What to consider when buying health insurance for your employees

By Trey Hinson

After 23 years in healthcare benefits, I've been fortunate to see trends come and go—twice in some instances. A perfect example is Direct Primary Care Models (DPCs), which are quickly becoming favorites in markets like Texas, the Midwest, and, more recently, Florida. If you look at the older HMOs of the '90s, you may notice several similarities in strengthening the power in the physician's hands.

As a business owner today, while the world is more complex than ever, there are navigation tools that can help you decide what products to consider when those annual renewals rear their ugly head in the near future.

Here are three:

Fully Insured Options
Many think of these as BUCA Plans, and despite what some say, they are still a solid fit for many employers today. If you have an employee population that is quickly aging and may have embedded medical conditions or unique needs associated with limited provider networks, this makes complete sense.

The main detractor of these plans is that you can expect rate increases each year, and your unused claims expense is placed in the insurance carrier's pockets. The main benefit is that you know exactly what your cost will be for 12 months, and businesses of any size can leverage these plans.

"As a business owner today, while the world is more complex than ever, there are navigation tools that can help you decide what products to consider when those annual renewals rear their ugly head in the near future.'"

Self-Funded Options

After the Affordable Care Act (ACA) was passed, employers received their first look at self-funded healthcare plans. Self-funding has long been a vehicle for groups that have become household names for healthcare benefits to employers of all sizes. Once considered a large employer product, the new self-funded plans can benefit employers with as few as 20 employees.

If you have an employee team that takes their health seriously or wants less-than-expected claims, self-funding may be a great option. Through integration with a quality stop-loss carrier, analytics vendor, third-party administrator, and medical management company, you can often save 15-20% off your current fully insured rates.

If you are interested, speak with your broker/advisor and ask about level-funded plan options. These offer the same premiums but may sacrifice some of the unused projected claims' loss.

Captive Options
In the past five years, as the ability to pool risk with like-minded business owners is highly appealing, Captive Health Plans have become quite common in the benefits space. You will find a variety of options in this space, with some offering fixed vendor partners while others provide a complete cafeteria plan of options.

To each their own with the selection, but when it comes to benefits and connections, I have always found that one size does not always fit all. From a cost consideration, you must imagine that a massive captive's stop-loss coverage buying power is highly competitive and worth a look.

As a business owner, you are in control of more options than you may know about. Whether you are a new entrepreneur with a small team or a large enterprise employer, take the time to discover what is the best fit for your organization and how you can make your benefit plan options work for you.

Next time, we will dive into the Top 5 benefit trends that have emerged to create savings for employers in the past three years.