Municipal budgets throughout southeastern Pennsylvania continue to be plagued by rising health care costs leaving communities with a host of unpleasant choices: reduce benefits, raise taxes, assume more risk or switch to some new and unproven carrier looking to expand market share with reduced rates.
The Delaware Valley Health Insurance Trust (DVHIT) is helping its members defy the trends by providing a remarkably stable health insurance platform with rates well below those of commercial carriers, while maintaining benefit levels and even offering several plan enhancements.
DVHIT is an example of the power of collective action, offering an alternative to the annual double digit percentage increases imposed by commercial health insurers. By contrast, the average DVHIT member received an increase of less than 6% for each of the past three years.
Benefit Plan Structure & Costs
The Trust offers a complete range of medical plans (HMO, QPOS, PPO and Indemnity), fully customized to meet the needs and interests of the member. Participating municipalities design their own benefit plans and coverage parameters. The Trust will both retain the current rate structure and offer guaranteed rates. Although health insurance carriers occasionally close plans or force groups into more restrictive plans DVHIT has never made unilateral changes which may compromise a municipality's relationship with its employees or unions.
For most applicants, the Trust will meet or exceed current commercial coverage at lower costs. More than half of the trust's current municipal members were previously Personal Choice clients.
At no additional charge, standard coverage enhancements include the following:
- Trust administered fitness reimbursement program for employee and spouse
- Vision benefits built into the medical coverage
- An Employee Assistance Program through Human Management Services
- Full access to Health AdvocateTM, a care facilitator for employees, dependents and family members
- A comprehensive Member Wellness Initiative
- COBRA Administration
- Ancillary Lines program providing discounted rates on life and long term disability coverage
We will provide side-by-side coverage comparisons with your current program upon request. The Trust accepts partial group enrollments.
Risk Financing
Through leveraging and economies-of-scale, the Trust will reduce current rates by 5% to 7%. Rate increases after the first year have been less than those experienced by municipalities covered by commercial insurers.
As with the other Delaware Valley Trusts, DVHIT is working towards a long-term solution to healthcare financing. The Trust's risk sharing model offers a number of advantages, including:
- Excess funds are returned to the membership. A rate stabilization fund (RSF) is a unique tool allowing each member the option of applying credits to monthly premium, thereby reducing payments. Members also have the choice of rolling their credit balance over to future years. In effect, the RSF allows each member the discretion of choosing the most opportune time to apply its own rate relief. The Trust adds interest to any rolled over balance. To date over $9.5 million has been allocated RSF credits.
- An expense ratio well below commercial fully insured or self-insured programs, without brokerage commissions or premium taxes.
- Investment income accruing only to the benefit of the membership.
- Improved control of health insurance premium dollars, products, services and management. For example, utilization information and key underwriting data has become the property of the Trust.
- The ability of the Trust to unbundle components of the plan (reinsurance, prescriptions, etc) in order to take advantage of more competitive alternatives.
- Multi-trust discounts that save an additional 1 to 2% in health premium for any municipality participating in more than one Delaware Valley program.
Networks
DVHIT contracts with Aetna and Delta Dental for access to their provider networks and discounts. Subscribers will receive the provider networks' ID cards. The Trust will conduct an analysis that will show a high percentage overlap in provider participation between the Trust's service providers and Blue Cross providers. The Trust also contracts with the insurers for claims processing services and reinsurance support.
Ancillary Lines
The Trust has an exclusive fee-limited partnership with The Standard Insurance Company for providing Group Life and AD&D, Long-term Disability and Short-term Disability coverage. The Standard has a strong public sector profile, and by leveraging the buying power of the Trust, we can offer preferred pricing and coverage enhancements. Premium savings will range between 10% and 20%, and the package includes multi-year rate guarantees.
Service
Customer service is provided through Trust staff with added technical support provided by dedicated teams at the contracted providers. When an employee calls the Trust office, they get immediate access to knowledgeable staff dedicated to the health program. For standard inquiries, we typically resolve the issue within 24 to 48 hours. For questions regarding treatment and care, staff may direct the patient or family member to Health AdvocateTM, a company designed to help navigate the health care delivery system.
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