health plans

The Compound Savings of SharedFunding

The value of SharedFunding is that it creates a gap between what you were paying for traditional insurance and what you pay with SharedFunding.

Unfortunately it’s typical for insurance costs to increase annually. However, we’ve found that by creating a gap with SharedFunding, that increase can be on less premium.

Traditional Insurance

You’ll be glad you brought it! Photo by Ricardo Resende on Unsplash

When you have traditional insurance, you need to buy the plan that you want to offer your employees. Makes sense, yes? The problem is that you are paying for this plan for every employee regardless if they use it or not.

The real benefit of insurance can be compared to an umbrella. You’ll be glad you have it with you when it downpours. Additionally, you’ll never mind when the sun comes out and you are carrying your umbrella.

At BBG, Inc., we’ve come up with a way to provide the protection of an umbrella at a fraction of the cost of traditional insurance.

SharedFunding

With SharedFunding, you can reduce the high premiums you are paying to the insurance company by buying catastrophic coverage. You are still buying an umbrella but just with a little more gap between you & the umbrella.

Typically we recommend purchasing the highest deductible available ($5,000, $6,350, $6,650). However, BBG will work with you to determine the appropriate amount of risk.

Then we’ll build out the plan that you want to promise your employees and deliver it to them. This is called SharedFunding:

  1. You buy catastrophic coverage from the insurance company
    • Your annual premium costs go down ↓
  2. We deliver the plan you want to your employees
    • It’s a promise to pay rather than buying from the insurance company

But won’t we fund the difference back in claims?

Healthcare is used unevenly and in the 14 years we’ve been doing ShareFunding, no client has ever funded back the entire premiums savings in claims.

Here is a simple example:

Things are starting to look up. Photo by Jude Beck on Unsplash

Let’s say that traditional insurance costs you $1.00 (haha, I know what world do I live in?? Just trying to keep it simple).

BBG comes in and recommends you buy the highest deductible possible for $0.60. Right now things are looking up as you’ve reduced your healthcare costs by 40%.

The next step involves building the SharedFunding plan you would like to promise to your employees. BBG can build any type of ShareFunding plan you’d like. Most employers choose to mimic their former traditional plan. This way employees still get the same benefit they are used to receiving.

Most likely you’ll end up funding approximately $0.20 in claims for employees who utilize the SharedFunding plan.

That brings your final cost up to $0.80 for a 20% savings. Not too bad, eh?

The Compound Savings of ShareFunding

Saving 20% on your healthcare costs when you initially set up SharedFunding is lovely, yes? But what makes it even lovelier is what happens in the years to come.

Since pictures speak 1,000 words, let me explain with a graph:


Here at BBG we tend to look at the average cost per employee per year as a benchmark. The reason is that your enrollment fluctuates each year. You can calculate your average cost per employee per year by taking your total costs divided by your current enrollment.

The above graph includes numbers from a real client who has been SharedFunding since 2012.

As you can see their average cost per employee per year were at $15,197 with traditional insurance in 2012/2013. By switching to SharedFunding that year, we were able to reduce that number by 39%. Whoa!! Then in 2014/2015 they embraced a more robust form of SharedFunding and reduced their cost another 21%.

While we are pretty good, we are not magical. Unfortunately, you’ll notice their healthcare costs did rise through the years with SharedFunding. However, the true value of SharedFunding is that your increases are on a smaller premium amount; hence, the compound savings of SharedFunding.

To show this we assumed they would have received a trend increase of 5% each year if they had stayed on the traditional route. Based on past renewal trends, this was an appropriate average increase to assume.

Firstly, they are not even close to what their average cost per employee was in 2011/2012. Secondly, while both graphs go up the gap between them grows!

Closing Thoughts

Healthcare is likely one of your biggest expenses as an employer. The math of self-funding may not work for small employers, but the math of SharedFunding most likely will.  Here are BBG, we have fun delivering strong benefits to your employees while reducing the amount of premium you pay to the insurance company.

Your employees will still have access to the network that the insurance carriers provide. Additionally, you will be protected from catastrophic claims with a mini stop loss in purchasing a high deductible plan from the carrier. Furthermore you can deliver the same benefits to your employees by promising to fund. Lastly, with a promise to fund, you, the employer, will be able to retain more dollars in your business.

If you are interested in seeing if SharedFunding might be a good fit for your company, don’t hesitate to reach out to us for a no obligation analysis.

Lastly, we will be running a series on SharedFunding and in this series we plan to get into the details on a more granular level.

The Wide Variation In The Price Of Diagnostic Tests Is Unrelated To Outcomes Or Quality Of The Provider: So Why Do We Pay More?

A study of spending on 12.5 million diagnostics tests by UnitedHealthcare once again revealed substantial variation in the prices patients pay for common diagnostic tests. The seven groups of common diagnostic tests included echocardiograms, mammograms and ultrasounds.

The price range for an echocardiogram — $210 to $1,830 – typifies and illustrates the wide variation in the price for common diagnostic tests. And, according to the report, the higher prices did not correspond to improved patient outcomes or to the quality of the provider.

So Why Do We Pay More?

“A more likely reason is that health care providers generally are incentivized to use their market power to increase prices, often resulting in overpriced services,” per the report.

A copy of the report can be found here.

We’ll write more in upcoming Two Minute Drill articles about what you can do to avoid the higher prices. You’ll learn how BBG paves the way for our clients via our SharedFunding program. They consistently experience lower costs without sacrificing quality of care.

  

“A more likely reason is that health care providers generally are incentivized to use their market power to increase prices, often resulting in overpriced services,”

Déjà Vu, Again – Small Group Transitional Relief Plans (pre-ACA) Extended Through 2020

Buried far below the most recent headlines related to eliminating the ACA, The Centers for Medicare and Medicaid (CMS) once again announced that employers in the small group market still enrolled in Transitional Relief Plans (pre-ACA) may keep their existing policies and plans for another year. CMS stipulates that ultimately the discretion for granting an extension again rests with state regulators and the respective participating insurance carriers who continue to make those plans available.  As we learned last year a few insurance carriers (e.g. Aetna) elected not to extend the Transitional Relief Plans beyond 2018. They instead chose to eliminate the option of renewing the old plans thus requiring impacted employers to move to ACA plans or one of the market compliant alternatives (e.g. level funding, MEWA, etc).

For more info click on the link below:

Extended Non-Enforcement of Affordable Care Act-Compliance With Respect to Certain Policies

Three Notable Employer Health Coverage Factoids In The News This Week……

…… that may be of interest only to me.

Amazon, Berkshire Hathaway and JPMorgan Chase Finally Has a Name

It only took eight months. The new nonprofit healthcare company founded by Amazon, Berkshire Hathaway and JPMorgan Chase finally has a name. It will officially be known as “Haven”. (Maybe it’s just me, but with all the introductory splash and all the money being thrown at this thing, but ”Haven”? Conjures up visions more of a retirement home or maybe an RV resort somewhere just of I-95 rather than healthcare innovator.)

Not much is known about Haven. Data, technology, improving employer healthcare, and not-for-profit is about all we know at this point and that’s according to Haven head guy Atul Gawande.

Two unrelated but interesting things to note about Haven:

  1. The nation’s largest health insurer, UnitedHealthCare, views Haven as a competitor. And,
  2. It wasn’t that long ago (last summer) that billionaire leader of Berkshire Hathaway and Haven co-founder, Warren Buffett, indicated that a single payor healthcare system may be the most effective system for cutting healthcare costs.

Not sure what to make of it or how it will ultimately affect the group health market but it’s still interesting.

Is Health Market Fragmentation the Culprit? The Main Driver of High Costs?

Following up on Buffett’s take, I read this week that the fragmented nature of the U.S. healthcare system (from employer-sponsored group coverage to the individual market to Medicare, and Medicaid, and the V.A., and coverage for Native Americans – is primarily responsible for today’s high cost of healthcare coverage? Could that be an over simplification? How would simply merging those lead to lower costs?

We’ll leave that for others to figure out.

In the meantime, we’ll just keep working hard on finding new and meaningful ways to mitigate the high cost of coverage for our employer groups and their employees.

Buying and Selling Health Insurance Across State Lines

The Interstate sale of health insurance is back in the news this week with the government’s release of a fifteen-page document requesting commentary. Some see this as surefire way to increase competition and ultimately lower the high cost of health coverage. Others see it as simply adding more chaos without much gain. My sense is maybe both. Some short term gain as well as adding to the chaos. Overall, seems like at best it may temporarily treat a symptom but doesn’t won’t move the needle much toward a cure.

We’ll see if it gets traction.

If it does get traction it will be interesting to track the unintended consequences as, sure as shootin’, there will be some.

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