Tag Archive for: health plan

Retrieving and Analyzing Claims Data on Fully-Insured Plans

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Many employers would like to better understand their healthcare spending. Until recently, it wasn’t easy for companies to retrieve health claims information. Fortunately, technological advances have made it possible for employers to analyze and leverage health program data.

Analyzing Health Program Data

Employers use data analytics to make sense of the large amounts of health program data collected. Using a robust data analytics tool, leaders can view what works and what doesn’t with their existing fully-insured benefits plan. This tool provides employers with the information needed to assess whether other options are the right choice for their organization. This is especially important now, as companies attempt to rebuild and repair budgets after the pandemic.

Using a claims retrieval tool, leaders can quickly and efficiently retrieve and view detailed claim reports in easy-to-understand language and diagrams. These tools make it possible for employees to share their Explanation of Benefits (EOB). This information is crucial in helping leaders better understand how their healthcare dollars get spent. Employers can also use a claims retrieval tool to assess how a level-funded or self-funded plan might help their business.

Although self-funding might not be the best choice for every organization, companies that make the switch to self-funding can save a significant amount of money over time with results as soon as year one. This could help offset rising healthcare costs. Unlike fully-insured plans, companies that take level-funded or self-funded approach enjoy increased transparency and control over their healthcare spending.

Retrieving Financial Reports

Financial reports aren’t typically available to small or mid-size companies. This can make it impossible for leaders to assess risk and create budgets.

In the past, companies had to pay a considerable amount of money to obtain financial reports. Fortunately, claims retrieval software makes financial data accessible to employers regardless of the size of their company. This is excellent news for small to mid-size companies which generally pay 8-18% more than larger firms for the same fully-insured health insurance plans.

An experienced benefits specialist uses claims retrieval software to retrieve and analyze claims data. The software takes employee EOBs and aggregates the data into a cost analysis.

Small to Mid-Size Companies Could Benefit from Speaking with an Employee Benefit Specialist

When armed with the right tools and resources, leaders can reduce healthcare spending and leverage data to improve their benefits program. Employers interested in learning more about healthcare spending should speak with an experienced benefits specialist.

MEBO has years of experience helping organizations customize their benefits plan to meet the unique needs and goals of their organization. Please contact us for more information about our services.

 

Health Benefits Could Give Employers a Competitive Edge

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Companies face tough competition when it comes to attracting quality employees. According to a leading job placement firm, Manpower Group, 69% of U.S. companies report talent shortages. This is the highest percentage in over a decade. In order to stay competitive, many companies have started offering a wider range of benefits. Although benefits like retirement savings plans and life insurance appeal to many, nothing matters quite as much as health insurance.

Health Insurance Provides Peace of Mind for Employees

As the costs of healthcare rises and employees worry about their health and the health of their loved ones, health insurance benefits become more important to workers. This year, it’s expected that many people that put off routine healthcare in 2020 will visit their doctor. Many more will seek out the COVID-19 vaccine as it becomes available. Employers that do not offer good health insurance benefits will likely find it difficult to attract and retain talented employees in the next few months.

In addition to health insurance benefits for employees, employers should consider offering health benefits to the family members of employees as well. Many workers worry about how they will pay for a major health event and offering health insurance to the spouse and children of employees can provide peace of mind. In fact, this might be the reason a candidate chooses one company over the next.

80% of respondents to a recent survey conducted by the American Institute of Certified Public Accountants reported they would choose a job with benefits over the identical job with 30% more salary but no benefits. This says a lot about what candidates look for when searching for a job. Based on these results, companies that offer an attractive employee benefit package could stand out above their competition, even if they offer a lower salary.

Final Thoughts

Employers have many things to consider in the upcoming months. As businesses attempt to regain their footing and navigate through difficult economic times, they’ll need talented staff to help grow their business. It’s crucial that leaders do all they can to ensure the best candidates don’t pass them by. Offering an attractive benefits package with health insurance benefits for employees and their family members could make all the difference in the world.

MEBO offers employee benefits, custom tailored to the unique needs of employers. We help businesses develop benefit plans that gets them noticed. Please contact us for more information or to schedule a consultation.

 

Employers Re-evaluate Their Employee Health Benefits in Light of the Pandemic

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COVID-19 impacted people around the world. For employers, COVID-19 created significant challenges and has changed the way that businesses function and thrive. As small businesses and large corporations attempt to find their footing in these trying times, the value of good employees becomes clear. Without hard-working employees, businesses stand very little chance of attracting and retaining new clients.

As workers face the challenges of remote work, stress levels rise to an all-time high. Even employees that have already returned to the office face mounting stress as they attempt to balance work and life. This is especially true for workers with small children or elderly family members at home. It’s crucial that employers provide adequate employee support and employee health benefits during this time.

After the pandemic, it will likely take a long time for employees to recover from the economic, emotional, and mental health effects of COVID-19. Taking a comprehensive approach to employee benefits can help put employees at ease and provide a sense of security.

Communication is Key

According to the October 2020 Leading Indicator Systems (LIS) Workforce Listening Study, two-thirds of all workers believe the worst is yet to come. When compared to the May 2020 LIS Workforce Study, 45% more workers are extremely worried about being able to take care of their family. The study also found that 75% of workers find it difficult to work under current conditions.

It’s more important than ever that employers show their employees they care about their wellness and support them. In addition to communicating regularly with employees and using surveys or other methods to evaluate employee emotional health and wellbeing, employers should communicate how they plan to support employees and their families throughout the year.

It’s important that employers reduce stigma around mental health and encourage employees to seek help when needed. Options like telehealth allow patients to connect with mental health providers via video conferencing software. This provides a convenient option and reduces stress around visiting a crowded office building. It’s also important that employers take some time to focus on mindfulness and gratitude in the workplace. This can help cultivate happiness and increase employee satisfaction.

Employers should discuss the importance of preventative care and physical well-being. These discussions should include tips on how employees can get the most out of their employee health benefits. If employers haven’t implemented or revised their employee health benefit plan, now is the time to do so. Employers that do not offer competitive employee health benefits will likely find it difficult to retain employees this year.

Orange County Employee Benefits Partner

MEBO offers customized employee benefit plans to meet the changing needs of employers and their staff. We work directly with our clients to evaluate their needs and develop a comprehensive plan. Please contact us for information about our services.

 

 

 

Retain Your Savings with Level Funding

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Integrating a new health plan strategy can reduce the amount of capital a business spends on overall health claims costs. With the high cost of healthcare in Southern California, most organizations agree that any cost-savings is worthwhile. However, many employers find they lose half of these savings to the company managing their health plan. At MEBO, we strive to help employers retain their savings and achieve the greatest benefits from their employee health plan.

By taking a Level-Funded approach to self-funding, organizations get the predictability of a fully-insured health plan and the cost-savings and flexibility of self-funding. Unlike a fully insured plan, employers retain 100% of their savings when claims are lower than expected.

Enjoy Increased Flexibility, Transparency, and Predictability

When selecting an employee health plan, many organizations opt for a Level Funded approach because of the predictability, visibility, and financial protection it offers. Monthly costs of a Level Funded plan include stop-loss insurance premiums, administrative fees, and estimated claims expenses.

With Level Funding, monthly costs are established in advance and employers pay a fixed or “level” amount each month. Employers also receive ongoing claims data. This valuable data makes it possible for employers to see exactly where and how their healthcare dollars get spent.

At the end of each year, if an employer’s estimated health care payments total more than the actual claim costs, the employer receives a refund for the difference.  Alternately, if claim costs exceed the estimated limit, stop-loss insurance covers the additional expense. Level Funding offers transparency and flexibility. Stop-loss insurance limits risk and caps financial exposure.

Flexible Approach

Level Funding is a type of self-funding. This allows employers to tailor the plan to meet the changing needs of their organization. Based on claims reports, employers can quickly locate areas that impact claim costs. They can then adjust their plan as needed. Based on health claim data, employers can also choose to implement strategies like employee education on wellness and preventative care.

Is Level Funding Right for Your Organization?

While Level Funding offers numerous benefits, it might not be the best fit for every business. It’s important that leaders fully analyze their needs and determine how their company will allocate the cost savings.

MEBO has worked with numerous employers to help them locate ways to reduce costs, increase transparency, decrease the frequency and severity of claims, and improve health outcomes for employees. Please contact us for more information about Level Funding, Self-Funding, and Fully Insured health plans. We look forward to hearing from you!

 

Top Reasons Your Company Should Offer Health Insurance Benefits

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Employers have many choices when it comes to the benefits they offer. While paid vacations and retirement plans can help attract top talent, nothing entices new hires more than health benefits. Providing a quality health plan reduces the number of sick days employees take. It also increases productivity and morale.

Although large companies with 50 or more full-time or full-time equivalent employees must provide health benefits per ACA rules, many smaller companies choose to offer benefits as well. According to the Kaiser Family Foundation (KFF), 31.2% of California businesses with less than 50 employees offered health benefits in 2019. According to Mercer’s Global Survey, 19.88% of all U.S. businesses are currently considering updating their benefits plan to better meet employee needs and 12.8% have already expanded healthcare support or benefits. An additional 16.4% plan to add or expand voluntary health benefits in 2021.

Business owners still unsure of whether to offer health insurance to their employees might want to consider the following reasons.

Saves Money on Taxes

When it comes to taxes, offering an employee health plan provides significant benefits. Employers that offer health insurance can take advantage of massive tax breaks.

Employer-provided health insurance premiums are tax-exempt, meaning employers can reduce or eliminate their tax duties altogether. Another benefit, employers can deduct any contributions they make on behalf of their employees. Paying for health benefits saves employers money over paying for higher salaries. Money spent on health benefits isn’t subject to payroll taxes or worker’s compensation premiums.

Provides Access to a Larger Network of Doctors & Hospitals

When employers purchase group insurance they gain access to a much larger network of doctors and specialists than available through individual health plans. In California, individual networks are generally two-thirds the size of group insurance networks.

Increases Productivity and Employee Morale

Offering health insurance provides employees with access to preventative care. Receiving regular check-ups helps catch health problems sooner, reducing sick days and the likelihood of serious illness.

Healthy employees have better focus and less stress. This boosts productivity in the workplace. Most employees state they would prefer good health benefits over higher pay. Offering health benefits improves employee satisfaction and helps attract new candidates.

Help Is Available

Employers often struggle to understand the different options and terminology associated with choosing a health plan. Fortunately, organizations do not have to go through the process alone. An experienced employee benefits specialist can help employers determine the right insurance plan for their organization. These individuals have years of experience and understand how to set everything up and ensure compliance with state and federal laws. They can also help answer questions employees might have regarding their health benefits.

MEBO offers employee benefit plans customized to meet the needs and requirements of businesses both large and small. Please contact us for information about our services.

Choosing the Right Health Plan for Your Employees

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Many employers find it difficult to locate quality staff. Offering a good benefits package is an excellent way to attract top talent. While it isn’t necessary for most small businesses, offering an employee health plan increases employee satisfaction and improves employee retention rate.

ACA Rules Regarding Employee Benefits in California

Under current ACA rules, companies in California with fifty or more full-time equivalent employees (FTEs) must offer ACA-compliant healthcare coverage. Organizations that do not comply with this law could face a penalty of $2,570 per eligible full-time employee.

Part-time employees that work less than 30 hours per week are not entitled to health benefits under this law. However, organizations with several part-time employees may still need to provide health benefits to full-time staff members. Two part-time employees that each work an average of 15 hours per week is equal to one full-time equivalent employee.

Even though organizations with less than 50 full-time equivalent employees do not need to offer health coverage to comply with ACA rules, doing so provides numerous benefits. Employers that offer health benefits can deduct all premiums paid throughout the year. In addition to impressive tax write-offs, offering health benefits increases employee satisfaction, attracts quality candidates, and boosts productivity. When employees receive regular and preventative healthcare, they’re less likely to call out sick and experience major health problems in the future.

Fully Insured VS. Self-Funded Health Plans

When deciding on the type of employee benefits to offer, employers can choose between a fully insured health plan or a self-funded health plan. While a fully insured health plan costs the same each month, self-funding allows organizations to pay for only what they use.

Level funding is the most popular form of self-funding.  Taking a level-funded approach provides organizations with control over the frequency and severity of claims. This increases predictability and keeps costs low.  A level-funded health plan provides the same cost-savings and flexibility as a self-funded health plan, with the predictability and financial security of a fully insured health plan.  By purchasing stop loss insurance, organizations in a self-funded arrangement limit their exposure to risk. Stop loss insurance protects the organization from large or excessive claims. This reduces financial risk, increases control over spending, and provides peace of mind. With stop loss insurance, the employer knows there is a limit on what they could potentially spend each year.

Perhaps the greatest benefit of self-funding is the transparency it provides. Self-funding allows employers to see where the largest claims are coming from. They can then use supply chain management strategies to control costs, while improving health outcomes for their employees. Self-funding offers increased flexibility over fully insured plans, as employers can adjust their plan and approach to meet the changing needs of their organization.

Employers considering self-funding often worry about ACA compliance. Self-funded or self-insured plans are not subject to state insurance laws and are exempt from certain ACA rules. In order to ensure ACA compliance, employers need to file the ACA’s 1094-B and 1095-B series with their taxes.

Employee Health Plans

Although self-funded plans used to be reserved for California organizations with 100 employees or more, new strategies allow smaller companies to take advantage of the cost-savings, transparency, and control that self-funding offers. However, it’s important that leaders fully analyze their needs when deciding on the type of health plan to offer. Employers should consider speaking with an experienced employee benefit specialist for advice.

Located in Orange County, California, MEBO develops customized employee benefit plans that meet the unique needs and goals of our clients. We work directly with each of our clients throughout the entire process, helping them mitigate risk and keep costs low.

Please contact us for more information about our services.