CERN LongTerm Care Scheme Conference of the Staff Associations of Internationals Organizations 2930

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CERN Long-Term CareSchemeConference of the
Staff Associationsof Internationals
Organizations 29-30 September 2005
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Contents

• CERN Health Insurance Scheme
• Nature of the CHIS
• Basic principles of the CHIS
• Scheme administration responsibilities
• Long-Term Care Scheme
• Background of the LTC
• Actuarial studies (scheme choice)
• Nature of the LTC
• Actuarial scenarios (no LTC with LTC)
• Financing of the LTC
• Benefits of the LTC
• Advantages of the LTC
• Some LTC statistics from 2001 - 2005
• Some CHIS LTC statistics from 1988 2004
• The future of the LTC
• Conclusions

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CERN Health Insurance Scheme (1)

• Nature of the CHIS
• Funding of the CHIS
• Contribution of active staff share between
  Staff Organisation 4.02 6.35 of basic
  salary
• Contribution of pensioners share between
  pensioners Organisation 4.02 6.35 of the
  last indexed monthly basic salary
• Contribution of spouses when they receive an
  income
• External administrator (UNIQA)
• Claims reimbursement
• Daily administration of the CHIS services

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CERN Health Insurance Scheme (2)
It is obligatory

• Basic principles of the CHIS
• Obligatory, everyone must participate
• Contributions are based on salaries only,
  independent of age of beneficiariesand of number
  of beneficiariesin the household
• All members of the family (spouse dependent
  children are cover).

It is a mutual scheme
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CERN Health Insurance Scheme (3)

• Freedom of choice of health care providers
  world-wide coverage
• Responsibility of each CHIS memberthe level of
  reimbursementshall not exceed the level of
  contributions

Freedom of choice
Collective responsibility
CHIS Insurance
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CERN Health Insurance Scheme (5)

• Scheme administration responsibilities
• CERN has the full control of the scheme
• CERN monitors the scheme
• CERN lays down the policies proposes
  modifications as needed
• UNIQA acts as a daily administrator of the scheme
• UNIQA implements the policies applies the CHIS
  rules
• UNIQA produces statistics and gives feedback

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Long-Term Care scheme

• Background of the LTC
• Before 2001 the CERN Staff Association worked to
  elaborate a LTC scheme and studied several scheme
  types
• Several actuarial reviews to obtain a forecast
  foresee the future evolution
• In 2001 CERN set up a Long-Term Care scheme,
  which is part of the CHIS
• The LTC scheme was set up as a result of the 2000
  five yearly review

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LTC Actuarial studies

• Technical basis
• Use available mortality tables for
  (non)dependents
• Do not include (big) safety margins the insurance
  companies include
• Aim at 60 of standard full-board Swiss cost
  (100 CHF)
• Three levels of dependency
• No adjustment foreseen for home care allowance

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LTC Actuarial studies

• Collective scheme versus individual commercial
  proposal

Regarding the CERN population this scheme is
cheaper but the solidarity between the young and
the old generations is not fully warranty
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Long-Term Care scheme (1)

• Nature of the LTC
• All CHIS members are insured, regardless of their
  age and medical history
• Three levels of dependency
• Low level
• Medium level
• High level

According to the members degree of ability to
perform some life essential actions
Not 3
Not 4
Not 5

• Taking food drink
• Going to the lavatory
• Coherence ability to communicate
• Orientation in space time

• Getting up, sitting down, getting into bed
• Mobility
• Washing grooming
• Dressing undressing

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LTC Actuarial Scenarios

• No LTC (only standard health coverage)
• 52 CHF per day for home care with 2580 CHF per
  year for paramedical expenses
• Hospitalization cost 1000 CHF per day
• 100 days per year for dependant are spend in
  hospital
• With LTC
• 85 CHF per day for home care
• Up to 2500 CHF per for paramedical expenses
• LTC scheme eliminates hospitalization cost

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LTC Actuarial Studies results
40 CHIS reduction cost with the LTC scheme
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Long-Term Care scheme (2)

• Financing of the LTC
• Affiliation and contribution are compulsory for
  CHIS members
• Increase by 0.6 of the CHIS rate contribution
  for all staff contributors
• Enlargement of the basis of contribution for the
  pensioners (0.6 corresponds to 1.2 of pension)
• Creation of a capitalized LTC Fund to pay the
  home care allowance

Staff members of the scheme are the single
contributors But the Organization is paying a
contribution for pensioners
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Long-Term Care scheme (3)

• Benefits

Not paid during hospitalization
50 of standard full-board Swiss cost 70 of
standard full-board French cost
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Long-Term Care scheme (4)

• Advantages of the LTC
• Cost reduction of increase in hospital bills
• Authorize the improvement of the long-term
  financial balance of the Organizations health
  insurance scheme
• Better cover for dependent persons
• Keep the CHIS equivalent to the LAMAL scheme

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Long-Term Care scheme (5)

• Some LTC Statistics from 2001 2004

2026 243 cases foreseen (3.1 of CHIS members)
37 cases evaluated in 2003 / 20 cases evaluated
in 2004
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Long-Term Care scheme (6)

• Some LTC Statistics from 2001 2004

Actuarial study 20 MCHF foreseen end of 2004
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Long-Term Care scheme (7)

• Some LTC Statistics in 2004 by age sex

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Long-Term Care scheme (8)

• Some CHIS LTC statistics from 1988 -2004

Evolution cost
Large increase for hospitalization in 15 years
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Long-Term Care scheme (9)

• The future of the LTC
• Actuarial study in 2006 to review the scheme and
  take a decision on adapting the daily allowance
• Looking for preferential providers in the field
  of nursing home help in France

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Conclusions

• The number of cases is in line with the forecast
• The LTC scheme meets needs. Some difficulties
  reported in the assessment of low dependency
  level
• The current financing of the LTC scheme is sound
  from an actuarial point of view.
• Adapt continuously the scheme to the future
  evolution of society, also to keep the LTC and
  CHIS equivalent to the LAMAL Swiss health scheme

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• END
• I am at your disposal for questions
• Joel LAHAYE
• CERN Staff Association
• Joel.lahaye_at_cern.ch

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LTC predicted number of dependants

• Hypothesis
• Present age distribution
• Expected numbers of staff and pensioners
• Mortality rates
• Statistics on dependency as function of age
• Projections
• 1999 18 known cases
• 2026 243 cases ( peak 3.1 of CHIS members)
• 2045 155 cases

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LTC Actuarial studies

• most efficient cost
• V1 0, V2 100, V3 175
• Regarding the CERN population this scheme is the
  more efficient but the solidarity between the
  young and the old generations is not fully
  warranty

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CERN Health Insurance Scheme
CERN has to protect its staff against the
financial consequences of illness, accident and
maternity
CERN Health Insurance Scheme must be globally
equivalent to the Swiss national scheme LAMAL

• Nature of the CHIS
• Set up its own scheme
• CHISBoard monitors the scheme proposes
  modifications
• Proposals are discussed at the SCC before
  decision by the DG
• Sometimes TREF, FC and Council if proposals
  concern benefits

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CERN Health Insurance Scheme (6)

• Financial balance of the CHIS

Contributions
2004 5800 Contributors 11868 Beneficiaries
Reserve
Mutual Fund
UNIQA
LTC
Reimbursements