Medical Care under Employee State Insurance

Medical Benefits under Employees' State Insurance Scheme

Risk selection in the Massachusetts State employee health insurance program.

Using the Diagnostic Cost Group (DCG) model developed from a national sample, we examine biased selection among one fee-for-service (FFS) plan, one preferred provider organization, and several health maintenance organizations (HMOs) in Massachusetts. The proportions of enrollees in low-risk groups are higher in the HMO plans and lower in the FFS plan. The average age in the FFS plan is 9 years ...

Options to Re-Design State Employee Health Insurance Benefits Presented

The State Employees’ Group Health Insurance Program has experienced growth in health care costs resulting in projected program deficits beginning in Fiscal Year 2001-02. Expenses are projected to exceed revenues by $28.8 million in Fiscal Year 2000-01 and are projected to exceed revenues by $121.3 million in 2001-02 and $225.1 million in 2002-03. The Legislature should consider options in four ...

State of Wisconsin State Employee Medical Plans Self-Insurance Advisability Assessment and Actuarial Cost-Benefit Analysis Executive Summary

Recent market and legislative changes to the health insurance industry, particularly the additional fees associated with the Affordable Care Act (ACA) and the current premium taxes paid on fully-insured plans has prompted the State of Wisconsin to consider the advisability of adopting a self-insurance arrangement for its state employee medical plan. Within a self-insured program, these fees and...

Public health insurance under a nonbenevolent state.

This paper explores the consequences of the oft ignored fact that public health insurance must actually be supplied by the state. Depending how the state is modeled, different health insurance outcomes are expected. The benevolent model of the state does not account for many actual features of public health insurance systems. One alternative is to use a standard public choice model, where state...