The majority of companies renew their health plans January 1st, and now is the time to act. Whether your company is in a fully-funded or self-insured plan, or a group health captive, decisions will have to be made soon, and the choices you make now, can make you pay later – in more ways than one.
Many companies working with a broker such as Clark & Lavey have been engaged with their benefits advisor throughout the year, reviewing claims experience (available to large groups) and identifying actionable items, so our clients generally have an expectation of where they stand, long before renewal. Conversely, if you don’t meet with your broker regularly, you may have no clue what to expect when that renewal comes in.
Here are some considerations to think about before you sign on the dotted line:
- How you fund your benefits matters. Looking at all fundings options can show you the difference in premium costs based on your funding method. Fully-insured plans give you the least amount of control, and for small groups – doesn’t factor in the health of your employee population. It provides the least opportunity to control costs, but does provide the assurance that no matter the number of claims, you will pay the same amount, which typically makes it the most costly. Self-funding provides greater control in managing your health plan, you pay stop loss against high claims, and you manage the risk. If premiums are not spent, they are returned to you. A health captive gives you control, and mitigates your risk – you are part of a bigger pool – and whatever premium costs you don’t spend, are also returned to you.
- Implementation of a pharmacy benefit management program for large groups, regardless of how they are funded, is a great savings tool. This can significantly lower an employer’s costs, and can be structured to negotiate lower costs of pharma for chronic diseases and more serious illness prescriptions that may be frequently prescribed to members.
- A good benefits advisor will review the options that you may not have previously implemented prior to sending out RFPs. Be on the lookout for this.
- Implementation of a good wellness program with measurable results can lower your medical loss ratio—ultimately lowering your premium rates. And, if your organization is too small for a formal wellness plan, consider educational and incentive initiatives that can improve the overall health and well-being of your employees.
- If your company doesn’t already have telemedicine as part of the plan, consider it. This cost-effective and convenient interaction with providers allows plan members to reach their healthcare providers online. Plan members can receive care for their non-serious health issues this way for the cost of a co-pay, but without having to leave home or their office.
- Voluntary products are often very appealing to employees, and since these are purchased by the employee with very little administrative effort, they are a win-win for everyone. With today’s tight labor market, trends in benefits should be reviewed to determine if your organization needs to enhance their benefit offerings to remain competitive.
Renewal time is a good time to re-assess the benefits that are currently offered in your plan. Clark & Lavey is here as a resource for your organization. We work with organizations of all sizes, and all industries, as well as non-profit and not-for-profit organizations. Whether you’re in a fully-insured or self-insured plan, we can help. Give us a call at 603.883.3773 or contact us online.