Opt-in or opt-out?

One cost-cutting strategy that I am excited about is moving opt-in disability insurance plans to ones implemented on an opt-out (auto-enroll) basis.

Because an opt-in requirement subjects these plans to potential adverse selection, the pricing and underwriting conditions associated with them are inferior to employer-funded group plans that have 100 percent participation and no pre-existing exclusions. Moving voluntary benefit programs to an auto-enroll situation drives pricing and underwriting that more closely resembles group plans.

The DOL recently issued an information letter reinforcing the value of auto-enroll by reaffirming its applicability for disability insurance. Defaulting employees into disability coverage drives huge savings and value.

The advantages of disability auto-enroll programs include: (1) huge savings in employee premiums versus traditional opt-in premiums; (2) dramatic increases in employee participation; and (3) significant savings in employer-funded programs.

With one group, we achieved 75 percent employee premium savings, 94 percent employee participation and 22 percent decrease in employer-funded premiums.

Kevin Kennedy, benefits consultant, TriBen Insurance Solutions Inc.

Networking (not that kind)

Employers have been using plan design and employee premium increases to control rising costs for years. However, with limited ability to increase premiums further and deductibles growing to a point of deterring use, employers are looking at their networks to ensure they are getting the biggest value.

Network strategies include narrow-network options, where employees are directed to high quality providers; centers of excellence for specific conditions like dialysis; and reference-based pricing.

Cara A. Kirsch, vice president, SilverStone Group

Behind the data

As we enter into another new year of benefits, the ability to help employees understand the data behind their providers will be critical. Helping guide employees to the highest quality and the lowest cost providers will render one of the strongest results that health care has ever seen! This is a very simple, yet powerful piece of education. And without the education, none of this could happen.

Employers are deciding to reinvest some of the savings to their employees by waiving deductibles and out of pocket expenses. It’s a win-win! This strategy makes “consumerism” real, as this allows a member to know the data needed to make better decisions!

Taylor Y. Lindsey, partner, Employee Benefits Consultants, Inc.

A+ education

My biggest cost-cutting strategy has been becoming well-versed and certified in pharmacy benefit management and committing to get my Masters in Health Benefit Design. I have also received my Certified Pharmacy Benefits Specialist designation and the savings potential has been tremendous.

My biggest personal trend has been educating myself and my city. I am building employee benefit education modules, which are courses for executives and HR. They are accredited and will take students through the health care/insurance continuum. I am also leading presentations, roundtables and “sip & learns” with partners.

Robson Baker, employee benefits and HR advisor, Clarus Benefits Group

Shopping spree!

Everybody loves a shopping spree—even a benefits-related one. The concept of defined contribution is not widely used in the enhanced benefit space, but approaching enhanced benefits from the DC perspective is a powerful and innovative tool that brokers can bring to clients as a cost-cutting strategy.

Why not take the funds that the employer spends on all of these programs collectively, and re-allocate them to provide a specific defined-contribution dollar amount, per employee, per month. This puts the employee in charge of their own needs and allows them control of how they use the funds, while also mitigating cost increases to the employer.

Ultimately, this strategy solves the current supply chain challenge that employers have with not being able to plan and predict each new plan year.

It’s an incredible way for an employer and their broker to bring predictability to an otherwise unpredictable area of benefits, while providing a new way for employers to attract and retain new talent.

Eric Silverman, founder, Voluntary Disruption

Focus on mental health

The biggest trend will be the overall advancement and delivery mechanism enhancements around behavioral health/mental health offerings. I’ll be watching both those offered through the traditional health carrier as well as stand alone mental health advocacy programs. With the increased awareness around this topic, our industry has an incredible opportunity to greatly reduce this increasing epidemic.

Trevor J. Garbers, vice president, practice leader, HUB International Limited

Direct primary care

Eight years ago, I was diagnosed with Type II diabetes, the same disease my parents and grandparents were plagued with. I told myself it wasn’t going to happen to me because I don’t eat like they do and exercise like they don’t. It happened anyway. I’m not totally innocent in the matter; I used my OB-GYN as my main source of health care for years, like most young women do, which was part of my downfall. In my defense, no one was talking about direct primary care in my small town when this was happening to me.

I’ve come to understand the error of our collective ways and how the devaluing of the primary care space has lead to higher downstream care for everything else. A physician friend of mine posted an article listing the top issues ruining medicine for physicians. Almost every issue, from “paperwork and administrative burdens” and “prior authorizations” to “no negotiating with payers” could be solved using the principles of direct primary care. I hope more primary care doctors will stop wasting their time working for insurance reimbursements and start healing patients again.

Cristy Gupton, president, Custom Benefits Solutions

AI advancements

In the next five years, we will witness the disruption of the world by improvements in artificial intelligence (AI). This revolution is becoming as monumental as when the iPhone came out 10 years ago. Entire industries will change, and new services are already delivering impactful results. Using machine learning to review health care claims data will allow for personalized recommendations, and health care guidance platforms will continue to evolve.

In 2019, we will see artificial intelligence further develop and be designed around humans. This will eliminate manual processes and leave workers with more time for higher value functions.

Rick Ramos, chief marketing officer, HealthJoy

Take your pick

The biggest cost-cutting trend is that there isn’t one cost-cutting strategy or trend for 2019. Each year, businesses focus more on the value being delivered. Everyone is trying to do more with less. By focusing on value, we can improve what we deliver for employers.

When we focus on what the client wants, we deliver lower plan costs, reduced risk, better benefits, and predictability.

There isn’t a single cost-cutting strategy or trend that will work for everyone. However, if we focus on delivering value that is important to the client, we can help them keep their costs low over time… and use every new tool at our disposal!

Allison De Paoli, founder, De Paoli Professional Services

More DPC!

I’m most excited about recommending direct primary care relationships. The DPC provider not only provides high-value, low-cost primary care, but also recommends and coordinates all medical services based on value and need.

We don’t have enough DPC providers in our area so I’ll be advocating legislators to change the law so DPC subscription fees can be covered under HSA accounts and actively soliciting the creation of new DPC facilities in our area.

Suzy K. Johnson, president, Employee Benefit Advisors of the Carolinas

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Cost-cutting strategies for the new year

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