Cost Avoidance Strategies
The growth in health care spending continues to plague American employers.
Plan sponsors have become accustomed to annually reviewing their health care plans to identify cost containment opportunities in the following areas:
- Benefits Provisions— Are plan deductibles, coinsurance, and copayments set at appropriate levels? What services should be covered and what services should be limited or excluded?
- Employee Contributions— How much of the premium cost should be borne by plan participants? How should annual premium increases be allocated between the plan sponsor and the plan participants?
Carrier/Administrator and Network— Is the carrier/administrator a good business partner for the plan sponsor? Do networks provide adequate access with a competitive level discount level?
One area that has received less scrutiny historically is eligibility—who is actually enrolled and receiving benefits from the plan? Typically, a plan provides coverage for full-time employees, their spouses and their dependent children. Plan sponsors may want to review their eligibility requirements and consider whether there are opportunities to move individuals off of their plans.
Reviewing and amending the eligibility provisions in your health care plan may provide you with an opportunity to reduce enrollment in your plan(s). If you would like to discuss this issue in more detail to determine if it is appropriate for your plan(s), please request a Free Consultation with one of our benefit experts.