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Employers Don’t Have to Accept Inadequate Health Insurance


We are just about at that time of year when the news headlines start screaming about health insurance premium increases for 2021. It is an annual event we have been enduring for the better part of 20 years. What makes 2020 different? Not much, except for a growing understanding among employers that they do not have to accept inadequate health insurance plans that charge too much and offer too little.

It is been said that necessity is the mother of invention. It turns out that invention has a younger brother known as adaptation. When necessity dictates, people and organizations will adapt in order to self-preserve. We are starting to see that now in the healthcare insurance marketplace.

Carriers Are in It for Themselves

A great piece recently published by Crain’s Cleveland Business likens the current health insurance paradigm to The Emperor’s New Clothes, the Hans Christian Andersen folktale published in 1837. The piece likens health insurance carriers to the Emperor. They are in it for themselves.

By the way, this is not necessarily a bad thing. Profit is the motor that sustains a free market economy. The problem is that when companies are allowed to do what they do unchecked by competition, some end up crossing the line.

That is where we are with health insurance. Carriers are more interested in high-cost services, high-priced medications, etc. They are less interested in actually making healthcare affordable to employers and employees. Why? Because employers have not held them accountable.

Just Going with the Flow

Employers have, for the most part, just go with the flow over the last several decades. They assume that they must settle for whatever their carriers offer. They go along with paying higher premiums simply because their carriers demand more money.

Dallas-based BenefitMall says that none of this is necessary. Employers don’t have to accept health insurance plans they don’t like. They do not have to quietly accept outrageous premium increases that cost them and their employees more money. They don’t have to accept higher out-of-pocket costs, less coverage, and so on.

So how do they change things? By standing up and holding carriers accountable. This is accomplished through a number of strategies:

  • Audits – Employers should be working with their brokers to conduct benefits audits every year. The simple fact is that there is no way to know how good or bad a health insurance package is without knowing its details. Audits provide those details.
  • Data and Analytics – We are applying data and analytics to so many areas of business these days, we ought to be applying it to health insurance plans. Data and analytics can tell employers a lot about ROI, employee financial impacts, health outcomes, cost-cutting measures, compliance, and so forth.
  • Practical Reviews – An extension of data and analytics is the practical review. Employers should regularly review things like preventative health measures, employee utilization of benefits, benefit accessibility, etc. Practical reviews serve to bridge the gap between hard data and employee reality.
  • Challenge Carriers – Finally, employers should be challenging what their carriers offer them. If a particular aspect of the health insurance plan is not acceptable, let it be known. Employers can tell carriers what they need and expect from their health insurance and then demand that it be made to happen.

It is important to note that BenefitMall represents some 120 carriers. They are just one general agency. There are many others representing hundreds of additional carriers. The point is this: there are enough carriers out there that employers can get what they want if they push hard enough.