On the Bleeding Edge...

of Consumer Centric Health Care. I make the distinction between Consumer Driven vs Consumer Centric because the plans we�ll be looking at encourage an insured to take at least some responsibility for their care. On the other hand, neither one would be HSA-compliant, so we�ll skip the CDHP label (at least for now).

My industry just loves acronyms: CDHP, HSA, HRA, PPO, you name it. Well, let�s add another one to that list: Self Directed Health Plan (SDHP). One of my carriers has just introduced one such, and it�s a pretty neat idea. They start with a high deductible group plan, and while they strip out the doctor�s visit co-pays, they leave intact the prescription drug card, as well as the co-insurance. The high deductible and absence of co-pays helps lower the cost dramatically.

�Well, Henry, what�s the big deal,� you may ask, �after all, we�ve seen low-end plans before.� What makes this one unique is that the carrier is paying the employee to stay healthy: the plan includes a Self Directed Account, funded solely by the insurer. That�s right, the carrier puts in $1,000 a year for each covered employee ($2,000 for families), to pay for routine and preventive care. Services such as annual physicals and immunizations get reimbursed directly by the carrier, but still count toward one�s annual deductible. Pretty cool.

A little bird tells me that one of our eastern seaboard states is working with an insurance company to develop and market a policy that�s also �out there:� all covered employees of companies that sign up for this coverage receive �executive series� medical exams. In fact, so do their covered spouses and children.

Once the employee�s (or family member�s) current health is assessed, they�re enrolled in a treatment plan (if applicable). They receive full policy benefits if they follow �doctors orders,� but receive a significantly lower level of benefits if they don�t. This will be very helpful for those with chronic conditions such as diabetes, Crohn�s, hypertension, etc.

The program is still in the planning stage, but the carrier, exam provider and re-insurer are all in place. So far, details are scarce, but I�ll pass them along as I learn of them.

Stay tuned�