Tier 2 is Dead!

Tier 2 is dead by Dr. RandyIt’s not just Health Care Reform that is turning the world of health care upside down. The cost shift to both the employee/consumer is dramatic and having an effect on sales.

The old paradigm of success being defined as having Tier 2 access is no longer valid. The out of pocket burden for the employee/consumer continues to increase based on higher coinsurance, copay and deductible amounts with the continued rise in the number of employers offering High Deductible Health Plans (HDHPs).

An enhanced critical review of product abandonment rates based on out-of-pocket burden should be conducted against the value of obtaining/maintaining Tier 2 access.  More emphasis (ie. access dollars) should be shifted to the employee/consumer in a targeted manner based on the various benefit design offerings.

Access Market Intelligence draws on a catalogue of more than 1,200 health plans deployed by over 200 of the country’s largest employers. The plans in this coverage provisions database cover approximately 25 million employees and family members – over one-tenth of the country’s working age population.