By Mike Barone

As employers approach their next renewal, the concerns that have been building this pandemic year are coming into focus. They’re in the throes of a major transition as they re-evaluate how their benefits are financed and administered and also how they ensure their employee benefits plans are truly aligned with employees’ needs. No one knows where the chips ultimately will fall, but here are two questions that keep them up at night:

1. How do we ensure we are optimizing our healthcare premium dollars?

Good question. For the fully insured, premium dollars are predicated on expected claims costs. If voluntary procedures were delayed during the pandemic, your premiums seem misaligned with utilization. But you may see an expected surge in delayed procedures reflected in your 2021 plan quotes at renewal.

You can still get more value out of your healthcare benefit dollars with options like:

  • Telehealth. Use a carrier-based system or an independent vendor. Employees probably got comfortable accessing healthcare this way during the pandemic. Promote it through education; your provider should have an app. It can save as much as 19% over inpatient care costs.
  • Mental health services. The isolation of remote working and all the added worries associated with the pandemic have made employee mental health a key concern. HR must weigh the right level of support for the right types of services and vendors to grow the engagement and productivity and mental well-being of their workforce.
  • Self-fund. your health plan and pay only for claims incurred. You also take on more risks (think catastrophic claims for specialty drugs), but smart management of your stop-loss insurance helps guard against them. You also gain access to tools not available in a fully insured plan – like captives and reference-based pricing.
  • Captives.  Smaller self-funded employers can share the risks of expensive claims through Employee Benefits Group Captives. A third of HUB clients in one group captive saw their healthcare costs decline last year, while pharmaceutical plan savings averaged 25% to 30%.
  • Reference-based pricing. Under this self-funded strategy, the plan negotiates a fair fee schedule with area providers based on analysis of past years of claims data. Reimbursements typically are higher than Medicare rates, but below most PPO rates.

2. How do we know our benefits lineup is going to sufficiently meet our people where they are at?

A big part of this challenge involves doing a better job of learning what motivates your employees. That takes being able to access and leverage employee data more effectively. To the extent that the data involves health claims and how different employee groups use different benefits, it’s not easily accessed or analyzed if you’re not self-insured. But that’s key to being able to walk a mile in everyone’s shoes to see how the perspectives shift among them. You will uncover opportunities to close gaps in your employee benefits plans and make smarter decisions in the process.

HUB International’s employee benefit specialists consult with employers of all sizes and in all industries on every aspect of employee benefits planning and management.