Insurance Poll--New--How are you Reducing Costs

jmcaa

As "Zanne" requested in the "Insurance Poll" thread......."what are people doing to reduce their health insurance costs?"

We are looking at changing the deductibles, upping the emergency room fee from $50 to $100, lowering the chiropractic to a minimum $500 per year, starting a $25 doctor visit co-pay, changing our prescription drug coverage from $10/$20 to a $15/$25/$45.

Anyone with other ideas?

Trinity

We also took off coverage to the chiropractor and it reduced our premium by quite a bit..guess there are alot of people with back problems. Also, how do you handle coverage of dependents? We have great coverage here with the employee 100% covered and spouse 75%. Then we cover half of dependents..your coverage could be reduced for dependents to help you lower your premiums as well. Also, are you allowing your employees to choose between plans or offering them all HMOs?

jmcaa

Currently we are self insured. Our rates are around $350 Single and $780 Family per month. Our employees currently pay $25/Single x 26 ppds and $82/Family x 26 ppds. We only have one plan at the moment $200/$400 Ded and 80/20 copay. We are looking into offering two plans--our current plan at a higher cost and the second plan with higher Ded, Copays for a cheaper cost for employees who don't utilize the insurance very much. We are changing the plan to utilize a preferred provider network with lower payments for out-of-network claims.

Our employees pay about 15% of cost for E Only; and 23% for Family.

Parabeagle

We reduced our cost per employee by $70/month the old-fashioned way: Switching carriers. Our plans short of that were to increase copays (which would have only realized about a 2% savings) or increase deductibles. So we shopped the market (which we do every year anyway) and found comparable coverage at a much lower cost. Just lucky, I guess.

mmurnahan

We have tried several things in the past 3 years.

First we went to a 3-tired RX plan with a formulary (that really made very happp!!!)
The next year we went to a 4-tired RX plan $10, 20, 40, 100, the co-payment is driven by the cost of the RX (this almost caused a revolt!!)
we've increased our PPO deductibles from $300 to $400
Increase your out of pocket max
Increase co-payments
increase number of days for hospital co-payment

We are a healthcare facility, and 5 years ago had an extremely RICH plan. We had 3 plans and they were all free to the employee. (for ee and family!)
Our HMO continues to be "free" to employee and family. We've started an EPO and it is free for employee and almost free for family, and then the PPO is the most expensive. Becuase you can't control the cost of the PPO, it cost more.

Ruby Tuesday

We are self-insured. A number of years ago, in order to educate our employees and make them more aware of the effect their lifestyle choices (i.e. poor eating habits; lack of exercise, smoking, etc.) has on their health we started offering health risk assessments. The HRA's consist of a short questionnaire (maybe 10 questions) as well as a phlebotomist taking blood. The employee is provided a comprehensive report and is "graded" on such things as cholesterol (good/bad), tryglicerides, glucose, etc.

We tie the score into the employee portion of the insurance premiums. If they score well they are eligible for a "bonus" off of their premiums. If you are worried about confidentiality, the reports ARE confidential. We are given a list of names that qualified for the bonus.

This tool has provided so much awareness. It has reduced our health care costs and has made our employees much more aware. We've had a lot of success stories - an employee that didn't know they had high blood pressure; an employee that took steps to lower their cholesterol. They stop by my office and brag about their successes.

HRA's are not the magic bullet but they sure are a great way to educate your employees. The majority of our employees are men and from my experience men do not like to go to the doctor so this is one way to bring the "doctor" to them. Once they see the numbers in black/white it makes it harder to ignore.

Zanne

I guess that I should participate, since I suggested this.

Last year we rolled our deductible from $300 to $500 and increased our copay on prescriptions from $7 to $10 for generic drugs and $14 to $20 for name brand drugs.

We are self insured and this year we have had a crop of babies. Four to date and we have three employees and one dependent due in 2004 so far. There are rumors that are going about that we are banishing the maternity clause in our plan. Not true.

We are going to look at reducing our chiropractic amount (currently you can have up to 52 visits a year!) and physical therapy. (up to 60 visits per year) Our TPA wants us to limit office visits - but I like the idea of our employees doing preventative care as opposed to using the ER when they are sick.

I like the idea of tying the health fair score into insurance premiums. We had a health fair scheduled for this month, but our hospital that we use has had cut backs so they aren't able to keep the fair. We're on the list for later in the year.

Zanne

SMace

We are doing several things beyond plan design. We do something similar to the HRA. We provide free health screenings for all our ee's. If they don't participate we charge them $3/week more for their premium. They also pay $4/week more if they smoke (we test them) and $3/week more if they don't exercise (honor system).

We are just beginning a program with our local hospital designed for ee's with diabetes, heart conditions, asthma and back problems. If they participate in the programs and do what they are supposed to do they either get free or reduced cost meds or free PT (back problems). We have begun by focusing on ee's with chronic problems and high costs (TPA determined the ee's).

In my opinion if you are relying on plan design only you missing a huge opportunity.