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  #71  
Old 09-25-2014, 06:50 PM
Actuarialsuck Actuarialsuck is offline
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The way I looked at it is because the employee contributions are very similar for PPO and EPO, there is no incentive to choose one over the other. For the same benefits, PPO is "better/richer" than EPO since you have an OON option so if you were told your member premium was the same between the two, you would obviously choose the PPO.

This creates an element of anti-selection coupled with the fact that (as you said above) the network discounts are worse in Seattle, it's not surprising they're running worse.

I'm going from memory so take what I say with a grain of salt.
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  #72  
Old 10-10-2014, 10:44 AM
jhn31 jhn31 is offline
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I think we should assume that there are more benefits than just those listed, right? For example, the PPO probably has a much more favorable set of Inpatient Hospital benefits than the EPO, which is why some (probably higher-risk) people choose it.

The EPO doesn't have the $1,000 OOP Maximum, but it's not like an EPO member is going to get anywhere close to that on $10 office copays anyway. Therefore, there must be some kind of unmentioned Inpatient benefit that could cause EPO members to rack up more than $1,000 OOP if they are hospitalized.
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  #73  
Old 10-29-2014, 12:26 PM
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I'm working on this now.

For Task 2A.2, shouldn't the estimated savings also reflect the decrease in the employee contribution by switching from PPO to EPO for each location?
I'm wondering the same thing.
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  #74  
Old 10-29-2014, 03:42 PM
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Also, it seems that compairing the average PPO PEPM weighed by enrollment by location given PPO to the average EPO PEPM weighted enrollment by location given EPO is wrong since you are comparing two things with different denominators. It seems like average PPO and EPO PEPM should be weighted by total enrollment (PPO and EPO) by location.
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Last edited by Brock; 10-29-2014 at 04:24 PM..
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  #75  
Old 10-29-2014, 07:05 PM
Jrickard Jrickard is offline
 
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I think it makes sense to include the change in contributions in the savings calculation, it's easy enough.

I believe part of the point of their calculation on a national basis is that it misses the differences in costs specific for each location. The question then goes to say to explicitly "conduct your analysis on a location by location basis." So I would agree with the last statement.
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  #76  
Old 12-08-2014, 11:21 PM
GSUACT GSUACT is offline
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Anyone is working on this module now? I am planning to submit in 2 weeks and would like to find a study mate for this.
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  #77  
Old 12-11-2014, 01:54 PM
nak44 nak44 is offline
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Anyone is working on this module now? I am planning to submit in 2 weeks and would like to find a study mate for this.
GSUACT - sent you a pm the other day. Let me know if you are still looking for a study mate. I am trying to finish this before the holidays.
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  #78  
Old 09-14-2015, 04:28 PM
NMC84 NMC84 is offline
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Does anyone have additional thoughts on including the change in employee contributions when developing the "savings" for task 2a?

It makes sense to me to include this because for any analysis for a self-insured customer, this would have to included. But it seems to me that the SOA was not intending us to do this otherwise they would have given employee contribution rates that made more sense.

Like earlier posts, I calculated that the 1% migration would result in claims cost savings of about $98K. If I take the associated drop in employee contributions from encouraging PPO members to switch to EPO plans, I get a loss of $312K, which more than obliterates the claims savings.

Any thoughts on this? I'm leaning towards including the claims cost savings so that it's clear that I calculated it correctly and then noting that Big would also see a major loss in employee contributions by pursuing this route.

Any advice or thoughts would be appreciated!
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  #79  
Old 04-25-2016, 09:38 PM
Alpha_Msp Alpha_Msp is offline
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I'm working on this at the moment and have a question on the length of each of the 3 or so memos I need to write. The instructions say 5-10 pages must be sufficient but I don't think some of my memos will go past 3-4 pages.

Should I be concerned? Do you remember how many pages your memos were?
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  #80  
Old 06-30-2016, 12:11 PM
Msandler Msandler is offline
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anyone working on this now?
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