The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.

The essential resource for designing and implementing employee benefits—bringing you up to date on critical new industry changes For nearly three decades, HR professionals and consultants have depended on The Handbook of Employee Benefits for authoritative answers to their questions about designing and implementing competitive employee benefits packages. Covering everything from general objectives to costs, this classic reference brings you up to date on critical changes driven by legislative developments, such as the new health-care reform law enacted by the passing of the Patient Protection and Affordable Care Act. The seventh edition of The Handbook of Employee Benefits features the knowledge and insights of the leading scholars and practitioners in the field. Filled with new and updated information and real-world examples, this edition focuses on health and group benefits: Health Benefits: health-care reform’s impact on employee benefits, new approaches to cost containment, how to access quality care, consumer-driven health-care plan designs along with dental, behavioral, prescription, and long-term care programs Life Insurance: group term, universal life, and corporate-owned life programs Work/Life Programs: traditional time off and family leave, child and elder care, and assistance for education, financial planning, and voluntary benefits Social Insurance Programs: Social Security, Medicare, and workers’ and unemployment compensation programs Group and Health Benefit Plan Financial Management: federal tax laws, funding health benefit plans—insured, self-funded, and captive arrangements Employee Benefit Administration: flexible benefit plans, fiduciary liability issues, and communications Issues of Special Interest: retiree welfare benefits, small company benefits, multiemployer plans, and international employee benefit planning An innovative, efficient employee benefit program has become one of the primary prerequisites to success in today’s lean business battleground. The Handbook of Employee Benefits provides the knowledge and tools you need to create plans that benefit the greatest number of employees, while allowing employers to maintain fiscal integrity and competitive advantage.

Association Health Plans & The Future of American Health Insurance explains how these new insurance plans can lower coverage costs for businesses & individuals. It also reviews coming insurance market changes as well as future health reforms. Written with wit and humanity, the book avoids politicized commentary and provides actionable information.