Much of that, of course, has been building since last year’s congressional approval of federal health-care reforms. They won’t be fully phased in until 2018, but already those changes have taken hold of the health-insurance marketplace.
Working with large-scale employers trying to reconfigure benefit plans to mesh with the new law, as well as with smaller companies trying to decide whether to retain coverage for employees, is difficult enough. Insurance pros are also studying legal challenges to the Patient Protection and Affordable Care Act, monitoring state efforts to set up health-insurance exchanges and keeping tabs on—even leading—groundbreaking corporate wellness strategies.
Then there are such developments as on-site medical care for companies trying to insulate themselves from the costs and regulatory burdens associated with employee health coverage, and emergence of the patient-centered medical home approach as a model for improving delivery of service and controlling costs.
All of that is connected, insurance professionals say, and part of an overarching goal shared by companies that want to attract and retain the best employees. Does a better health-insurance benefit still hold that cachet for employers?
“Absolutely it does in the majority of business segments,” says Rick Kahle, president of Lockton Companies’ Employee Benefits Division. “They’re going to stay in the game; for them, that’s the price of poker. We still have a significant number of business clients that want to purposely have a competitive advantage in their benefits, and are leading with that in the conversation.”
Much has been made in recent weeks of two national studies suggesting that between 10 and 30 percent of U.S. companies could discontinue employee health insurance as a result of federal reforms. But those studies, area insurance executives say, aren’t conclusive. Insurers point to small sampling bases involved in those studies, which also were limited to larger employees with insurance requirements vastly different from those of small and mid-size companies. Those bigger organizations are not reflective of this region, said Danette Wilson, group executive over external operations and chief marketing officer for Blue Cross and Blue Shield of Kansas City.
“Kansas City is dominated by mid-market companies of up to 2,000 employees; there are not a lot of jumbo employers here,” she said. “And in that mid-market, they typically have within them HR departments that are able to research health-care reform and dig into it a little more than the small business owner.
“At the end of the day, the same uncertainty hangs over their heads, but with the mid- and large employers, what we really see different from small businesses is that they are actively working at helping employees have better health.”
A premier example of that is Lockton client Layne Christensen Co., whose chief executive, Andy Schmitt, has put in place a multi-tiered approach to cost control. Drawing on the expertise of Vivian Neuharth, a registered nurse, Layne is personally taking their wellness message to their employees across the country. Layne also implemented a consumer-driven health plan that offsets higher deductible levels with a robust health-savings account program that encourages saving for health expenses and further rewards employees who participate in preventive health activities. The company was able to cut per-employee increases in health-insurance costs by nearly a third.
That’s one example of take-charge approaches that more companies are embracing, says Jack Bastable, a practice leader for health and productivity at CBIZ.
“Some companies have cultures where they reward top performers in everything,” he noted. “But if benefits are another form of pay, why not recognize those people who use their benefits better? This is consistent with that culture.”
Wilson cited the same development among larger companies. She said there is “a real desire to collaborate with their health-care partner, the carrier, to have an impactful wellness program. And what we have found is that one size does not fit all. Companies have different cultures, different challenges within their work forces. So we work with them to find the right objective, lend our expertise, and try to blend a program into their culture.” 