Highlights
- Employers are looking for a long-term health plan solution and control over a top expense. Self-insurance offers numerous advantages.
- Brokers who shop around for different fully insured plans every year are “quote machines,” making a change without distinction and not providing value.
- Health insurance brokers must transition to becoming consultants, or true benefits advisors, to go beyond the status quo and provide more employer health insurance options like self-funded health insurance.
- A self-funded insurance plan with Roundstone’s group captive offers more flexibility in plan design, transparency, and savings and may be an excellent choice for your clients who are a good fit for self-insurance.
The benefits advisors we partner with have one very important thing in common. They are truly advocating for their client’s best interests. They are keeping current on the latest trends in health insurance and not just going through the motions; they can’t afford to. They recognize the value of self-funded insurance and how the group medical captive model can benefit small to midsize businesses that now have the option to self-insure.
As word gets out that employers have options other than being fully insured, advisors will need to show those employers health insurance options, including self-insurance, and help guide them to what’s in their best interest.
Some advisors may think self-funded health insurance is a great option but too risky unless you’re a Fortune 500 enterprise. Self-funding with a group captive, however, offers all the benefits of self-insurance without the volatility and risk. The captive is a consortium that helps to manage risk and allows competitiveness with larger organizations.
Advisors who work with Roundstone gain the power of its self-insured group captive. The captive bands together hundreds of companies to share the risk of self-funded health insurance — and also share the rewards in the form of savings. Roundstone works with advisors to help them understand how the captive funding model works and the many benefits it provides through the self-insured model.
The Need for More Employer Health Insurance Options Like Self-Insurance
According to the New York Times, average premiums this year for employer-sponsored family health insurance barely budged from last year (source: Kaiser Family Foundation). But a surge in inflation this year, plus a return by patients to pre-pandemic levels of doctor visits, suggest bigger increases are coming.
In addition to rising costs, many companies have felt trapped in their traditional insurance policies. Many small to midsize employers are paying for coverage they don’t need under a fully insured plan, costing them money and leaving their employees with insurance that doesn’t meet their needs.
A 2022 survey conducted by Ease, a benefits enrollment company, says that 75% of respondents believe companies will expect more insurance options at enrollment time this year. Top priorities for those surveyed include well-being programs, voluntary benefits, and cost containment solutions to lower costs and improve member well-being.
75% of respondents believe companies will expect more insurance options at enrollment time this year
The survey also indicates a significant focus on attracting and retaining employees with advantageous benefits packages. 38% of employers cite improving employee engagement and satisfaction as a goal this year, and 23% want to implement flexible benefits to help attract new talent to their business.
What Options Are Employers Looking For? The Benefits of Self-Funded Health Insurance
As an advisor, familiarizing yourself with what your clients will expect at enrollment is vital to helping them find a plan that fits their budget and coverage needs. 94% of companies surveyed by Ease expect their advisor to offer ongoing support and guidance year-round, not only at enrollment. This can include educating your clients on self-insurance as a viable option under the group captive model.
With Roundstone’s approach to self-funded insurance, you can help your clients design their plans to cut costs their way. From the Summary Plan Design to Third-Party Administrator (TPA), Pharmacy Benefits Manager (PBM), and wellness program aspects, you and your client can choose which elements to add and how to incentivize them with plan members.
Self-insurance delivers more customized care at a lower cost because they aren’t paying for benefits they don’t need.
Here’s a quick checklist to consider when presenting health insurance options like self-funded plans to employer clients.
Cost Containment Options
Nearly 40% of survey respondents expect cost containment solutions for their healthcare plans. For advisors, this means offering customizable self-insured plans that allow for changes throughout the year. It also means providing your clients with a self-funded health insurance solution that lets them access claims data to discover where they can apply cost containment solutions to save on healthcare expenses.
Unlike traditional insurance that offers no transparency or access to claims data, a self-insured health insurance plan from Roundstone offers full transparency, giving you the right data and analytics to find areas of impact to control costs and optimize plan utilization. Our CSI Dashboard is a data and analytics tool that helps your clients gain insights into their claims data.
You (and your clients) can use this tool to understand where they might be under- or overspending and implement cost containment solutions to save big through self-funded health insurance — especially on the biggest cost drivers of any health plan, including specialty drugs and musculoskeletal conditions. We also provide quarterly Area To Impact (ATI) reports that go deeper and provide a personalized side-by-side comparison of your client’s data against benchmark data to see the “low-hanging fruit” and focus cost containment measures accordingly.
As an advisor who works with many TPAs and other solution providers, you can leverage Roundstone as an expert resource. We continually vet solutions to ensure that what we are recommending to you and your clients actually delivers quantifiable results. We help you put together a super-team to help support and grow your business with self-insurance as a valuable and viable asset.
Digital Capabilities
More businesses are expecting digital/virtual capabilities from their health insurer. 43% of respondents to the Ease survey conduct business with a workforce that is at least partially remote, making online enrollment and benefits elections vital. 39% of those surveyed said they expect plans that offer virtual capabilities, which can cover anything from benefits enrollment to customer support to online explanations of benefits.
They may also expect virtual healthcare services as part of their package. 20% of respondents expect that benefits will offer a telemedicine option so members can access healthcare from home.
So when you are evaluating TPAs and other benefits navigation services and/or point solution providers, check their apps. Make sure they are robust with a great user experience (UX) and that they continue to invest in technology as a differentiator for their business. It will differentiate you, too.
Behavioral Health Treatment Access on a Self-Insured Plan
2022 has shown a trend toward better behavioral health treatment access. Your clients will likely want some sort of coverage for mental health treatment. The Ease survey showed that almost 33% of respondents expect access to behavioral health coverage to meet the rising need for such care.
Self-funded insurance plans, by design, give you the flexibility to add state-of-the-art mental health programs that are tailored to your particular employee and workplace needs. At Roundstone, for example, we work with an Employee Assistance Program (EAP) to help with stress and work/life balance and to provide support for more serious issues with addiction, crisis, and grief counseling.
Wellness Programs Further Reduce Costs in a Self-Funded Insurance Plan
These days we look at health holistically. As a result, wellness has become a top priority for many employers. Nearly 30% of Ease respondents expect their insurance to offer wellness resources. These benefits can include a wellness program that incentivizes healthy lifestyle choices or access to educational resources through online courses or mobile apps.
With a self-funded insurance plan from Roundstone, your clients can implement a wellness program to help their employees improve their mental and physical health. And your clients can also build incentives into their self-insured plans to boost well-being program engagement among plan members. We have vetted many solutions, and our experts can help you and your clients choose the most effective options.
Personalized Attention and Support
As a benefits advisor offering self-insurance as an option, customer experience is a great way to differentiate your business.
Because health insurance is such a big decision for any company, it takes on even more weight. That’s why you need to provide next-level engagement, expertise, and personalized attention and support.
Roundstone prides itself on our excellent customer service. We work with our advisors as trusted partners, along with the TPA and any other solution providers, to surround your clients with personalized attention from our team of Relationship Managers. We pull it all together and make self-insurance simple with an excellent customer service experience.
Expand Your Employer Health Insurance Options with Self-Funded Health Insurance
Advisors who partner with Roundstone on the self-insured model not only see increased client satisfaction, but smoother renewals, and a positive impact on their business growth. Roundstone’s self-insured group captive plans give your clients the freedom to build their plans from the ground up, allowing them multiple options for plan elements to meet their unique financial and coverage needs.
Speak to a Roundstone representative today or download our e-book to learn how a self-funded group captive insurance plan can be a great solution for many of your clients looking for a real strategy to fight the rising costs of healthcare.
