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Consumer Directed Health Plans


Most of you have heard about "consumer directed health plans". The Bush administration has been a strong supporter of this concept as a way to get a handle on soaring healthcare costs. The recent inaugeration of Mr. Bush signals that consumer directed health plans will increasingly make up a larger percentage of group medical plans over the next several years. In the past, consumer directed plan designs have taken on many forms: Medical Savings Accounts (MSAs), Flexible Spending Accounts (FSAs), Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs).

Many experts consider HRAs and HSAs to be the first generation of viable consumer directed health care products. HRAs are typically paired with a high-deductible health plan and are employer-funded Section 105 defined contribution plans. HSAs are the latest version of consumer directed health care plans. The core components of HSAs include a high deductible insurance product and a cash spending account. HSAs combine the pre-tax treatment of a FSA, the portability and roll-over characteristics of a 401(k), and the tax-free distributions of a Roth IRA.

One of the main goals of any consumer directed health plan should be to get the consumer more involved in both the cost and statistical outcomes of certain healthcare procedures. Informed healthcare consumers will make wise healthcare decisions and typically these decisions will result in both lower costs and improved quality.

Although the advantages of HRAs and HSAs can be substantial, employers will want to do their homework prior to setting them up. Effective implementation will require a clear understanding of the consumer directed healthcare plan that best fits your organization as well as the administrative requirements. Employee education will be essential. Companies will also need to look into how the creation of a HSA or HRA may affect their HIPAA medical privacy compliance requirements.

Just like most endeavors, the successful implementation of a HSA or HRA will greatly depend on how much research your organization does on the pro's and con's of each alternative. The type of consumer directed health plan that best fits your company will depend on a combination of your corporate structure as well as the overall objectives of your group health insurance plan.

Although consumer directed healthcare plans are becoming very familiar to human resource managers and other benefit professionals, remember that your employees and their dependents will need a substantial amount of education and communication.

Michael Ertel is the President of Ertel & Company ( http://www.ertelandcompany.com ) and has over 15 years of experience in the health insurance business. He is the founder of http://www.MedicalInsuranceNow.com which is an internet based service that assists individuals, families, and small business owners by providing side by side comparisons of health insurance alternatives and the convenience of applying for health coverage online.


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