Comments on: Is self-insurance right for your company?

By: concerned

concerned — Mon, 03 Nov 2008 16:49:16 +0000

As a way to be safe from high dollar claims, you should look at getting stop-loss insurance. Just a couple claims could make this quite cost efficient.

By: perplexed

perplexed — Fri, 26 Sep 2008 15:33:09 +0000

Thanks Circle V HR, I’m going to contact our broker on Monday morning to see what we need to do to add these co-pays. Great idea!!!!!!!

By: Circle V HR

Circle V HR — Thu, 25 Sep 2008 20:35:33 +0000

We are a self-funded plan and through the introduction of co-pays for specific plan items, i.e. ambulance, out-patient-surgery, CT/MRI, etc. we have been able to hold our weekly contributions at a level that has not been raised in five years. I would suggest taking a look at your plan design and determine those services that are being used the heaviest and look at putting co-pays on these services beyond the typical $15 office visit. This strategy allows you to pass the cost to those employees that are using the plan and may offer some relief in raising your weekly contributions.

By: perplexed

perplexed — Thu, 25 Sep 2008 18:33:59 +0000

We’re facing the same situation as last year. Our premiums skyrocketed because of THREE employees whose claims amounted to over 200,000 dollars. Now that we are not self funded, (we were last year) we can’t tell who the “sick” employees are. One employee racked up 45,000 dollars in prescriptions alone!!!! Our only out is to raise the weekly contributions and raise the deductibles. Or do we have another choice? Responses are welcomed.

By: Brian Mohrlant

Brian Mohrlant — Fri, 19 Sep 2008 12:30:49 +0000

No, organizations should not go as far as only hiring young, non-smoking males, just to better their employee census for health insurance quotes. This, of course, will leave you with worrying about much more than an unfavorable renewal increase!

However, they should be conscious in structuring their health plans in ways that do not deter these individuals from taking coverage.

One way to do this is to only offer medical insurance through only ONE carrier, so the younger AND older employees are included in the same carrier’s quote.

Another important point is to remember that if you continue to “pass the buck” each year on to employees, and the monthly contribution amount becomes exorbitant, you’ll eventually see the “ideal” healthier employees find lower-cost coverage elsewhere, likely through an individual plan, leaving the majority of the “sick” employees on the plan.

And a third note is simply good education to your new employees (who are often younger) about the health plan offerings. Get them informed to get them on the plan.

By: Barbara Perry

Barbara Perry — Fri, 19 Sep 2008 11:27:37 +0000

I am very concerned with the following from this article:

1. Unfavorable employee mix

It’s impossible to completely eliminate the risk of unexpected, high-dollar health claims. But here’s a guideline to lower your risk. Health claim stats suggest the “ideal” employee population for a self-insured plan is predominately young, non-smoking and male.

It sounds like it is being suggested that only young, non-smoking males be hired?