HIP/Dual Benefit Plans

The HIP/Dual Benefit Plans option consists of the following:

  • Offer individuals a choice of being in 1 of 2 benefit plan options.
  • One plan is a richer plan with a lower premium contribution - e.g., Health Improvement Plan (HIP)
  • The other plan is less rich with a higher premium contribution - e.g., the Standard Plan
  • Eligibility requirements for being in the richer plan includes agreeing to responsibilities and taking required actions throughout the year to enroll and remain in the plan.
  • Failure to meet the requirements results in being removed from the richer plan and moved to the less rich plan.

There are many advantages to this type of plan, such as:

  • Offers the greatest integration opportunities regarding benefit design, support system, engagement, administration and results
  • Meets or exceeds PPACA/Health Reform changes and mandates
  • Resolves key gaps in PPACA/Health Reform changes and mandates
  • For 9 consecutive years to date, paid claims (medical and Rx) have been lower than 2006 with no increases In out-of-pocket co-pays, co-insurance, limits or premium contributions.
  • Other metrics have documented the use (engagement) of HIP-related population health support resources and over 200 other related positive impacts and outcomes that adult participants in HIP attribute to his/her/family use of specific resources and related dual-plan approach as an incentive to use specific support resources and take other key actions at certain times.