Fields J A, Poole B S
University of Connecticut, USA.
Benefits Q. 1997;13(2):22-8.
The marketplace for health benefits for public sector employees is large and complex with a great variety of approaches for providing care and a difficult patchwork of regulatory and collective bargaining regulation to deal with in designing a plan. Public sector workers' plans are subject to an additional constraint provided by the political nature of the process. The products sold to public sector plans are not regulated as ERISA plans, given the exclusion of government plans and the differential regulation of collectively bargained plans under the HMO act. This article attempts to guide the reader through some of the difficulties of this marketplace, pointing out pitfalls and opportunities where they appear.
公共部门雇员的健康福利市场规模庞大且复杂,提供医疗服务的方式多种多样,在设计计划时要应对监管和集体谈判规则的拼凑难题。公共部门工作人员的计划还受到该过程政治性质所带来的额外限制。鉴于政府计划被排除在外,以及根据《健康维护组织法》对集体谈判计划的差别监管,出售给公共部门计划的产品不受《雇员退休收入保障法》计划的监管。本文试图引导读者了解这个市场的一些困难之处,指出出现的陷阱和机遇。