lvena

So sorry you have not seen it. All of this is currently permissable in the new reform environment and has been used by carriers/emloyers/self-funded groups for years. Getting identifiable private health information is not needed, rather, the self-funded group plan is designed (via benefits, contribution, rating structure, network etc.) to attract good risk and avoid high risk enrollment. Some high risk will get through, but if the employer really wants them out, it would not be that difficult.

I have not had time to review this article in much detail, but the idea that an employer can construct a self-funded plan and "direct" the high-cost employees towards another plan is not only possible, but has been done for years. There are many mechanisms available, but the most easily designed one is employee contribution. This can be done via a 125 plan or by having age banded rates. What I don't know though, is what the consequences of this will be. My guess is that over time we will get a better picture.