In the fully insured market, premium rates don’t reflect your individual experience — employers with lower claims costs subsidize higher-claim organizations. There’s also no way to see which claims are driving most of your costs.

Fortunately, you do still have options to control health plan spending:

• Plan design — Changing from a rich plan design (such as a PPO) to a lower-cost plan (such as high-deductible) can reduce your company’s premium.
• Plan funding — Switching to level-funded (or partially self-funded) often costs less than fully insured, because your plan is rated on your group’s favorable medical history and you pay costs based on your company’s actual experience. You also have more flexibility in plan design and increased visibility into claims costs.
• Plan optimization — Rounding out a higher-deductible plan with virtual care and a health reimbursement arrangement (HRA) can reduce fixed-cost premiums while maintaining coverage levels for your employees.

Improving Plan Design

Recent updates to the Affordable Care Act (ACA) and other events may cause changes in your plan member population. Medicaid will be retracting in some states, and low-income individuals and families who become ineligible for coverage may turn to employer health plans. On the other hand, recent updates to the ACA “family glitch” may expand eligibility for families to purchase coverage through the Marketplace, even if your company offers benefits to the employee.

There are steps you can take to ensure your employees are accessing the most appropriate and affordable coverage to meet their needs:

• Plan contribution — Reviewing your plan design and contribution strategy can help your company maximize employee satisfaction based on the choice of benefits offered.
• Employee communications — Your employees may not be aware of the various coverage options available to them and their families, such as Marketplace or Medicare, or even a spouse’s employer plan. Designing an employee benefits communication strategy can help educate your employees and give them tools to evaluate different options for their specific needs.

Increasing Employee Benefits Satisfaction and Engagement

Like most businesses, your company has probably already started a new plan year — and your employees already have questions. USI Insurance Services’ Benefit Resource Center helps answer employees’ questions about their benefits and can assist with billing issues and claims resolution. This also reduces the volume of questions business managers have to deal with following open enrollment.