Here are 3 steps you can take to achieve significant results.
Employee benefits, especially health insurance are becoming more and more expensive. Employers are having to deal with inflation, supply chain issues, employee retention and recruiting, so it’s very difficult for employers to afford benefit packages that are attractive to employees. Add competitive wages to that mix and it makes it even more difficult.
Here are 3 steps you can take to achieve significant results.
First, replace your fully insured plan for one that is partially self-funded. Instead of paying a fixed premium to BUCA (Blue Cross, United, Cigna, Aetna) and giving them the cash flow advantage, only fund claims if and when they occur. In addition, a fully insured plan has taxes and fees that a partially self-funded plan does not. A partially self-funded plan gives control back to the employer in terms of cost and plan design.
Second, unbundle the plan. Rather than “bundling” the plan with an insurance company, whereby they control the administration, the network, the pharmacy benefits, and the premiums, “unbundle” these programs by using Best In Class companies that specialize in each of these areas. You won’t be compromising the benefits you offer, you’re simply assembling your own plan rather than one that’s “off-the-shelf.”
Third, carve out Specialty Drugs. Specialty Drugs are extremely expensive and are consuming a large portion of health insurance costs with no end in sight. If you are using BUCA for your health insurance then you have one of the big Pharmacy Benefit Managers (PBMs) for your prescription drug coverage. These PBM’s will not allow a carve out of Specialty Drugs – they make too much money on the spread pricing and the rebates. Employers need to implement a health plan that allows for an independent PBM to be in place who in turn will allow for Specialty Drug carve outs. An employer can subsequently contract separately with a Specialty Drug plan that can obtain these drugs at little or no cost.
We’ve designed a Blueprint For Health Plan Success that details these three steps and how to implement them. An employer must use due diligence when selecting any of the programs with Best In Class vendors. Having done this for hundreds of clients over the years, we’ve already identified those who are in fact, Best In Class.
Our Blueprint also identifies several other will areas that an employer should consider to help reduce health plan costs. Every employer has a different culture, different employee demographics, and different needs, so that a customized plan can be designed to meet those needs. If you would like more information about “how to” do these steps, or request a copy of the Blueprint, email me at [email protected] and I’d be happy to send it to you. You can also visit www.strategichpc.com
