7AggregateHealthCareSpending(1980–2010)Governmentportionofpaymentsincreasing;totalprojectedtobeover$2trillionby2009$0$500$1,000$1,500$2,000$2,5001980199019951998199920002001200220032004200520062007200820092010InUS$BillionsOOPPrivateInsuranceGovernmentSource:CMSMercerHumanResourceConsulting8MedicalTrendsPopQuizHowmanyyearswillittakegrossmedicalcoststodouble,assumingnospecificemployerinterventionsornationalhealthcare?–10ormore–9–8–7–6–5orfewerMercerHumanResourceConsulting9MedicalTrendsResponsesfromagroupof25actuarieswhohadtimetogettheircalculatorsWhenwillMedicalCostsbeDoublethe2002Level?0246810122003200420052006200720082009201020112012201320142015NeverYearNumberofrespondentsMercerHumanResourceConsulting10LegislationMedicarePrescriptionDrugs–Ifmadeintolaw,willhavemajorimpactonretireebenefitsandstrategies–Initialconfusionaside,shouldhavepositiveimpactonretireeplans–ExpectcostshiftingtonegativelyimpactactiveplansEEOCProposedchangesinADEAregulations–Clinevs.GeneralDynamicsWellsFargocase–Appearstoallowpre-funding(andtax-deductibility)ofentireretireeliabilityanILPapproachwon’tbeexactlysamenumberasFASliabilityfundinginyears2+wouldbelimitedtoservicecost–IRSweighingitsoptionsMercerHumanResourceConsulting11ProposalstoIncreaseCoverageAmongEarlyRetireesFewgovernmentprogramsexceptforfinanciallyindigentCOBRAextensionsand/orMedicarebuy-insProhibitionsonpost-retirementbenefitreductionsExpandedpre-fundingforretireemedicalStillfewviableproductsforpre-65inindividualmarketthatovercomeaccessandaffordabilityissues.MercerHumanResourceConsulting12ADEAIssuesImpactonretireemedicalcoverageAgeDiscriminationinEmploymentAct(ADEA)prohibitsdiscriminationagainstpersonsage40orolderintermsandconditionsofemploymentAge-baseddistinctionsinemployeebenefitplansarepermissibleonlyif:–Aspecificstatutoryexceptionapplies,or–Equalbenefit/equalcosttestissatisfiedPlanmustprovideequalbenefitsforolderandyoungerworkers,orPlanmustincurequalcostsforolderandyoungerworkersThirdandSixthCircuitCourtsreachdifferentconclusionsEEOCreviewingADEAregulationsMercerHumanResourceConsulting13MarketplaceChangesConsolidationofMajorHealthCareCarriersEmployeroptionsaregreatlyreduced,carriershavemorecloutUnitedHealthcareHealthSourceProvidentCIGNAEquicorMetrahealthUSHealthcareAetnaTakeCareFHPPacifiCareHealthSourceCIGNAAetnaUSHealthcareNYLCarePrudentialHealthCareFHPPacifiCareProvidentTransamericaEquitableHCAMetropolitanPartnersAetnaGSDHPLincolnNationalHPsTakeCarePacifiCareHealthPlanofAmericaWellPoint/BlueCrossofCaliforniaHancockMassMutualTravelersUnitedHealthcareAetnaPacifiCareHealthSystemsWellPoint/BlueCrossofCaliforniaCIGNABCBSofGeorgiaMultipleBCBSPlansFewerMajorBCBSMercerHumanResourceConsulting14MarketplaceChangesPBMconsolidationcontinues;threemajornationalPBMsremainCPIAPICPNRxNetValueRxDiagnostekPerformHCSHP