As employers and their agents search for ways to manage costs in a more regulated post-reform environment, many are moving to partial self-funding. While some employers are interested in avoiding new regulations that will impact traditional fully-insured plans, most are looking for a way to control costs and maintain flexibility in plan design.
Self-Funding enables a health benefit plan to meet the specific needs of a covered group and stop loss insurance protects the plan against claims that exceed anticipated levels. When claims are lower than anticipated, the savings remain in the plan, rather than insurance carrier reserves.
As independent benefits administration specialists, we handle all the administrative concerns associated with self-funded plans, including enrollment, claims administration and management reporting. Predictive modeling helps identify factors driving cost increases and disease management strategies can help plan participants and dependents receive the personalized care they need. When symptoms can be identified early, costly claims can often be avoided.
Is the Stick Gaining Strength in Wellness?
While incentives are often a part of wellness programs, disincentives are being talked about with increasing frequency. Experts say that incentives often produce high levels of enthusiasm and engagement in the early stages of a wellness program, with diminishing results going forward. For that reason, some organizations are beginning to consider what may be described as “low impact” disincentives.
An example might be giving an employee the opportunity to avoid a cost increase by taking a recommended wellness action, rather than giving a monetary reward for taking the action. Those who make the decision to not engage themselves in the activity will see a cost increase, while those who participate avoid the increase. While this option would not be considered a big stick, it is an approach that some employers are considering.
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In cooperation with NAEBA