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Niov`esnia K`edzk Oev` Ocszs

eij ^cpv @m|dc~`` K`edzk \ dei\v`s`iz`j f~2 AJN Nispveio` Ea`io~$ Nio)

5

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Qk`v` Ev` Q`3E _ie|skcz cg zk` K`edzk Oev` Ocsz _nzpeznci

K`edzk oev` ocszs kew` f``i niov`esnia ez eiedevmnia vez` gcv i`evd~ e j`oej`

P|qevj zv`ij ni k`edzk oev` ocszs ev`sdcqnia$ ~`z ocsz niov`es`s ev` cpz|eonia zk`vez` cg nigdeznci)

Ocszs niov`es`j ni 6

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3/55

Iezncied Zv`ijsEw`vea` Eiiped K`edzk Oev` Ocsz Niov`es`s

_cpvo`2 K`qnzz K`edzk Wedp` Ninzneznw`$ 6

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

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Iezncied Zv`ijsK`edzk F`i`gnz Ocszs

_cpvo`2 K`qnzz K`edzk Wedp` Ninzneznw`$ 6)5%

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Iezncied Zv`ijsK`edzk F`i`gnz Ocszs

_cpvo`2 K`qnzz K`edzk Wedp` Ninzneznw`$ 6

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

6/55

Iezncied Zv`ijsK`edzk F`i`gnz Ocszs

_cpvo`2 K`qnzz K`edzk Wedp` Ninzneznw`$ 6

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

7/55

Iezncied Zv`ijs_kngz zc Ocispm`vnsm ^n`djs OJK\ Avcqzk

\`vo`izea` cg edd m|dc~`vs cgg`vnia e ocispm`v-jnv`oz`j k`edzk |dei +OJK\. fes`j ci `nzk`v e k`edzkv`nmfpvs`m`iz eoocpiz +KVE. cv e k`edzk sewniaseoocpiz +K_E. ociznip`s zc vns` +niov`es` ni 6

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

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Iezncied Zv`ijs_kngz zc Ocispm`vnsm ^n`djs OJK\ Avcqzk

OJK\s j`dnw`v`j spfszeiznedd~ dcq`v ocszs |`v`m|dc~`` zkei \\Cs cv KMCs ni 6

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Iezncied Zv`ijsGeozcvs D`ejnia zc Niov`es`j K`edzk Oev` Ocszs

_`w`ved mevh`z ocijnzncisqcvhnia ni zeij`m kew` d`j zce j`oej` cg piv`dez`j k`edzkoev` ocsz niov`es`s)

Pij`vszeijnia eiiped k`edzk|dei v`i`qed vez` niov`es`s ns`ss`izned ni gcvmpdezniaedz`vieznw`s eij scdpzncis zc

|dei okedd`ia`s) Nz ns edsc|`vzni`iz gcv `jpoeznia`m|dc~``s efcpz zk` vezncied`f`knij ei~ |dei cv ocizvnfpznciokeia`s f`nia nizvcjpo`j)

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Kcq Jnj Q` A`z K`v`3Geozcvs D`ejnia zc Niov`es`j K`edzk Oev` Ocszs

J`mcave|knos

c Zk`v` ns e spfs`up`iz vns` ni zk` coopvv`io` cgokvcino jns`es`s eszkme$ k`evz jns`es` eij

oeio`v eij e v`dpozeiz i``j gcv mcv` v`scpvo`szc gnakz zk`s` jns`es`s)

c D`ejs zc `d`wez`j pzndnreznci cg |v`sovn|znci jvpaseij czk`v m`jnoed s`vwno`s$ eij ei cw`vedd vns` ni

jcddev `{|`ijnzpv`s ci k`edzk oev`)

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

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Kcq Jnj Q` A`z K`v`3Geozcvs D`ejnia zc Niov`es`j K`edzk Oev` Ocszs

J`mcave|knos Jvemezno Vns` cg \v`sovn|znci Jvpa Ocszs

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

12/55

Kcq Jnj Q` A`z K`v`3Jvemezno Vns` ni \v`sovn|znci Jvpa Ocszs

Eoocvjnia zc O`iz`vs gcv M`jnoev` ' M`jnoenj_`vwno`s +OM_.2

c _|`ijnia ni zk` P)_) gcv |v`sovn|znci jvpas qes*657)1 fnddnci ni 6

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Iezncied Zv`ijsEw`vea` Eiiped K`edzk Oev` Ocsz Niov`es`s

Ew`vea` Eiiped \`vo`izea` Okeia` ni _`d`oz`j Iezncied K`edzk@{|`ijnzpv`s$ 5>>7-67-6

1 17

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Iezncied Zv`ijsEw`vea` Eiiped K`edzk Oev` Ocsz Niov`es`s

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Iezncied Zv`ijsEw`vea` Eiiped K`edzk Oev` Ocsz Niov`es`s

Jnszvnfpznci cg Zczed \pfdno \v`sovn|znci Jvpa @{|`ijnzpv`s f~Z~|` cg \e~`v$ 6

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

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Kcq Jnj Q` A`z K`v`3Jvemezno Vns` ni \v`sovn|znci Jvpa Ocszs

\vnmev~ v`escis gcv niov`es`j jvpa ocszs

c Niov`es`j pzndnreznci

Mcv` |`c|d` ev` psnia mcv` |v`sovn|znci jvpas$ qknokjvnw`s p| s|`ijnia) Gvcm 5>>1 zc 6>1 zc 56)7 ni 61).

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17/55

Kcq Jnj Q` A`z K`v`3Jvemezno Vns` ni \v`sovn|znci Jvpa Ocszs

\vnmev~ v`escis gcv niov`es`j jvpa ocszs

c Niov`es`j \vno`s

V`zend |v`sovn|znci |vno`s niov`es`j ei ew`vea` cg7)> |`vo`iz e ~`ev gvcm 5>>1 zc 65.) Zkns ns mcv`zkei 6)0 znm`s zk` ew`vea` eiiped vez` cg nigdeznci+6)7 |`vo`iz. cw`v zkez j`oej`)

Ni 6

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18/55

Kcq Jnj Q` A`z K`v`3Jvemezno Vns` ni \v`sovn|znci Jvpa Ocszs

\vnmev~ v`escis gcv niov`es`j jvpa ocszs

c Okeia`s ni Z~|`s cg Jvpas Ps`j

Es i`q jvpas `iz`v zk` mevh`z eij `{nsznia ci`s dcsz|ez`iz |vcz`oznci$ s|`ijnia ns egg`oz`j) Ng i`q jvpas

ev` ps`j ni |deo` cg d`ss `{|`isnw`$ cdj`v ci`s$s|`ijnia niov`es`s cw`vedd)

Ng i`q jvpas sp||d`m`iz vezk`v zkei v`|deo` cdj jvpazv`ezm`izs$ cv ng zk`~ zv`ez e ocijnznci icz |v`wncpsd~zv`ez`j$ s|`ijnia oei niov`es`)

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8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

19/55

Kcq Jnj Q` A`z K`v`3Jvemezno Vns` ni \v`sovn|znci Jvpa Ocszs

\vnmev~ v`escis gcv niov`es`jjvpa ocszs

c Ejw`vznsnia

_|`ijnia gcv ocispm`v

ejw`vznsnia ni 67 +*?)1 fnddnciw`vsps *

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Kcq Jnj Q` A`z K`v`3\v`sovn|znci Jvpas eij Nispveio` Ocw`vea`

Pinispv`j ejpdzs ea`s 5; zc 7: ev` mcv` zkeizqno` es dnh`d~ es zkcs` qkc ev` nispv`j zc ewcnjgnddnia e |v`sovn|znci$ opzznia p| |ndds cv shn||niajcs`s cg m`jnoeznci f`oeps` cg ocszs)

c Jvpa ocw`vea` ocm`s gvcm zk` gcddcqniascpvo`s2

@m|dc~`v ocw`vea`

M`jnoev`

M`jnoenj

j

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Kcq Jnj Q` A`z K`v`3\v`sovn|znci Jvpas eij Nispveio` Ocw`vea`

@m|dc~`v Nispveio` Ocw`vea`2

c \vcwnj`s 511 mnddnci Em`vnoeis qnzk ocw`vea` ni

6

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

22/55

Kcq Jnj Q` A`z K`v`3\v`sovn|znci Jvpas eij Nispveio` Ocw`vea`

M`jnoev`2

c Zk` M`jnoev` \v`sovn|znciJvpa$ Nm|vcw`m`iz eijMcj`vinreznci Eoz cg6

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23/55

Kcq Jnj Q` A`z K`v`3\v`sovn|znci Jvpas eij Nispveio` Ocw`vea`

M`jnoenj2

c Bcniz g`j`ved-szez` |vcavem zkez |e~s gcv

m`jnoed essnszeio` zc 7< mnddnci dcq-niocm`nijnwnjpeds eij ns zk` meni scpvo` cg cpz|ezn`iz|kevmeo~ s`vwno`s zc zk` dcq-niocm`|c|pdeznci)

c Zk`v` ev` jngg`v`io`s ni szez` |cdnon`s qnzkv`aevj zc oc|e~m`izs$ |v`g`vv`j jvpas eij zk`emcpiz ez qknok |v`sovn|zncis oei f` gndd`j)

K Jnj Q A z K 3

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24/55

Kcq Jnj Q` A`z K`v`3Opvfnia Knak \v`sovn|znci Jvpa Ocszs

E wevn`z~ cg |pfdno eij |vnwez` szvez`an`s kew` f``i`m|dc~`j zc zv~ eij ocizeni vnsnia |v`sovn|znci jvpaocszs$ niodpjnia2

c Pzndnrnia meiea`m`iz szvez`an`s

c Jnsocpizs eij v`fez`s

c M`jnoenj

c M`jnoev`

c \pvokesnia \ccdsc Ocispm`v Eoznci

c Nm|cvzeznci

K Jnj Q A z K 3

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

25/55

Kcq Jnj Q` A`z K`v`3\v`sovn|znci Jvpas eij Nispveio` Ocw`vea`

Pzndnreznci Meiea`m`iz _zvez`an`s2c K`edzk |deis kew` `{odpj`j o`vzeni jvpas gvcm

ocw`vea`$ ps`j upeiznz~ jns|`isnia dnmnzs eijniov`es`j `ivcdd`` ocsz-skevnia emcpizs)

Ni 6

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

26/55

Iezncied Zv`ijs\v`sovn|znci Jvpas eij Nispveio` Ocw`vea`

Emcia Ocw`v`j Qcvh`vs qnzk Zkv``- cv Gcpv-Zn v \v`sovn|znci JvpaOcsz _kevnia$ Ew`vea` Oc|e~s$ 6

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

27/55

Kcq Jnj Q` A`z K`v`3\v`sovn|znci Jvpas eij Nispveio` Ocw`vea`

Jnsocpizs eij V`fez`s2

c Jvpa |vcavems +|pfdno eij |vnwez`. i`acznez`qnzk |kevmeo`pznoed meipgeozpv`vs zc v`o`nw`

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c Meipgeozpv`vs qkc qeiz jvpas ocw`v`j f~M`jnoenj mpsz |vcwnj` v`fez`s zc szez` M`jnoenj

|vcavems gcv jvpas |pvokes`j)c _cm` szez`s kew` i`acznez`j ejjnzncied v`fez`s

cv sp||d`m`ized v`fez`s)

K Jnj Q A z K 3

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

28/55

Kcq Jnj Q` A`z K`v`3\v`sovn|znci Jvpas eij Nispveio` Ocw`vea`

M`jnoenj2

c Zk` J`gnonz V`jpoznci Eoz cg 6

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

29/55

Kcq Jnj Q` A`z K`v`3\v`sovn|znci Jvpas eij Nispveio` Ocw`vea`

M`jnoev`

c Zk` M`jnoev` \evz J jvpa f`i`gnz mcw`js|`ijnia gvcm zk` |vnwez` s`ozcv eij M`jnoenj

zc M`jnoev`$ mehnia M`jnoev` zk` iezncisdeva`sz |pfdno |e~`v cg |v`sovn|znci jvpas ni6

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

30/55

Kcq Jnj Q` A`z K`v`3\v`sovn|znci Jvpas eij Nispveio` Ocw`vea`

\pvokesnia \ccdsc _cm` |pfdno eij |vnwez` cvaeinrezncis kew`

feij`j zca`zk`v zc gcvm |v`sovn|znci jvpa|pvokesnia |ccds zc niov`es` zk`nv |pvokesnia

|cq`v zkvcpak knak`v wcdpm` eij skev`j`{|`vzns`) _cm` cg zk`s` |pvokesnia |ccdsniodpj`2

J`|evzm`iz cg J`g`is` eij zk` WE

Mpdzn-szez` fpdh fp~nia |ccds zkvcpak qknok szez`s

|pvokes` jvpas gcv zk`nv M`jnoenj

_zez` `m|dc~``s

_`incv$ dcq-niocm` eij pinispv`j |kevmeo~ essnszeio`|vcavems cv czk`v |pfdno |vcavems

Nijnwnjped szez` |pvokesnia |ccds

Kcq Jnj Q` A`z K`v`3

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Kcq Jnj Q` A`z K`v`3\v`sovn|znci Jvpas eij Nispveio` Ocw`vea`

Ocispm`v Eoznci

c Ocispm`vs ev` jcnia zk`gcddcqnia zc v`jpo` zk`nv|v`sovn|znci jvpa ocszs2

V`up`sznia ok`e|`v jvpas cv a`i`vnos

gvcm zk`nv |k~snoneis eij |kevmeon`s Psnia zk` Niz`vi`z eij czk`v scpvo`s

zc meh` |vno` ocm|evnscis

Psnia zk` Niz`vi`z zc |pvokes` jvpas

Fp~nia ez jnsocpiz szcv`s

Fp~nia cw`v-zk`-ocpiz`v +CZO.nisz`ej cg |v`sovn|znci jvpas

Fp~nia jvpas ni fpdh eij |ndd-s|dnzznia

Psnia mend-cvj`v |kevmeon`s

Psnia |kevmeo`pznoed ocm|ei~ cvszez` jvpa-essnszeio` |vcavems

Kcq Jnj Q` A`z K`v`3

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Kcq Jnj Q` A`z K`v`3\v`sovn|znci Jvpas eij Nispveio` Ocw`vea`

Nm|cvzeznci

c Knak jvpa ocszs kew` d`j scm` nijnwnjpeds zc|pvokes` |v`sovn|znci |vcjpozs gvcm jnszvnfpzcvsni Oeieje eij czk`v ocpizvn`s +hicqi es

nm|cvzeznci cv v`nm|cvzeznci qk`i zk` jvpa

ns meipgeozpv`j ni zk` P)_).)

c Nz ns ndd`aed gcv |kevmeon`s cv qkcd`sed`vs zc|pvokes` jvpas gvcm czk`v ocpizvn`s$ ~`z zk`acw`vim`iz jc`s icz edqe~s szc| ocispm`vs

gvcm |pvokesnia jvpa |vcjpozs eovcss zk`fcvj`v)

D`ansdeznci `ieoz`j ni 6

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

33/55

Kcq Jnj Q` A`z K`v`3Geozcvs D`ejnia zc Niov`es`j K`edzk Oev` Ocszs

J`mcave|knos Jvemezno Vns` cg \v`sovn|znci Jvpa Ocszs

@{|eisnci cg \vcwnj`vs

Kcq Jnj Q` A`z K`v`3

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

34/55

Kcq Jnj Q` A`z K`v`3@{|eisnci cg \ vcwnj`vs

\vcwnj`vs cgg`v mei~f`i`gnzs zc zk`ocmmpinzn`s zkez zk`~s`vw`$ fpz v`upnv` e

av`ez j`ed cg oe|nzed zcgp`d zk`nv avcqzk)

Oe|nzed `{|`ijnzpv`sf~ kcs|nzed s~sz`ms

eij czk`v |vcwnj`vs|deo` p|qevj |v`sspv`ci zk` ocszs cg mei~m`jnoed s`vwno`s)

Kcq Jnj Q` A`z K`v`3

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

35/55

Kcq Jnj Q` A`z K`v`3Geozcvs D`ejnia zc Niov`es`j K`edzk Oev` Ocszs

J`mcave|knos Jvemezno Vns` cg \v`sovn|znci Jvpa Ocszs

@{|eisnci cg \vcwnj`vs

Ociscdnjeznci cg Meiea`j Oev` Ocm|ein`s

Kcq Jnj Q` A`z K`v`3

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36/55

Kcq Jnj Q` A`z K`v`3Ociscdnjeznci cg Meiea`j Oev` Ocm|ein`s

Pij`v-|vnonia$ q`eh pij`vqvnznia eij zk` ocszd~|vco`ss cg essnmndeznia eoupnsnzncis kes d`ej zcs`vncps jn|s ni |vcgnzefndnz~ eij szcoh |vno`s gcv edeva` ipmf`v cg oevvn`vs)

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mevh`z ev` icq geo`j qnzk mpok d`ss ocm|`znzncieij e v`i`q`j ocmmnzm`iz zc eokn`wnia k`edzk~v`zpvis$ qknok kes v`spdz`j ni niov`es`j vez`s)

Kcq Jnj Q` A`z K`v`3

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

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Kcq Jnj Q` A`z K`v`3Geozcvs D`ejnia zc Niov`es`j K`edzk Oev` Ocszs

J`mcave|knos Jvemezno Vns` cg \v`sovn|znci Jvpa Ocszs

@{|eisnci cg \vcwnj`vs

Ociscdnjeznci cg Meiea`j Oev`

Ocm|ein`s#Nispv`vs \cdnznoed @iwnvcim`iz eij Acw`vim`iz V`apdeznci

Kcq Jnj Q` A`z K`v`3

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Kcq Jnj Q` A`z K`v`3\cdnznoed @iwnvcim`iz eij Acw`vim`iz V`apdeznci

_zez`#g`j`ved meijez`s kew`niov`es`j zq`iz~-gnw`-gcdj cw`vdesz zkv`` j`oej`s) Meijez`sz`ij zc ocigdnoz qnzk cvjp|dnoez` ci` eiczk`v$ eij

pspedd~ ocm` qnzk ei niov`es`jocsz gcv zk` k`edzk oev` s~sz`m)

Nssp`s spok es |v`sovn|zncijvpas gcv s`incvs$ M`jnoev`

v`gcvm eij ocw`vea` gcv zk`pinispv`j qndd edsc ociznip` zc|de~ e fna vcd` ci |cdnznoed eijd`ansdeznw` ea`ijes eij qndd |pz|v`sspv` ci ocszs)

Kcq Jnj Q` A`z K`v`3

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39/55

Kcq Jnj Q` A`z K`v`3Geozcvs D`ejnia zc Niov`es`j K`edzk Oev` Ocszs

J`mcave|knos Jvemezno Vns` cg \v`sovn|znci Jvpa Ocszs

@{|eisnci cg \vcwnj`vs

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Ocm|ein`s#Nispv`vs \cdnznoed @iwnvcim`iz eij Acw`vim`iz V`apdeznci

Niov`es`j Pzndnreznci eij Ocispm`v J`meij

Kcq Jnj Q` A`z K`v`3

8/8/2019 Group Health Ins Rates and Stratagies Grant Davis GDI

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Kcq Jnj Q` A`z K`v`3Niov`es`j Pzndnreznci eij Ocispm`v J`meij

Pzndnreznci cg k`edzk oev` s`vwno`s kes niov`es`jjp` zc zk` gcddcqnia2

c Nm|vcw`m`izs ni m`jnoed |vco`jpv`s eijz`okicdca~

c Nigdp`io` cg meiea`j oev`c @d`wez`j ocispm`v eqev`i`ss eij j`meij

c Fccsz ni zk` ipmf`v cg |veoznonia |k~snoneis+oeps`j zk` ipmf`v cg spvanoed |vco`jpv`s eij

|v`sovn|znci jvpa ps` zc vns` snaingnoeizd~.)\v`w`iznw` s`vwno`s +fv`esz oeio`v sov``inias$nmmpinrezncis gcv okndjv`i eij jneaicszno|vco`jpv`s. kew` edsc niov`es`j ni pzndnreznci)

Kcq Jnj Q` A`z K`v`3

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Kcq Jnj Q` A`z K`v`3Geozcvs D`ejnia zc Niov`es`j K`edzk Oev` Ocszs

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Kcq Jnj Q` A`z K`v`3Geozcvs D`ejnia zc Niov`es`j K`edzk Oev` Ocszs

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Kcq Jnj Q` A`z K`v`3K`edzk Oev` _|`ijnia eij M`jnoed Ocsz Nigdeznci

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