The debate over healthcare reform wages on, and plans and proposals for legislation change constantly. Employers who are trying to choose a healthcare plan for their employees may feel overwhelmed by the possibilities. However, instead of getting bogged down in the details of future proposals, employers have the option of relying on benefits advisers who can help them create customized, effective plans for their companies.

You may want to get involved with your local politicians and discuss how certain changes in healthcare policy could affect your business, says Thomas Stautberg, principal at Stautberg Benefit Advisors. “But don’t spend too much time on it right now, because it changes every day,” he adds.

With all the changes coming down the road, the companies handling employee group benefits are in more of a direct advisory role than they have been in a long time.

Erick Schmidt, vice president and managing principal at the Cincinnati office of McGohan Brabender Employee Benefit Solutions, points out the importance of reviewing your healthcare plan. “Companies need to continue to review with their benefits brokers to make sure they’re getting the right advice and forming a long-term strategy,” he advises.

Return on Investment

Effective health care remains a top priority for employees and a top expense for most employers. Businesses’ annual medical expenses continue to rise steadily every year, says Mike Stahanczyk, benefits manager for the Cincinnati office of Hylant Group, and that puts additional stress on companies that are already battling economic hardships.

“It’s really impacted every employer I’ve worked with,” he emphasizes. “Everybody’s trying to find the same solutions. Medical is one of the higher costs that an employer will face during the course of the year.” Trying to balance cost with employee satisfaction is always difficult, and it’s only getting more so as budgets tighten.

Wellness plans that seem to go over-and-above may be viewed as an additional expense, Schmidt says, but the alternative to implementing them isn’t appealing. While it’s often difficult to measure the return on investment in wellness plans in dollar amounts, it does pay off to have healthy, productive employees showing up for work each day. (Check out the ROI calculator created by Dr. Steve Aldana and Dr. Troy Adams on www.wellsteps.com: under “resources,” then “tools.”)

One Plan Does Not Fit All

Stautberg emphasizes that customization of healthcare programs is key to their effectiveness. Just as a doctor analyzes health symptoms to come up with a diagnosis, your benefits adviser should analyze what is making your premiums go up to create an appropriate solution.

“Ideally, a client should be open to learning to fix the root of the problem, not just putting a Band-Aid on it,” Stautberg says.

For example, he notes, many companies move to a high-deductible program as a knee-jerk reaction to the need to reduce healthcare costs, often without really understanding why. Employers should identify their goals, whether they’re for cost-savings or for employee health, so that advisers can develop a plan to address them.

“It’s like a giant puzzle, and we’re trying to find the right solution,” Stahanczyk says. “Every company is different on what they want to achieve as far as their healthcare plan goes.”

Lowering Premiums

Employers are increasingly using alternative solutions to lowering healthcare premiums through wellness programs, Stahanczyk says. For example, many have implemented smoking cessation programs that stipulate that employees pay a higher premium out of their paycheck if they continue to smoke. “It makes employees healthier and offsets that risk from a premium perspective,” he explains.

Whichever wellness programs make sense for your company, Stautberg advises integrating them with your medical program. Medical insurance and wellness plans should be working hand-in-hand, but many times they work completely separately of one another, he notes.

For example, if you have major claim issues in a particular area, wellness programs should integrate with disease management to address those directly. Stautberg also suggests having a wellness committee and strategic planning process within your company, so that your employees are directly involved.

Another program that has been successful in lowering premiums in recent years is one that rewards employees whose spouses stay on their own employer’s healthcare plan, if they have one. “That’s something that Hylant Group has promoted heavily in the past few years,” Stahanczyk says.

Picking an Adviser

With changes on the horizon, now is a good time to assess the consultant or agency that is giving you advice on your benefits programs.

Schmidt suggests evaluating whether you’re getting support and clear communication on things such as wellness initiatives, benefits plans, negotiation with carriers and government compliance.

When choosing an adviser, Stahanczyk says, “Look for creativity and ability to find solutions that may not be mainstream.”

In general, whoever is advising you regarding your benefits should set a plan to meet specific goals. Your benefits adviser should address the following questions, Stautberg says: Where do you want to be in three years, how do you get there, and how do we help you?

“There are a number of good quality people out there that are advising,” he adds. “Just make sure someone’s advising you. Make sure that someone is walking you through the path and not just doing product placement.” 

Ask the Experts

Angie Wright
Senior Vice President, Sheakley

Q: Are there programs available to Ohio employers that can help reduce the cost of doing business during this tough economic time?

Discount opportunities on workers’ compensation premiums can help employers save a significant amount of money. Programs such as Group Rating, Group Retrospective Rating, One Claim Program and the Deductible program are available through the Ohio BWC. Also, employers who implement the BWC’s Drug Free Workplace Program can potentially earn discounts on their premium while developing a safer work environment for their employees.

Thomas J. Stautberg
Principal, Stautberg Benefit Advisors, LLC

Q: Why is choosing the right group benefit program so important to your bottom line?

A comprehensive benefits package that fits the needs of your employees and business is crucial — It could mean the difference between attracting and retaining valued staff members or losing them to the competition. The best benefits buyers push the envelope and develop a long-term strategy.

Ask yourself:

  • Are we offering the right plans?

  • Are we providing incentives for healthy behaviors?

  • How can we help employees become better healthcare consumers?

  • Culturally, what is our workforce ready for?

  • Are we attracting and retaining “A” players?

Kenneth C. Page
President and CEO, HealthSpan

Q: The health reform debate includes a discussion regarding competition in the marketplace. What are your views on health reform, and what will HealthSpan’s role be going forward?

We support reform in the context of some high level objectives. Two themes coming out of the debate relate to the lack of competition in many markets and the need to change the delivery system. Market competition is imperative to assure employers and individuals have good choices and cost effective options. It is true we cannot reform health care by just focusing on coverage – we must address the delivery system by reducing inefficiencies and creating more primary care capacity.

Connie Matchett
Group Rating Director, Employers Choice Plus

Q: What types of changes can we expect from the BWC in the upcoming group rating year?

Once again the BWC is making changes that impact companies and their potential group discount. One of the most important is that the maximum discount is expected not to exceed -65 percent. Furthermore, the BWC is expected to continue the group rating assessment factor to all group rating participants. These are just some of the reasons why having an experienced and competent TPA to advise you on all programs, discounts and group plans is essential.