News |3 min read

What is your Healthcare Coverage Strategy?

Healthcare is probably one the most expensive line items on your balance sheet. For decades now, small businesses have been conditioned to look at health insurance in 12-month intervals, instead of with a long-term strategical lens. What if there was a way to look at health insurance as a vehicle to sustainably lower long term operational costs?

Most employers don’t have a strategy for healthcare costs

Most employers have a strategy for growth, a strategy for sales, a strategy for their workers comp/business insurance and everything in between but not health insurance. Large companies have the resources and infrastructure on their side to help control healthcare costs. They also have carriers and brokers at the ready offering them preferential treatment. All while small businesses question if they can even afford to offer health insurance.

As a small business, it’s understandable that you have not had the time or the resources to dedicate to establishing and adhering to a strategy to lower your healthcare costs. Luckily through AADOM, you now have the tools and the expertise to do so! The question isn’t how do I pay the lowest amount over the next 12 months but what do I do to consistently lower my long-term costs in the coming years.

One way to start lowering healthcare coverage cost is by looking at plan options like level funding. Level Funding is an out of the box risk financing vehicle that is a steppingstone between fully insured and self-insured options. Level funded plans typically include four main components: administrative costs, individual/aggregate stop loss coverage, and claims. (We know this sounds confusing; we promise to explain.)

Level Funded plans give small businesses the freedom and autonomy of self-insurance with the financial protection of a fully insured plan. The company funds their small claims to the carrier monthly at their maximum liability. If the insured exceeds that maximum, then the carrier steps in and covers the payments. This is known as your ‘stop loss’.

At year end, the carrier does an audit of the insured’s incurred small claims vs the amount that was funded throughout the year to see if there is a surplus or deficit. If there is a surplus the employer can receive some of the unused claim funds back! A team of proactive experts, a bundle of supplemental tools, and employee educational content throughout the year can help you adhere to your strategy and see potential return of claim funds.

Level funded plans deliver several benefits for small employers

Level funded plans deliver several benefits for small employers: Cost savings, plan design flexibility, less red tape bureaucracy, lower health insurance taxes (employer facing) and access to claims data. How can this help me realize the strategy I need?

Claims are basically the Holy Grail to determine whether your insurance carrier is profiting off your employees or whether you are costing them money. This is why most carriers refuse to share this information if you are a small business. When you have access to your claims, it makes creating a healthcare coverage strategy simple.

Level Funded plans offer flexibility that is unmatched

Level Funded plans offer flexibility that is unmatched by its fully insured counterparts. There are less restrictions on what an employer can do with a level funded plan, offering you flexibility with plan designs. By having more freedom with a Level Funded option, you are more likely to have plan continuity year to year which would not restrict access to care for your employees. Furthermore, by funding your claims in small increments (without paying the fully insured overhead of an insurance carrier), you get increased flexibility with improved cash flows throughout the year. If those things weren’t enough, level funded plans also allow employers to lower their state health insurance taxes!

If you are a small business and are tired of the cookie cutter overpriced fully insured options, level funding could fit your needs. As an AADOM member you have exclusive access to DentalOfficeHealthcare.com where you can learn more about your healthcare coverage options and speak with a licensed consultant to see if level funding could help you build the right healthcare coverage strategy.

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