July 03, 2012

Chamber of Commerce Health Plans

The Chamber of Commerce plans have three carriers to choose from:
  1. Harvard Pilgrim
  2. Fallon
  3. Health New England
Please note that Health New England is only appropriate for employers in Western Massachusetts.  Even with three carriers, there are a limited number of plan designs available.


Harvard-Pilgrim offers NO traditional "co-payment" plans, but only high "deductible" plans starting at $1,500 for their traditional larger network and $1,000 for the smaller "Focus" network. Similarily, Fallon has NO "co-payment" plans, and deductible plans start at 1,000 for all three of their networks: Select, Direct and the newly formed Steward.

Why join? There are discounts for these limited plans. How much? You can save 3% on the premium by going through the Chamber of Commerce versus going to the carrier direct. This discount, however, comes with a cost:
  1. Annual membership fee:
  2. Monthly administration fee: Harvard-Pilgrim charges $20 per month per subscriber. A group of two employees will be charged $40 per month or $480 for the year!!Fallon varies the monthly fee by coverage (single is $5/month, employee/child is $9/month, employee/spouse is $10/month, family is$15 per month).
  3. Wellness Program Penalty: At the end of each calendar year subscribers who are active participants will be calculated. Businesses that fall short of a 60% active participation threshold will be assessed a one time $100 charge for each covered employee short of the threshold in the calendar year.
After the Annual Membership, monthly administration fee and any wellness penalties, how much of your 3% savings is left? And that assumes you like one of these high deductible plans. In addition, it also assumes that the rates are more competitive than Blue Cross or Tufts, which the Chamber of Commerce does not offer. We do not see this being viable until the up front discount is more in thee 5-10% range.



1 comment:

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Even with three providers, there are a small variety of strategy styles available.