Self-insurance in times of growing and retreating managed care

Health Affairs

Volumn 22, Issue 2, 2003, Pages 202-210

  Gabel, Jon R ^a   Jensen, Gail A ^b   Hawkins, Samantha ^c  

^a Health Research and Educational Trust (HRET)   (United States)

^b WAYNE STATE UNIVERSITY   (United States)

^c HRET ^*  (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COMPARATIVE STUDY; COST; ECONOMICS; EPIDEMIOLOGY; FEE; HEALTH CARE DELIVERY; HEALTH INSURANCE; HEALTH MAINTENANCE ORGANIZATION; INSURANCE; LEGAL ASPECT; QUESTIONNAIRE; RISK; STATISTICS; UNITED STATES;

COST SHARING; DEDUCTIBLES AND COINSURANCE; FEES AND CHARGES; HEALTH BENEFIT PLANS, EMPLOYEE; HEALTH CARE SURVEYS; HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT; HEALTH MAINTENANCE ORGANIZATIONS; HEALTH SERVICES ACCESSIBILITY; INSURANCE BENEFITS; INSURANCE COVERAGE; PREFERRED PROVIDER ORGANIZATIONS; QUESTIONNAIRES; RISK; UNITED STATES;

EID: 0037363390     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.22.2.202     Document Type: Review

References (16)

1. P. Fronstin, Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 2001 Current Population Survey, Issue Brief no. 240 (Washington: Employee Benefit Research Institute, December 2001).
2. EBRI, Fundamentals of Employee Benefit Programs, 5th ed. (Washington: EBRI, 1997), 5-9.
3. G. Acs et al., "Self-Insured Employer Health Plans: Prevalence, Profile, Provisions, and Premiums," Health Affairs (Summer 1996): 266-278.
4. Readers interested in a more comprehensive discussion of the pros and cons of ERISA should refer to U.S. General Accounting Office, Report to Congressional Requesters, Employer-Based Health Plans: Issues, Trends, and Challenges Posed by ERISA, Pub. no. GA 1.13:HEHS-95-167 (Washington: GAO, 1995).
5. P. McDonnell et al., "Self-Insured Health Plans," Health Care Financing Review 8, no. 2 (1986): 1-16.
6. Reported in Acs et al., "Self-Insured Employer Health Plans."
7. M.S. Marquis and S.H. Long, "Recent Trends in Self-Insured Employer Health Plans," Health Affairs (May/June 1999): 161-166.
8. B. Atchinson and D. Fox, "The Politics of the Health Insurance Portability and Accountability Act," Health Affairs (May/June 1997): 146-150.
9. R. Frank, C. Koyanagi, and T. McGuire, "The Politics and Economics of Mental Health 'Parity' Laws," Health Affairs (July/Aug 1997): 108-119.
10. S. Laudicina and K. Pardo, State Legislative Health Care and Insurance Issues: 1999 Survey of Plans (Washington: Blue Cross and Blue Shield Association of America, December 1999).
11. J. Gabel et al., "Job-Based Health Insurance in 2001: Inflation Hits Double Digits, Managed Care Retreats," Health Affairs (Sep/Oct 2001): 180-186.
12. Acs and colleagues' analysis also includes data from the 1991 Health Insurance Association of America survey of employers and the 1987 National Medical Expenditure Survey. See Acs et al., "Self-Insured Employer Health Plans."
13. Marquis and Long, "Recent Trends."
14. In 1993 KPMG did not ask employers with HMO plans about self-insurance status. Therefore, for HMO plans in 1993 we have used data from the RWJF Employer Health Insurance Survey.
15. InterStudy reported that 68 percent of HMOs suffered underwriting losses in 1997.
16. The exception to this statement is the premium for stop-loss protection paid to reinsurers.