Educate Employees • By educating your employees in certain aspects of healthcare, they can become better consumers of healthcare. Controlling Prescription Drug (RX) Costs • Brand name medications vs. generic: Generic medications can cost up to 85% less than their brand name equivalent. Keep in mind that generic drugs are heavily regulated and undergo a rigorous review process before approval. The FDA tests them to ensure 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. Outpatient Imaging or Testing Costs • The cost of outpatient imaging or testing can vary significantly depending on where the test is completed. The most expensive testing is typically in an outpatient setting at a hospital. This is an area where most people decide to have their imaging or testing done where their doctor writes the order. If the imaging is done at a hospital, the cost can be anywhere from two to three times the cost of what it would cost at a stand-alone imaging center. Employees must do investigation work upfront prior to having imaging or testing done. Most stand-alone imaging centers can send your results to your doctor or provide them directly to you. Consider offering HSA (health saving account) as your low-cost plan • HSA or consumer-driven health plans are a great way to engage your employees in understanding health care costs and driving their consumer behavior to save money on health care expenses. Employees participating in HSA health plans are more likely to be cost-effective when spending health care dollars. This can keep your overall claims costs down and impact better rate stability. Important Underwriting Factors in Group Health Insurance • Participation is a very important factor in underwriting health insurance. No matter the size, employer participation in your health plan is extremely important. It is important to keep participation in your group health plan as high as possible and not allow it to go under 50% of the total employees or 75% of eligible employees, not including those with a valid waiver. Most insurance companies will add a participation load to your rates if your participation drops below these levels. Many insurers will not provide a health quote for employers under these participation levels. • It is not to your advantage to switch health insurance companies too often. One of the questions underwriters will ask is how many insurance companies you have been with the past five years. Two is okay, but more than two may limit who will provide a quote. • Employer Contribution plays a vital role in your rates. Our analysis of benefit clients shows that those who contribute more toward “employee only” for health insurance have higher participation, which helps keep overall rates down. • Telehealth benefits and overall benefit education can plan a major role in keeping claims costs down and impact lower medical loss ratios! Did You Know? • Did you know that GADA has an in-house insurance agency specializing in employee benefits? We would be happy to discuss your employee benefit challenges to determine if we can provide better solutions. Our goal is to provide the most competitive costs, top customer service and keep our benefits clients informed. ► Navigating the System and Making the Best Decisions EMPLOYEE BENEFITS – INSURANCE INSIGHTS Shawn Presnell, Managing Director of Insurance Services Shawn Presnell, Managing Director of Insurance, at 770-432-1658 x240, or shawnp@gada.com; and Amber Ryan, Benefits Specialist, 770-432-1658 x241, or at amber_ryan@gada.com. PLEASE CONTACT US IF WE CAN HELP ANSWER ANY SPECIFIC INSURANCE QUESTIONS: ISSUE 1., 2022 17
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