title: An efficient employer strategy for dealing with adverse selection in multiple-plan offerings: an MSA example.
abstract: This paper outlines a feasible employee premium contribution policy, which would reduce the inefficiency associated with adverse selection when a limited coverage insurance policy is offered alongside a more generous policy. The "efficient premium contribution" is defined and is shown to lead to an efficient allocation across plans of persons who differ by risk, but it may also redistribute against higher risks. A simulation of the additional option of a catastrophic health plan (CHP) accompanied by a medical savings account (MSA) is presented. The efficiency gains from adding the MSA/catastrophic health insurance plan (CHP) option are positive but small, and the adverse consequences for high risks under an efficient employee premium are also small.
authors.affiliation: Health Care Systems Department, Wharton School, University of Pennsylvania, Philadelphia 19104-6218, USA. pauly@wharton.upenn.edu
authors.forename: M V
authors.initials: MV
authors.lastname: Pauly
authors.forename: B J
authors.initials: BJ
authors.lastname: Herring
mesh_terms: D003256:Community Participation; D003659:Decision Making, Organizational; D017598:Efficiency, Organizational; D005249:Fees and Charges; D006264:Health Benefit Plans, Employee / Q000458:organization & administration*; D006801:Humans; D015273:Insurance Selection Bias; D007354:Insurance, Major Medical / Q000706:statistics & numerical data*; D020402:Medical Savings Accounts / Q000706:statistics & numerical data*; D017059:Models, Econometric; D020379:Risk Adjustment; D014481:United States