INSURANCE INSIGHTS Employee Benefits: Best Practices and Navigating the System EDUCATION FOR EMPLOYEES By educating your employees in certain aspects of healthcare, they can become better consumers of healthcare. CONTROLLING PRESCRIPTION DRUG (RX) COSTS Generic medications can cost up to 85% less than their brand-name equivalents. Keep in mind that generic drugs are heavily regulated and go through a rigorous review process before they’re approved. The FDA tests them to make sure they offer the same benefits as brand-name medications. Studies have shown that 87% of the time, the generic medication was equally as effective as its brand-name equivalent. In 2025, prescription drugs accounted for approximately 30% of total health plan claims! GLP-1 diabetes/weight loss medications can make up more than 20% of overall prescription drug costs, making generic options a way to control costs. OUTPATIENT IMAGING AND TESTING COSTS The cost of outpatient imaging or testing can vary significantly depending on where the test is completed. Hospital outpatient facilities are often the most expensive option, yet many patients have their tests completed there because that is where their provider sends the order. Imaging performed at a hospital can cost two to three times more than the same service at a stand-alone imaging center. Encourage employees to research their options and compare prices before scheduling testing. CHRONIC HEALTH CONDITIONS Chronic conditions such as heart disease, cancer, diabetes, Alzheimer’s disease and mental health conditions impact millions of Americans. A majority of the $5.3 trillion in healthcare spending is from people living with chronic or mental health conditions. The contributing risk factors include tobacco use, poor nutrition and excessive alcohol consumption. Regular physical activity can reduce these risk factors. CONSIDER OFFERING AN HSA (HEALTH SAVINGS ACCOUNT) AS YOUR LOW-COST PLAN HSA plans, or consumer-driven health plans, are a great way to engage your employees in understanding the costs of healthcare and driving their consumer behavior to save money on healthcare expenses. Employees who participate in HSA health plans are more likely to be cost-effective when spending healthcare dollars. This can keep your overall claims costs down and improve rate stability. SHAWN PRESNELL Managing Director of Insurance Services, GADA THE GENERATOR 20
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