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Cost Tool
Notes:
An employer who wants to calculate how much their costs would increase if they added coverage for THBs can use a tool like this one.
It should be customized to the situation of the specific employer.
Each row breaks down one portion of the cost, for example, Therapy, HRT RX, HRT MD, and Surgery.
The columns show C (the total cost for that procedure,) E (the employee share, based on 15%,) Er (the employer share, remaining after subtracting the employee share.)
CP represents the amount the employer is Currently Paying, which varies from plan to plan, but will certainly include at least the Maintenance HRT (22 and 16 cents.)
IC is the increased cost due to magnet effect, long term growth due to increased demand. Unless you have data to show otherwise, the experience of Lucent, Avaya, and San Francisco suggests this number should be zero.
The increased cost to the employer, I, is therefore Er – CP + IC.
Each employer can determine and enter their own numbers.
Because the E share will be almost 10 cents, and the CP share is at least 38 cents, the I share (increased cost to the employer) should not be more than 16 cents.
The employer can then multiple their own I (cost per insured) by their number of insured employees and dependents.
This will provide an estimate of the total increased cost to offer THBs.