It’s that time of year when the leaves start changing colors, temperatures are cooling, pumpkin spice is showing up in everything, and if you are a business owner, broker or human resource leader, you are probably buried in employee health benefits renewal season.
Many of us dread this time of year and while in the midst of it, may run into a few roadblocks that leave us asking questions like:
- Are these health benefits in our company/organization budget?
- Are we choosing the right plan for my team?
- How will my decisions affect our culture?
To help answer these questions and others, The Karis Group has prepared a list of tips & resources to guide you through the renewal season.
Health Insurance Renewal Season Tips & Resources
If your company or organization offers healthcare coverage options, as most do, you will need to renew insurance coverage on an annual basis to stay up to date. The insurance carrier you choose for your employees usually will update their rules, regulations, adjust their rates, and may offer different health coverage options. As a leader for your organization or company, you must stay up to date on what is happening on a local, state, and federal level that may impact your healthcare coverage decisions.
Do Your Research
Renewal Season occurs annually, and it is essential to choose the right health coverage option that fits your team. Doing your research and shopping around are the first steps in this process. It is best to work with an independent broker (we include links to trusted broker associations below) to review your coverage options, negotiate your premium rate and/or potentially adjust your contribution strategy.
There is also a rising trend among employers to switch to alternative healthcare coverage options like medical cost-sharing. Groups like Sedera and Samaritan Ministries offer healthcare cost-sharing alternatives to traditional health insurance that may be an option for you. In the end, doing your research and ensuring you’ve explored all options will help you make an informed decision.
Review Claims, Set Goals & Budget Accordingly
Another concern that arises each year is setting goals and budgeting for your health benefits package. Reviewing your historic claims data and analyzing your member populations specific healthcare needs will allow you to customize your benefits plan and set realistic goals. Additionally, selecting a premium reimbursement approach will allow the employer to choose how much to contribute to employee's health benefits.
When allocating budget, also consider the intangible benefits of your health benefits choices. Having the right health benefits package for your employees will often increase retention, happiness, and decrease turnover.
Review Your Contribution Strategy
Some companies choose to offer their employees the option of a defined contribution health plan instead of paying premiums. A defined contribution health plan is when an employer will set a fixed dollar amount that will go towards their employees' health plan. Employees can use this amount as allowed to reimburse themselves for specific health insurance costs.
Another valuable option is to provide a Health Savings Account (HSA) paired with a HDHP so employees can set aside pre-tax money to cover qualified medical expenses. For 2020, the limit for HSA contributions is $3,550 for individuals and up to $7,100 for a family. To learn more about Health Savings Account, you can read the Healthcare.gov HSA overview page.
Cost Containment – Navigation & Negotiation
Healthcare costs continue to rise for employers and employees; According to a Kaiser Family Foundation Employer Health Benefits survey, annual premiums for employer-sponsored family health coverage reached $19,616 this year, up 5% from last year and there is no sign of healthcare costs decreasing soon. There are many reasons for rising medical expenses, but there are a few proven methods for containing costs, including clear healthcare navigation, patient education and medical bill negotiation.
The Karis Cost Containment Suite of Services assist countless entities in decreasing their healthcare costs while maintaining or improving quality. For the last 23 years our services have guided members to medical cost savings through bill negotiation, healthcare navigation, and expanded access to quality care.
Our Healthcare Navigators guide members with concierge-style navigation service through a confusing healthcare system, providing an average of 60.5% average savings via cost comparison. Elements of the service that may support benefit packages include: Cost Comparisons for Surgeries, prescriptions, imaging, MRI’s and lab work; Provider Searches; Medicare, Medicaid Questions and appeals; Appointment Scheduling & Transferring Medical Records.
With our Bill Negotiator Service, patient advocates that are highly skilled in unique negotiation strategies work with members to bring down inflated medical bill prices. Bill negotiation strategies may include direct provider negotiation, reference-based pricing & when appropriate financial aid assistance to drive savings. On average, our service saves members 40%-70% on their out-of-pocket medical expenses. These services are offered based on a PMPM (Per Member Per Month) and/or percent of savings model.
Additional Resources
We’ve compiled a few additional helpful resources for further learning:
- If you are looking to learn more about groups supporting employers and brokers to shift away from the status quo, we recommended reading up on our partners, Next Gen Benefits & Health Rosetta.
- This Workforce article, “6 Things to Ask Your Insurance Broker Before Renewing” offers excellent questions to consider during renewal season.
- Staying up to date with compliance requirements such as HIPAA, COBRA, ERISA, and the ACA to avoid expensive fines. To learn more on requirements for compliance, visit The U.S. Department of Labor Compliance Assistance Guide- Appendix A: Self Compliance Tool
- Lastly, here is a helpful video from SHRM overviewing best practices for HR professionals managing open enrollment season:
We hope this information was useful as you decide which customized health benefits components to provide to your employees/members. Remember, do your research, review your contribution strategy, budget accordingly and explore helpful cost containment services that will decrease costs while improving member support and quality of care.
If you have any questions about Karis Cost Containment Services you can contact us to schedule an intro call.
Blog Photo by Brooke Cagle on Unsplash
