Top 10 Money-wasters for Group Health Insurance Benefits
November 30th, 2009 by sugig
As an employer or a participant you might be leaving money on the table by not properly taking advantage of certain features and benefits of your company’s health insurance. As a licensed Consultant and Group Benefits Brokerage company, with clients across the country, we are successful in reducing group benefit expenses because of our experience and our intimate knowledge of the factors used in determining pricing. This top 10 list should be helpful in increasing your insurance knowledge, maximizing your plan benefits and possibly reducing your company’s expenses.
Background and Overview:
For most companies, group benefit plans, specifically medical benefits, are among the highest non-producing company expenses. Unlike other expenses, medical benefits hits home since it affects our employees and our families personally. Therefore, it is of paramount concern that the CFO and Director of Human Resources take into consideration the needs of their employees, the needs of their employees’ families, pricing, and specific benefits being offered.
The ability for an employee or an employee’s family member to use a favorite physician such as a Pediatrician or an OB/GYN is often affected by this decision. The ability for employees and their families to use specialized treatment centers in the event of a catastrophic medical situation also lies in the balance of the Health Benefits decision. Quality and access to medical care varies from insurance carrier to insurance carrier.
Staffing and Retention:
The primary purpose of Group Benefits as a whole as it relates to employers is to attract and retain employees. It goes without saying that the broader the benefits, the easier it would be to attract and retain a higher quality workforce.
As a reciprocal, industries that utilize high turn-over positions with minimum-wage employees may not necessarily choose to utilize the highest quality insurance policies to attract and retain employees. Employee pools may be abundant and the bottom-line total expenses may be more important than the quality and level of care offered.
With that said, let us share with you some money-saving ideas and under-utilized features of your medical benefits. Keep in mind that some items may relate to your current coverage while others suggest a change in coverage or a change in features of your plans.
The following represents our list of the top 10 frequently made mistakes as it relates to Group Health Insurance. This list is in no particular order. Each item may or may not apply to your current situation.
Top 10 Medical Benefits Mistakes:
1. Not Catching Medical Problems Early
2. Not Using the “Value Added Benefits”
Many times, when you think of medical benefits you only think about doctor visits and drug plans. Often, employers and employees do not realize that their insurance carrier might also include services known as “Value Added Benefits”.
Examples of Value Added Benefits Include:
a. Vision – some carriers have pre-negotiated discounts for vision care such as eye exams and eyeglasses.
b. Nutrition and Supplementation – Certain carriers provide discounts or reimbursements for nutritional supplements. Supplementation might keep employees healthier and prevent certain diseases. Some employees are often already paying out-of-pocket for supplements so any discounts become bottom-line savings for the employee.
c. Quit Smoking - Employees may be entitled to discounts on programs that relate to quitting smoking. Without going into a lecture as it relates to the dangers of smoking, let’s just say that when an employee is ready to quit, it is easier to do it with the help of professional programs. In the event that the Surgeon General is right about the dangers of smoking, healthier employees are happier and more reliable as an employee. This could also avoid future hospital visits and catastrophic treatments as well as delay premature death.
d. Weight Management – Employees may take advantage of weight management programs. In some cases employees might already be using well known programs such as Weight Watchers™ or Jenny Craig™. Many scientific medical studies directly relate disease and health risk to an individual’s weight. Once again, a healthy employee calls in sick less often, is more productive, and on a selfish side, is likely to minimize the number of claims against your Insurance Policy. Certain company sizes in certain states may be rated and premiums are charged based on the claims filed against the insurance carrier.
e. Gym Membership – Discounts and reimbursements may be available for health club membership.
f. Hearing - Certain hearing centers may have pre-negotiated discounts with your insurance carrier.
g. Bicycle Helmets - Safety equipment such as bicycle helmets may be available at a discount with specific insurance companies and retailers. Certain states mandate that children under a specified age are required to wear a helmet while riding bicycles, skateboarding, or roller skating. Even if helmets are not mandated, it is alarming how many serious injuries might have been prevented with the proper head protection. If you need or want a helmet anyway, you might as well get a discount on it.
h. Store Discounts - Various retailers may have a pre-negotiated incentive worked out with your insurance company such as baby stores or household goods. This is good for the store from a marketing prospective and it is good for the consumer to get a discount.
i. Security Improvements – Security companies my provide discount services for your home protection and safety additions.
j. Stress and Alcohol Management - Different services may exist for stress management and alcohol rehabilitation and treatment programs.
k. Mail Order Discounts – Certain carriers offer additional discounts for mail order prescriptions. This is especially useful for drugs prescribed for the long-term such as heart medicine or cholesterol drugs. You know you need it any way so you might as well stock up by mail.
3. Not Getting a Second Opinion:
Different Insurance professionals have different experiences and abilities. Some Brokers are only Brokers while others are also Licensed Insurance Consultants. Some Brokers specialize in Property and Casualty or Life Insurance while others specialize in Group Health. If you are concerned with your Health Insurance rates and services, perhaps a specialist is what your company really needs.
Speaking as an insurance professional, we of all people, respect and appreciate client loyalty based on past service and existing relationships. On the other hand, how do you really know that you have the most appropriate policy and features if you do not get a second opinion from a different Broker or Consultant? If the relationship with your Broker is that solid, it would not be difficult for your Broker to keep your business. If your Broker’s skills are not current and sharp as it relates to your company, his/her complacency might be costing your company tens of thousands, if not hundreds of thousands, of dollars.
4. Not Looking at the Big Picture of Total Costs
Very often, companies only look at the monthly premiums associated with their healthcare coverage. This is not the only variable when it comes to insurance rates.
Do you really want to have to pay for everyone’s insurance if they do not want insurance or prefer to waive coverage and go on their spouse’s plan? That means paying higher expenses for something that will likely never get used by certain people.
5. Not Listed as the Right Group Size (or Perhaps a Different Stated Size) Is There Common Ownership?
Depending on your circumstances, such as what state that you do business in, you may or may not benefit by being classified as a small group or as a large group. By simply classifying clients in the most appropriate group size we have saved clients thousands of dollars.
6. Not Knowing Your Employee Population or Offering Different Plans
Similar to #5 in classifying the group size, money can also be saved by having an overall understanding of the demographics that makes up your group. Typically, younger people are healthier and can often afford to take certain medical risks that older employees cannot afford to take. If you realize that your company is mostly made up of younger people who are healthy, it might be a good idea to utilize a high-deductible tax qualified plan with a Health Savings Account (HSA).
7. Not Comparing your Coverage to Your Peers:
The trick is to be competitive without giving away the shop. Typically, to generalize for a moment, law firms might offer the best insurance available for the money while assembly line workers might be given average benefits for manufacturing. But what is average and how do you find out what is standard and customary?
A “Benchmark Analysis” is a report that can be ordered to get statistics and trends about comparable companies in your industry, company size, and/or in your region. Although these reports often cost some money, the information provided could be valuable in attracting and retaining qualified employees without giving away all of the profits.
8. Blindly Auto-Renewing
Even if you love your Broker, it is a mistake in not treating each renewal period as an opportunity to find out what policies or other insurance companies are more competitive or appropriate for your company.
9. Not Using the Right Tax Treatment for Your Company
Although we encounter this particular “money-waster” often, we are not an accounting firm and suggest that you speak with your tax advisor, accountant, or CPA before doing anything.
10. Losing Money Due to Poor Administration.
We hear about it almost every day. Due to poor administration, employers neglect to advise the insurance carriers of newly terminated or newly eligible employees.
So What is Your Next Step?
It’s great that you made it this far into the article and that by itself gives you plenty of things to look at in deciding if you are making any of the above mistakes. In some cases you can change your behaviors midstream. For example, you can find out from your current carrier if there are any Value Added Benefits that you may not be aware of. You can also make sure that your company has an accurate list of employees who should be on the policy or need to be added.
Once again, Group Health Insurance is one of the largest non-producing expenses for most businesses. It is up to the business as well as their employees to maintain an active role with wellness, routine exams, and disease management programs. Insurance might be considered an expense, but when it comes down to it, health and lives are at risk.
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