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 >
When a Walmart employee needs an organ transplant or spinal surgery, they don’t go to their local hospital. If they’re enrolled in the company’s benefits program, all Walmart associates can go to the Mayo Clinic for certain surgeries—with Walmart footing the bill. The company has a contract with the Mayo Clinic to provide services to its employees, and has similar contracts with other health systems throughout the country. Continue Reading >
Without its employees, your business is nothing but an idea. If you have a team of highly-qualified, deeply-engaged people working for you, you’ll generally go a lot further than you would with a team of middling performers. The best employees also tend to be the people who have the most job options. Someone who has an incredible resume, glowing references and a long list of skills and certifications may be able to be picky about where they work. Not only do you want those employees coming to work for you, but you also don’t want them going to work for your competitors. To get them on your team, you’re going to have to offer competitive health benefits. Employers considering going the self-funded route often wonder if they will be able to offer appealing healthcare benefits. 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 >
Small businesses have to be creative to survive in a competitive market. For many of these businesses, embracing a new kind of healthcare strategy is key to controlling costs and attracting top talent. Self-funding your healthcare plan means paying employees’ claims directly instead of paying premiums to an insurance carrier. 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 >
For a startup to last beyond a few years, all the stars have to align. The business has to have a great product and a way to reach its customers. There has to be a place for that product in the market. Investors have to be willing to fund the business until it starts earning profits, which may take years. A successful startup also needs a team of skilled employees who are engaged in the work and committed to building something that lasts. Providing high-quality health insurance is one way a growing startup can attain and retain top talent. Self funding and stop loss coverage are two tools that can make that goal achievable. Continue Reading >
Collecting patient data is essential to the future of medicine. Here are some of the innovations already affecting the industry. Continue Reading >
After more than 25 years in stop-loss, I can say with experience that the stop-loss landscape is constantly evolving. Staying on top of the trends is the key to maximizing your coverage and taking advantage of your best options. One resource I rely on to understand the field is the Aegis Survey. Continue Reading >
When it comes to health insurance, choice is a good thing. American employers are spoiled for choice these days, with a variety of insurance arrangements available to even small businesses. But all that choice necessitates making some tough decisions. Before you can get into the nitty-gritty about benefits and co-pays, first you have to make a big decision. Should your company be fully insured and pay premiums to an insurance company, or should you choose self-funded insurance, sidestepping the insurer and paying employees’ claims yourself? 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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