Title:

Senior Consulting Actuary

Joined Spring:

I joined Spring in May 2014, shortly after graduating from Northeastern.

Hometown:

Central MA

At Work Responsibilities:

My actuarial focus is mainly health and medical stop-loss.

Outside of Work Hobbies/Interests:

Sports

Fun Fact:

I’ve been known to card count.

Describe Spring in 3 Words:

Never a dull Moment!

Favorite Movie/TV Show:

Inception/Seinfeld

Favorite Food:

Cheese

Favorite Place Visited:

Italy

Favorite Band/Musician:

Changes by the day!

If You Were a Superhero, Who Would You Be?

Batman.

Name One Thing On Your Bucket List:

Retire

What is One of Your Proudest Moments?:

I don’t know that I have any singular big ones, but I am proud every time we get positive client feedback

If You Win the Lottery, What is the First Thing You Would Do?

Invest!

What are You Passionate About?

Financial Literacy

The Problem

In the insurance, healthcare and benefits world, we have been helping clients challenged by things like inflation, hardened insurance markets, rising healthcare and prescription drug costs, remote and hybrid work, and other trends that continue to ebb and flow. On top of these dynamics, many consumers and organizations are beginning to open their eyes to the crisis that is long-term care in the U.S. The issues in this area became alarmingly obvious in the wake of the pandemic, and has continued to remain a top concern over the last several years. State Medicaid programs pick up significant long-term care costs and they are looking for ways to minimize these expenses.

Multiple studies show that 70% of Americans over the age of 65 will need Long-Term Care (LTC) at some point in their life, with the average duration being 3 to 4 years. The cost of an LTC stay is even more unaffordable than other components of healthcare in the U.S., with 2021 national annual averages as follows:

Long-Term Care insurance (LTCi) exists to prepare and provide a cushion for LTC needs.  With the LTC costs and expected use of the LTCi policy,  individual LTC is expensive. Forbes reported that the average LTCi cost for a male age 60 looking to purchase an LTC pool of $165,000 of coverage costs $1,200 a year. When we weave these factors into the aging population shift we’re experiencing, where the number of Americans aged 65 or older is expected to increase by 47% by 20501, we can see a huge problem on the not-so-distant horizon. Over the last 2 decades, the challenging environment has caused many LTCi carriers to exit the market, making coverage and pricing even more of an uphill battle.

Legislative Developments Driving New Entrants and Programs

Like with Paid Family and Medical Leave (PFML), states are starting to take things into their own hands regarding an LTCi funding solution, recognizing the dire situation for their constituents and the extensive drain LTC puts on publicly-funded programs like Medicare and Medicaid.

The State of Washington was the trendsetter in this area, passing its WA Cares program in 2022, key points of which include:

While Washington may be the first, many other states have LTC legislation on their docket. In 2019, California created a Long Term Care Insurance Task Force to explore the feasibility of developing and implementing a competent statewide insurance program for LTC services and support. To date, the Task Force has made the following recommendations for a more flexible program of that in WA:

The state of the California legislation is still in flux and it is uncertain when it will go into effect. In addition, some sort of LTCi plan is being or has been considered in over 10 other states including Connecticut, Colorado, North Carolina, Georgia, and Oregon. Legislation has been proposed in New York, Massachusetts, Pennsylvania, Minnesota, and Michigan, in addition to the two programs highlighted above.

While the maximum benefit payout (in the case of WA) will not be sufficient for most LTC needs, it is a step in the right direction, necessitating conversation and planning, and reducing some of the state’s burden. We do believe this trend will gain steam and momentum in the coming years. While some may be tempted to “wait and see,” we saw in Washington that many didn’t have time to secure a different option prior to the legal deadline and so were responsible for the tax. For this reason, we strongly advise our clients and their employees to review their LTC options now, while options still exist.

While state LTCi programs such as WA Cares revolve around an employee or employer tax, there is still administrative and compliance burden on employers to withhold, report, and submit those taxes. For these and other reasons, it may behoove employers to explore other options for employees either through a voluntary program or one partially sponsored by the employer.

Solutions in the Market

Luckily, long-term care insurance products have evolved from standalone LTC insurance to a hybrid program including life and LTC, or life and chronic illness riders. We also expect to see annuities becoming a bigger option in the future. Traditional medical insurance and long-term disability (LTD) typically will not cover much of anything related to LTC. More prevalent options include the following:

These solutions can be structured for groups (employer-paid or voluntary), executive carve-outs, or for individuals. Underwriting can come in the following formats: guaranteed issue, modified, or full.

Takeaways

For employers, LTC needs and insurance should be one piece of your reward and risk management strategy. We encourage companies to look at the LTCi realm and support employees where they can. A captive insurance model may provide a unique and cost-effective funding strategy. For individuals who already have an LTCi plan, you may want to consider “layering up” to ensure adequate coverage. Take a look at your duration limits, inflation riders, and other components. Regardless of your current position, a statutory LTC program could be coming to your state, and it’s best to be proactive in this area. Your broker/consultant should be equipped to help you navigate this complex landscape and provide solutions that make sense for your organization and its employees.


1 https://www.prb.org/resources/fact-sheet-aging-in-the-united-states/

Within the employee benefit market, the term point solution has become watered down and leveraged for all add-on programs that complement a core benefit offering. Unfortunately, this has led many benefit professionals to feel like point solutions do not add value. The truth is that some point solutions add immense value while others fall short, but the challenge is the answer is different for each employer.

Employers must consider their healthcare and employee benefit spend, including but not limited to potential incentives; corporate culture and goals related to employee engagement, health and productivity; capability and service guarantees with core providers; and anticipated utilization of core and point solutions to evaluate their offerings and where point solutions may make sense.

Assess Current Offerings

The first step in considering point solutions is to evaluate your current offering(s). Catalog your current partners, what services they perform, what you are paying them, and when your contract renews. In addition, summarize any performance guarantees or return on investment metrics as well as standard reporting that is provided and at what frequency. 

For most employers, this exercise in gathering data related to your offerings will shine a spotlight on a few critical areas:

In order to address these questions and come to any conclusions regarding your point solutions, this assessment needs to run in tandem to a market analysis.

Understand the Market

It is important to understand the plethora of solutions available in the market. The most efficient way to gather this intelligence is to talk with your current health plan and broker/consultant. We help many clients, including edHEALTH, on mapping out and understanding the universe of options in the realm of point solutions and then creating a targeted strategy based on tailored benchmarks. But don’t stop there. Find other resources that can educate you on options, perhaps another advisor or an industry conference. These conversations do not require a deep dive (yet) into each solution. Instead, they should provide enough for you to think about what’s possible as you compare and contrast what you have versus what you anticipate needing in the future.

Identify Pain Points

The most valuable point solutions work to solve a pain point that your core health offering cannot address as well as serve as a targeted comprehensive solution. This is why solutions around specific diagnoses have evolved (e.g., musculoskeletal, cancer, fertility, hypertension, etc.) and for engaged claimants often provide better experiences, more favorable outcomes and even potential cost savings. 

Consider your pain points both qualitatively and quantitatively. Look at data from employees to understand what is not working well for them in the process. Then look at the data from your health plan and understand where you are above their benchmark in spend by major diagnostic category, or have any outliers in the data. For example, our client edHEALTH, a captive for educational institutions, recently began offering a new diabetes management program, which was implemented based on their member schools’ input and supporting data.

Bringing it all Together

Once you have assessed your current offering, gotten a better understanding of what is available in the market, and identified your pain points, it’s time to compare and contrast those three areas of review and arrive at your desired future state. 

Start where program overlaps exist and see if you can simply remove programs without employees experiencing a loss in coverage/benefit. In some instances, those overlapping programs may be provided free of charge from your vendor but still may cause confusion among your employees or be absorbing credits that could be used for other programs. In addition, vendors may be willing to negotiate removal of those services, freeing up funds for other programs. 

After you have explored overlapping programs, consider programs that are currently offered but do not seem to align with your pain points. It’s possible that a point solution is working so well and achieving the desired impact that it is positively impacting spend. If so, this is a point solution you want to continue. Your vendor partner should be able to demonstrate via data how the point solution is working, what employees/claimants are being impacted and how to continue these favorable results. If the vendor partner cannot prove successful data for your population, be skeptical; it may still be a value-add program, but some cynicism is helpful in this very complicated review of point solutions. 

Once you have reviewed overlapping programs and those that do not align with your pain points, you should review all other point solutions against market offerings. Ensure your solutions are keeping pace with the market both in pricing as well as service offering and performance standards. For programs involving considerable spend, a request for proposal (RFP) may be necessary,. For programs with minimal spend, a few calls with competitors may provide enough insight to determine if an RFP is necessary. If your solutions are not competitive, do not have appropriate performance standards, or have not demonstrated their value, you should consider replacing them or, at a minimum, renegotiate with strong performance or return on investment parameters. 

This review must be data driven, but it will often involve both art and science. Sometimes a program may be a worthy partnership for your culture even if cost savings may not materialize. Only you and your team will be able to make that decision, but just because the decision is not solely routed in cost savings doesn’t mean you shouldn’t track utilization, engagement and return on investment. Those may be even more critical for programs that will need to be defended in the future.  Many HR and benefits professionals are feeling point solution fatigue, and are asking questions around impact, risk, and reward. If you could use assistance conducting a point solution audit, or would like advice on best practices in this area, please get in touch with the Spring team.

Current State

Weight loss medications, Glucagon-like peptide-1 receptor agonists (GLP-1RA) s, have risen in popularity beyond anyone’s imagination and there is no sign 2024 will be any different. Endorsements by top Hollywood celebrities, aggressive and compelling consumer marketing, new direct-to-consumer options, and research demonstrating their benefits related to both heart and kidney disease, have left employers wondering if they should rethink their coverage choices.

Many employers have seen the impact on their budgets, adding on average $15,000 annually per patient in pharmacy costs. It is common for employers to focus only on short-term impacts and fail to connect the benefits of weight loss to long-term health care costs and goals. On average, patients who are overweight may incur healthcare costs that are 50% higher than someone of a healthy weight. Is it time we shift our thinking and focus more on the long-term?  Is it possible that there is a subset of your population that would benefit from these medications? Would you reconsider your position if the right safeguards were in place?

The Bigger Picture

Did you know?1

The American Medical Association (AMA), the World Health Organization (WHO) and other medical boards have recognized obesity as a chronic disease by for well over a decade. It is a complex metabolic condition that is impacted by genetics, behavior, and environment. Obese individuals have too much fatty tissue stored as energy within their bodies and their ability to change the body’s response to excess fatty tissue is often unsuccessful despite great efforts. 1 2 3

Obesity’s role in the development and/or progression of many chronic diseases, such as type 2 diabetes, hypertension, cardiovascular disease, kidney disease, stroke, sleep apnea, osteoarthritis, and certain types of cancer, is well documented. A person with obesity has an 80-85% risk of developing type 2 diabetes, and cancers associated with excess weight contribute to 40% of all cancers. It is easy to overlook that obesity not only impacts the physical body but also a person’s mental health.

The CDC reports that more than 50% of adults diagnosed with moderate to severe depression who were also taking an antidepressant were obese. Overall, 43% of adults with depression were obese compared with 33% of adults without depression, and women with depression were more likely than men to be obese. This was true across all age groups among women and was also seen in men aged 60 and older. 3 4

To Include or Exclude

As we enter 2024, the demand for weight loss medications continues and is anticipated to increase since much of 2023 was plagued with drug shortages.  Despite these shortages, the average employer saw double digit increases in the GLP-1RA category which includes drugs for both diabetes and weight loss. Many employers continue to struggle, unable to justify unrestricted access and coverage for their members while striving to offer benefits that provide value and fair access.

As employers look for innovative ways to combat soaring healthcare costs, re-evaluating coverage of weight loss medications to a subset of members could be a critical piece of the puzzle. The International Foundation of Employee Benefit Plans (IFEBP) reports that 22% of employers in the U.S. currently cover prescription drugs for weight loss, and 32% offer weight management programs. Another survey showed up to 42% of employers were revisiting coverage for 2024 and beyond. 5 6 3

This year started off with somewhat of a curveball in this area, with Eli Lilly announcing LillyDirect, a direct-to-patient portal, allowing some patients to obtain its newly released drug, Zepbound (tirzepatide) for as little as $25 a month. LillyDirect uses the telehealth platform, FORM, where patients reach independent telehealth providers who can complement a patient’s current doctor or serve as an alternative care option. This news has been received with mixed emotions. Many obesity experts feel this is a long overdue service that improves access and addresses affordability concerns. Others feel this is another move by manufacturers to circumvent health plan sponsors and improve their market share. Many are calling for transparency between telehealth providers and the pharmaceutical company to rule out any conflicts of interest. 7

If you are exploring adding weight-loss drug coverage to your plan, a critical first step is to ensure members are educated about these drugs, essentially demystifying the media hype. The truth is these drugs are expensive, have side effects, and cannot do the job alone. Inadequate education regarding the side effects and how to manage them has caused many people to stop therapy, resulting in wasted healthcare dollars. The medications must be part of a comprehensive program that highlights the importance of healthy food and physical exercise. Members need to understand their responsibilities and how they will be held accountable for demonstrating their continued commitment to the plan. It has been demonstrated that those who stop the drugs regain, minimally, 75% of the weight because long-term behavioral changes and/or healthy eating habits did not form. 8 2 9 10 3

Employers also need to find ways to monitor their financial interests, such as:

  1. They must be active participants in designing coverage criteria and ongoing monitoring parameters.
  2. They must ensure they create a comprehensive approach, complete with a robust clinical review and ongoing monitoring at frequent intervals to evaluate a member’s response to therapy. As part of that, employers need to recognize the importance and impact that social determinants of health and health equity have when discussing weight.
  3. Determine ways to implement opportunities for members to access healthy food choices and physical activity and add additional wellness incentives to your benefit offerings.
  4. Be sensitive to the views/ or needs of your employees; do not make the out-of-pocket expenses so significant that they essentially restrict access.
  5. Finally, monitor your financials closely, request frequent in-depth reporting, and hold your PBM accountable for ensuring appropriate coverage/monitoring, access to competitive pricing, rebate incentives and formulary placement.

Conclusion

Ultimately the choice to cover these medications is an organizational decision, but it’s critical to have all the information necessary to make this decision, starting with a robust view of your population demographics. With high rates of obesity for most health plan sponsors, a prudent and thoughtful approach to expanding weight-loss coverage will be required. Attempts like this to tackle the obesity epidemic could produce long-term savings with lower overall healthcare costs, prevention of progression of existing diseases, and, most importantly, a better quality of life and employee experience. It has also been demonstrated that many people would remain at a job solely to retain coverage if offered and approximately 44% of people surveyed reported that coverage of these medications could be an important decision point in whether to accept a new position. 11 4 12 13 14 6 8

No matter your decision on offerings, the more you can offer through communications and education will help your plan participants make informed decisions and understand their role in achieving and keeping weight off. To realize tangible results, all parties must be committed. If you could use guidance around weight loss drug strategy or would like a clinical pharmacist to assess your population and needs, please get in touch with the Spring Team team.


1 https://www.cdc.gov/obesity/data/adult.html
2 Obesity Statistics. The European Association for the Study of Obesity.
3 Public Health Considerations Regarding Obesity. StatPearls
4 https://www.hsph.harvard.edu/obesity-prevention-source/obesity-consequences/health-effects/
5 https://ir.accolade.com/news-releases/news-release-details/glp-1-coverage-employer-plans-could-nearly-double-2024
6 https://www.cdc.gov/nchs/products/databriefs/db167.htm
7 https://investor.lilly.com/news-releases/news-release-details/lilly-launches-end-end-digital-healthcare-experience-through
8 https://icer.org/news-insights/press-releases/icer-publishes-evidence-report-on-treatments-for-obesity-management/
9 https://www.webmd.com/diet/obesity/obesity-health-risks
10 https://www.npr.org/sections/health-shots/2023/01/30/1152039799/ozempic-wegovy-weight-loss-drugs
11 https://jamanetwork.com/journals/jama/fullarticle/2812936
12 https://www.ama-assn.org/press-center/press-releases/ama-urges-insurance-coverage-parity-emerging-obesity-treatment-options
13 https://www.milliman.com/en/insight/payer-strategies-glp-1-medications-weight-loss
14 https://www.niddk.nih.gov/

With winter quickly approaching, the Cayman Captive Forum last week provided a great escape from the cold weather and a fantastic excuse to visit a tropical paradise. As Cayman is the second largest captive domicile (behind Vermont), it is more than a vacation spot; a rewarding opportunity to address top trends and practices in the captive insurance and risk management space. Here are some driving topics of interest this year:

AI and Risk Management

As concerns surrounding artificial intelligence (AI) dominate headlines and conversations worldwide, it was only fitting that it was a popular topic of discussion this year at Cayman. AI holds an interesting position in risk management, in that it can be used to help identify risks and create efficiencies; but also can create vulnerabilities in cyber and digital. Here are a couple of innovative sessions on AI’s impact on risk management:

During the presentation “AI and your Captive,” beverage distributor, Southern Glazer’s Wine and Spirits explained how they were able to optimize their captive using AI and machine learning tools.

In the eye-catching session, “Chat-GPT/AI Concerns in Claims/Risk Settings,” risk experts reviewed how AI is being used in cyberattacks, especially towards healthcare organizations. They also examined the recent emergence of AI chatbots in healthcare.

Cyber Risks

This year there have been over 327 healthcare data breaches reported to the US Department of Health and Human Services, involving more than 40 million patients’ data1. Cyber is a top priority for risk managers, especially those working for healthcare employers. Here are some highlights:

The session, “Complex Cyber: Renewal to Claims” looked at current cyber insurance market trends for healthcare organizations and recommendations for protecting patient information from adverse incidents.

With emerging technologies, cybercriminals have more tools than ever at their disposal. A presentation titled “Cybersecurity Trends and Tomorrow’s Challenges: Future-Proofing Your Organization” highlighted strategies to combat evolving cyber threats.

Risk Face by Healthcare Organizations

As Cayman is the largest domicile for healthcare organizations2, healthcare-related risks receive a lot of buzz each year, and 2023 was no exception. Healthcare organizations face unique challenges, some of which include:

a) Social Risks

Within the healthcare sector, risk management teams must balance distinctive social and legal issues on top of day-to-day operations. Some noteworthy sessions included:

– The presentation, “The Impact of Social Inflation on Captives and Others,” reviewed shifting trends in medical professional liability and explored how risk management teams can better understand changing social influences and the risks tied to them.

– One engaging session entitled, “Reproductive Care Post-Dobbs: Protecting Patients and Providers,” provided insights into how a healthcare organization was able to identify emerging risks associated with reproductive care.
b) Workplace Safety and Medical Malpractice

With unique risks come unique coverages. Healthcare organizations often must turn to specialty insurers and experts to evaluate risks associated with workplace violence and medical malpractice. These topics were widely discussed during the conference:

– In the one-of-a-kind session, “Active Shooter Workplace Violence – Claims Coverages Consequences,” the Captive Owner from the University of Pittsburgh Medical Center drew takeaways from their mass shooting over a decade ago.

– A session on “Implementing Structured Communication Processes to Avert Malpractice Claims & Reduce Patient Harm” spotlighted how nearly half of malpractice claims come from miscommunication and provided suggestions on streamlining communication.

– The final session of the conference “People Behaving Badly” reviewed a high-profile case where medical providers harmed patients and professional liability considerations for healthcare companies when disciplining or terminating staff.
c) Other Priorities

In addition to the topics discussed above, some other notable healthcare industry-focused sessions included:

– As virtual care continues to be popular post-pandemic, a group of risk experts discussed recommendations for “Managing the virtual practice of medicine in multiple states & the unique risks associated with this practice.”

– In a virtual session, “A total guide to total cost of risk,” an actuary and captive consultant discuss how to properly calculate and identify Total Cost of Risk (TCOR) and suggestions on how to adjust to changes in TCOR.

The Cayman Captive Forum was a strong finish to the year in terms of lessons learned and connections made. The farewell beach party is always an added bonus!  We welcome this chance to reflect back and look forward to what 2024 has in store for the captive space.


1 https://www.urologytimes.com/view/health-care-cyberattacks-soaring-in-2023
2 https://caymanintinsurance.ky/about/

Spring has been recognized as one of the Top Employee Benefits Consulting firms in Massachusetts by Mployer Advisors, who focus on connecting employers with top-rated insurance advisors. We’d also like to congratulate our colleagues at Boston Benefit Partners, An Alera Group Company, for making the list as well! You can find the full update here.

As we prepare for 2024, we are in an interesting time for HR teams in that they are facing challenges such as back to office strategies and changing workplace expectations, all on top of a full plate of duties. Last week I attended the Northeast HR Association (NEHRA) Annual Conference, which brought together leaders and industry experts to delve into crucial topics that have become front and center HR today. This year’s conference explored vital themes, including mental health/well-being, innovative leadership tactics, and the importance of Diversity, Equity, and Inclusion (DEI). Here are the highlights from this enlightening event.

Nurturing Mental Health and Well-being

One major theme at NEHRA’s Annual Conference this year was meant health and well-being, a popular topic in the world of HR. The discussions were both insightful and innovative, with presenters emphasizing new trends and practices to help support employees’ mental health. Here are some presentations I found impactful:

– In the session, “Neuroinclusion in the Workplace: A Win-Win for Both Employers and Employees,” a well-being expert discussed strategies to support neurodivergent employees to foster workplace collaboration and effective communication.

-The Founder and CEO of Wellbeing Works, Shanna B. Tiayon discussed how HR departments can support employees experiencing trauma though proper communication and resilient HR structures.

– The closing keynote, titled “Transform Your Workplace Through Connection & Community,” focused on developing an understanding of the benefits of having a connected work community and how to develop inclusive programs.

Innovative Leadership Tactics

One of the most pertinent points discussed was the role of HR in shaping leadership. The event brought forward outside-the-box ideas for fostering leadership excellence, creating an inclusive environment, and retaining and developing potential future leaders. Below are some presentations I would like to spotlight:

– A presentation titled “Who’s on Deck? Succession Planning that Eliminates Fears and Reduces Cost,” reviewed the advantages of promoting talent internally and tips for developing middle management for leadership roles.

-A leadership development expert explored top management tactics and the importance of developing workplace conditions that bring out the best in people. The session was titled “Reimagining Managers: Why the Best Managers Don’t Manage People.”

– In the era of hybrid work, effective and efficient meetings can be challenging. The breakout presentation, “Mastering the Art of Meetings: Powering Up Your Gathering,” reviewed ways to prioritize productivity without sacrificing workplace culture during meetings.

Championing Diversity, Equity, and Inclusion (DEI)

Developing and enhancing DEI efforts continues to be a top priority for HR teams. The importance of setting measurable goals, conducting bias training, and engaging with underrepresented communities was emphasized. The conversations highlighted that DEI isn’t just an HR issue; it’s a business imperative. Organizations that embrace diversity are better equipped to innovate, excel, and adapt to the ever-changing global landscape. Here are a couple of presentations with insights I wanted to share:

– Two HR professionals discussed “Practical strategies to imbed DEIB Considerations Into Your Hiring Practices.” Some main points included implementing blind resumes, training hiring managers and recruiters on unconscious bias and diversifying the interview panel.

-In the session “Building a Personalized and Equitable Benefits Program,” the presenter discussed effective and realistic tactics to improve DEI efforts in employee benefits without breaking the bank.

In conclusion, the NEHRA Annual Conference 2023 proved to be a valuable platform for HR professionals to deepen their understanding of a plethora of challenges employers are facing. The event’s discussions and insights provided attendees with the knowledge and motivation needed to lead HR into the future, creating workplaces that are not only more productive but also more compassionate and equitable. The NEHRA Annual Conference continues to be a beacon for HR professionals in the northeast as they navigate the evolving landscape of the industry.

Running a small to medium-sized business (SMB) can be financially challenging, especially when it comes to providing competitive employee benefits and managing insurance costs, since economies of scale generally benefit larger organizations. However, with strategic planning and calculated decision-making, SMBs can maximize savings without compromising on the well-being of their employees. In this article, we’ll explore cost-saving methods for SMBs in the areas of health insurance and employee benefits.

1) Conduct a Comprehensive Benefit Audit

Before making any changes, start by conducting a thorough audit of your current benefits package. This will help you understand where your company is overspending or underutilizing benefits. Key points to consider:

2) Emplore Self-Funded Health Plans

Many smaller organizations look past a self-funded model due to resource constraints and risk appetite, but various versions of self-funding can work for smaller employers. According to Kaiser Family Foundation’s 2022 Annual Survey, 35% of workers in small firms (3-199) are in a level-funded plan, a self-funding option. Level-funded plans often have a steady monthly rate employers contribute to cover claims, administrative costs, and stop loss coverage. Many of these plans limit offerings to smaller companies with fewer covered lives.

3) Leverage Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), and Flexible Spending Accounts (FSAs)

Consider HSAs, HRAs and FSAs for employee healthcare expenses, or if you are already offering one of these solutions, be sure to communicate the offering and encourage utilization among your workforce. These help employees pay for medical expenses beyond what is covered by your health plan and are particularly well-suited to pair with a high deductible health plan. Some offer tax advantages and can help reduce the financial burden on employees demonstrating that the company is invested in them. Depending on what path is chosen, employers can contribute to the account.

4) Offer Telemedicine Services

Telemedicine services have gained popularity, especially in the wake of the COVID-19 pandemic. By offering telehealth options as part of your health plan, you can potentially reduce healthcare costs associated with office visits and encourage preventative care. In 2023, most health plans provide some level of telehealth, but allowances and nuances vary, and it is worth a closer look.

5) Implement Wellness Programs

Wellness programs can lead to healthier, more productive employees and lower healthcare costs. Consider offering incentives for employees who participate in wellness initiatives such as fitness challenges, smoking cessation programs, or health screenings.

6) Negotiate with Insurance Providers

Leverage your broker/consultant to negotiate with insurance carriers and ensure you are getting the best coverage at the best rate. Our team helps clients explore options for bundling different types of coverage or increasing deductibles to reduce premium costs, and regularly seek competitive quotes from multiple providers.

7) Promote Employee Education/Communication

Educate your employees about their benefits and how to use them effectively. By ensuring that employees understand their coverage, they are more likely to make informed choices, reducing unnecessary healthcare expenses. Effective open enrollment communication strategies are essential in ensuring employees take advantage of benefits offered.

8) Consider Voluntary Benefits

Voluntary benefits, such as dental, vision, and life insurance, can be offered at little cost to the employer. These benefits can be partially funded by the employer, or fully funded by employees, depending on your budget and strategy. In any case, it will help bring costs down and provide nontraditional and more customized coverage for employees based on their needs (e.g., pet insurance, identity theft protection).

9) Review and Adjust Annually

Market conditions and employee needs change over time. Regularly review your insurance, health plans, and benefits package to ensure they align with your business goals, budget, and employee demographics. Adjustments may be necessary to stay competitive and cost-efficient, and new tools and solutions are being launched at a rapid pace.

10) Seek Professional Advice

Consult with insurance brokers, benefits consultants, or financial advisors who specialize in working with SMBs. Subject matter experts, like our team at Spring, can help you navigate the complexities of insurance and benefits, ultimately saving your company time and money.

In conclusion, cost-saving methods in insurance, health plans, and employee benefits for SMBs require strategic planning and a commitment to employee well-being. By conducting regular reviews, being as targeted as possible, negotiating with providers, and exploring innovative options like telemedicine, SMBs can achieve a balance between cost savings and providing valuable benefits to their employees. Remember that a well-crafted benefits package can be a valuable tool for attracting and retaining top talent in a competitive job market. If you’re interested in reevaluating your current benefits package or wonder how your programs stack up, our consultants and actuaries would be happy to assist.

Our Managing Partner, Karin Landry was quoted in a recent Captive.com article on potential savings when switching to a captive instead of the commercial market. Check out the full article here.