As the stop-loss landscape evolves, keeping an eye on emerging trends helps self-insured employers control healthcare spending. Knowing what’s been happening over the last few years can help employers anticipate what might be coming up around self-funding, stop-loss and high-cost claims over the next few years. Continue Reading >
Providing benefits for your employees requires you to balance cost control with the needs and wants of your workforce. As decision makers, you have to scrutinize every expense that crosses your desk. That’s especially true when you’re making financial decisions on behalf of a municipality. Controlling your stop-loss costs is just one way to stretch your healthcare dollars without sacrificing employee benefits. Having the right level of stop-loss coverage allows a municipality to cap its financial risk while it provides a high-quality self-funded plan to its employees. But the stop-loss decisions you made last year may not reflect your current needs. That’s why we urge you to seek competitive quotes every year, even if you’re already working with a healthcare consultant. Continue Reading >
When your employees are unwell, your business is unwell. Supporting employee health is good for morale, good for productivity and really good for your budget. Having a largely healthy workforce is a key element of controlling health care costs, especially for self-insured employers that cover their own medical claims. Continue Reading >
It’s preferable to stop a fire from starting than it is to stop the flames from spreading, or to undo the damage that they cause. Prevention is naturally a primary goal for healthcare providers, who strive to keep patients from becoming sick and/or getting sicker. But self-insured employers benefit from this branch of healthcare too. Though it’s hard to say definitely if preventive medicine will help you dramatically slash costs, embracing prevention has lasting benefits for all involved. Continue Reading >
When was the last time you scrolled through the health and fitness apps available on your favorite device? Maybe you’ll check them all out the next time you have, oh, five or six free days in a row. That’s probably about how long it would take you to review the full range of health apps available in your device’s app store. Continue Reading >
Saving money is the primary reason that many employers decide to provide self-funded insurance. Balancing that objective and the healthcare needs of employees can be an ongoing struggle. Trimming benefits would help you cut spending, but not without sacrificing employee health and morale. Instead, think about making some strategic shifts to your plan. For some employers, it only takes a few small changes to dramatically slash healthcare spending. Continue Reading >
How can you make this upcoming year the best one yet for your business? It’s a lofty goal, but an achievable one too – that is, if your employees are ready to give you their best work this year. Launching a workplace wellness program is one way to motivate them to do just that. Continue Reading >
As we head into a new flu season, self-funded employers have good reason to be concerned about healthcare costs. Let’s face it, the flu is bad news for everyone. The best case scenario involves a healthy adult getting a mild case, spending a week feeling miserable and maybe making a single trip to the doctor. But others aren’t as lucky. Continue Reading >
As employers increasingly seek out methods to control costs without sacrificing benefits, stop loss coverage has emerged as a useful tool. It protects the self-funded employer from having to pay out-of-pocket for employees’ catastrophic claims. One of the ways to secure stop loss coverage is via a stop loss captive. Continue Reading >
Did you know self-funded plans are required to comply with ERISA guidelines? Typically when we think of ERISA we think of pensions and retirement benefits. However, even though the plan pays for healthcare coverage, a self-funded plan is fundamentally a pool of money. And that money needs to be insured. In order to protect the members, ERISA covers the plan and its fiduciaries. Continue Reading >
In 2011, the top 5 most expensive medical conditions treated in US hospitals were: Septicemia, Osteoarthritis, Complication of device, implant or graft, Liveborn, and Acute myocardial infarction
From 2010 to 2013, the number of claims that were individually $1 million or above rose by 1,000%
In 2017 approximately 18% of the American public will purchase insurance through exchanges, radically transforming the health insurance landscape.
In 2014, 98% of large firms (= 200 Workers) offer 1+ wellness programs to their employees.
The most costly 1% of patients account for 20% of national health expenditures – accruing average annual expenses of nearly $90,000 per person.
6% of firms offering fully-insured plans report they intend to self-insure because of Obamacare.
In 2014, PPO plans remained the most common plan type, enrolling 58% of covered workers.
In 2012, 93% of businesses with 5,000+ employees and 80% of companies with 1,000-4,999 employees were self-funded
Massachusetts has the third-highest prevalence of self-funded insurance in the small-group market (Fewer than 50 employees).
In 2013, the average deductible was $2,906 for individuals selecting plans from marketplaces. This compares with average deductibles of $1,135 for an individual with employer coverage.
In 2013, the average annual premiums for employer-sponsored health insurance are $5,884 for single coverage and $16,351 for family coverage, up 5% and 4% respectively from 2012.
From 2010 – 2013, cancer followed by chronic/end stage renal disease and leukemia accounted for the top 3 costliest illnesses.
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