Who helps employers design their health insurance benefits?

Health Affairs

Volumn 19, Issue 1, 2000, Pages 133-138

  Susan Marquis, M ^a   Long, Stephen H ^a  

^a RAND CORPORATION   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COMMERCIAL PHENOMENA; CONSULTATION; HEALTH INSURANCE; HUMAN; INSURANCE; METHODOLOGY; ORGANIZATION; ORGANIZATION AND MANAGEMENT; PROGRAM DEVELOPMENT; QUESTIONNAIRE; STATISTICS; UNITED STATES;

COMMERCE; CONSULTANTS; DECISION MAKING, ORGANIZATIONAL; HEALTH BENEFIT PLANS, EMPLOYEE; HUMANS; INSURANCE COVERAGE; PROGRAM DEVELOPMENT; QUESTIONNAIRES; UNITED STATES;

EID: 0033632018     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.19.1.133     Document Type: Article

References (10)

1. J.B. Christianson, "The Role of Employers in Community Health Care Systems," Health Affairs (July/Aug 1998): 158-164.
2. D.W. Garnick, K. Swartz, and K.C. Skwara, "Insurance Agents: Ignored Players in Health Insurance Reform," Health Affairs (Mar/Apr 1998): 137-141.
3. The survey methods are described in Research Triangle Institute, 1997 Employer Health Insurance Survey: Final Methodology Report (Research Triangle Park, N.C.: Research Triangle Institute, 1998). The Community Tracking Study is described in P. Kemper et al., "The Design of the Community Tracking Study: A Longitudinal Study of Health System Change and Its Effects on People," Inquiry (Summer 1995): 195-206. The states are California, Colorado, Connecticut, Florida, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Vermont, and Washington.
4. The survey methods are described in Research Triangle Institute, 1997 Employer Health Insurance Survey: Final Methodology Report (Research Triangle Park, N.C.: Research Triangle Institute, 1998). The Community Tracking Study is described in P. Kemper et al., "The Design of the Community Tracking Study: A Longitudinal Study of Health System Change and Its Effects on People," Inquiry (Summer 1995): 195-206. The states are California, Colorado, Connecticut, Florida, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Vermont, and Washington.
5. The question was, "Is this a plan that is purchased from an insurance company or HMO, or is it a self-insured plan?" For further discussion of self-insured employers, see M.S. Marquis and S.H. Long, "Recent Trends in Self-Insured Employer Health Plans," Health Affairs (May/June 1999): 161-166.
6. All establishments that offer insurance were asked, "Does your company purchase health insurance through: a health insurance purchasing cooperative or alliance; a business coalition; a multiple employer trust or a multiple employer welfare association; or a trade or professional association or other membership organization?" For further discussion of pooled purchasing arrangements, see S.H. Long and M.S. Marquis, "Pooled Purchasing: Who Are the Players?" Health Affairs Quly/Aug 1999): 105-111.
7. For establishments offering multiple plans, we computed an average premium for the establishment by weighting the premiums for the separate plans by the number of enrollees.
8. To do this, we measured the actuarial value of the plan benefits by estimating the expected share of a standardized expenditure distribution each plan would cover. The adjusted premium was then measured as the observed premium multiplied by the ratio of the average share of benefits paid by all plans to the expected share of benefits paid by this plan.
9. Based on a review of legislation in all states for 1990-1997 by the Institute for Health Policy Solutions. See R. Curtis et al., "Health Insurance Reform in the Small-Group Market," Health Affairs (May/June 1999): 151-160. See notes to our Exhibit 3 for a list of the states in the high and medium groups.
10. The estimates control for firm size because both the likelihood of using external participants and the characteristics themselves are correlated with firm size.