Self-Funding Keeps Growing

With time running out on an opportunity for Congress to repeal and replace the Affordable Care Act and open enrollment season approaching, thousands of small and mid-sized businesses are likely bracing for another round of premium increases. A growing number of employers, however, will choose to avoid the uncertainty plaguing traditional group insurance markets by moving to a self-funded health plan – an option that provides an opportunity for savings and far more plan design flexibility.

Healthcare benefits continue to be perhaps the biggest obstacle facing small and mid-sized businesses. The Self Insurance Institute of America reports that between 2011 and 2016, the average annual deductible for employer-sponsored plans increased by 49% and the percentage of firms with fewer than 200 employees still providing health benefits fell from 68% in 2010 to 55% in 2016.

Self-funding on the other hand, has proven to be a far more responsible alternative for employers, enabling thousands to not only use their health benefit plan to attract and retain high quality employees, but to do so at an affordable cost. While self-funding has long been a staple for the nation’s largest employers, nearly a third of companies with 200 or more employees now offer at least one self-funded option.

Everyone Benefits from Flexibility

There are many reasons for the growth of self-funding, with flexibility and access to valuable claims data high on the list. Since self-funded plans are governed by ERISA, they avoid many of the costly mandates governing fully insured plans. To manage risk, stop loss coverage is obtained to cover claims that exceed anticipated levels. If claims are below anticipated levels, the plan retains the savings that would have been paid to an insurance carrier in the form of non-refundable premiums. Benefits can be customized to meet the unique needs of the group. When an independent TPA is engaged to administer the plan, claims data can be analyzed to identify chronic conditions and other key cost drivers. Services such as telemedicine and mobile transparency tools can be added to make physician access more convenient and more affordable. From plan design to data analysis, everyone benefits from the flexibility that a self-funded plan can provide. It’s the biggest reason why more small and mid-sized companies continue to move to self-funding with help from an independent TPA.

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Paid Sick Leave in Minnesota

Sick LeaveAs a result of identical ordinances passed by both City Councils, workers in the Twin Cities became entitled to paid sick time leave on July 1st of this year. While the state legislature tried to protect employers, businesses are now required to offer employees one hour of paid sick leave for every 30 hours worked. The Minneapolis ordinance allows companies with five or fewer workers to offer unpaid time, but St. Paul does not offer this exemption. Overall, employees can accrue up to 48 hours per year and roll that over to the next year.

Time off can be used for illness or medical care of the employee or family, a closure of daycare facilities or schools and for counseling, legal support or related services due to an incident of domestic or sexual violence.

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Small Businesses Doing More

ebso-smallbusinessAccording to Deloitte Consulting LLP, small and medium sized employers with 100 or more workers are contributing considerably more towards the cost of employee and dependent healthcare benefits than legally required – about 73% of the total cost, on average. Regional differences also exist, with companies in the Northeast contributing more toward the cost of family coverage and companies on the West coast contributing more to individual coverage.

Even as healthcare costs continue to increase, consultants agree that employers of all sizes will continue to contribute significantly to healthcare benefits as the job market continues to tighten and retaining top talent remains a top priority.

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Stop Loss Legislation

stop-lossIn New York, industry efforts to support self-funding for smaller groups have led to legislation extending the grandfathering of existing stop-loss policies for groups of 51 to 100 for an additional year, through January 1, 2019.

Other legislation impacting access to stop-loss insurance products by smaller groups has taken effect in Minnesota and is slated to become effective in New Mexico on July 1st. Attachment points are still being discussed in New Mexico and it appears that new opportunities for smaller groups may emerge in Minnesota as well. Since our last newsletter, legislation prohibiting small group stop-loss failed to advance beyond committee debate in the State of Maine.

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EBSO Benefits Develops Enterprise-Wide Solution with Enquiron Partnership

EBSO, Inc., a third party administrator with corporate headquarters in Milwaukee and St. Paul has expanded their partnership with Enquiron to provide Enquiron’s solutions to all of their self-funded clients. This expansion allows EBSO to deliver value to more clients and further assure that their clients are kept well informed regarding changing employer laws and regulations, placing EBSO’s expertise far above their competitors in the TPA marketplace.

“By including the Enquiron suite in our standard service offering, EBSO is able to extend the peace of mind we bring to our broker partners and clients,” said Bruce Flunker, President of EBSO Inc. “Gone are the days of responding to a client with the words: ‘you’ll have to check with your benefits attorney.'”

Each EBSO client now has unlimited access to Enquiron’s award-winning HR, employment and ERISA law content, tools, and guidance, including articles, training courses, guides, forms and more. Clients’ access to employment law and ERISA attorneys saves both time and significant amounts of money each year.

“We are excited that EBSO and Enquiron have expanded our partnership,” said Brian Hansen, Vice President of Business Development at Enquiron. “We are committed to listening to our partners and crafting a product suite that will deliver practical value to their clients and position them well against their competition.”

About EBSO Inc.

EBSO, Inc. is a third party administrator.  With corporate headquarters in Milwaukee and St. Paul, EBSO has grown to become a leader in the TPA industry. Today EBSO has offices throughout the United States including Arizona, Minnesota, Iowa, Kentucky, New Mexico, Ohio and Wisconsin. EBSO’s philosophy is to seek out the best resources, the timeliest information and the most innovative technology and use it to provide customers with cost-effective solutions in a way that is personal, fast, direct and honest.

About Enquiron®

Enquiron, www.enquiron.com, headquartered in Boston, Massachusetts, provides consultative business solutions to employers in all 50 states, across various industries, sectors and sizes. Since 1996, Enquiron has revolutionized the way that services impacting HR, Employment Law, Health Care, Retirement, Cyber and more are delivered to and utilized by employers. Enquiron has locations across the United States and is a trusted partner to organizations who need specific answers to specific questions.

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EBSO Helps 40 Square Cooperative Solutions Celebrate Open Enrollment!

EBSO 40 Square40 Square Cooperative Solutions, a health care cooperative formed to help Minnesota agricultural producers and their employees obtain affordable health care coverage, officially began open enrollment on November 1st.

40 Square contracted EBSO to design and administer new self-funded health plans. With the cost of health insurance continuing to skyrocket throughout the U.S., forming a health care cooperative has been on the minds of Minnesota farm families for many years.

During the 2017 legislative session, the Legislature and Governor Mark Dayton approved a law that enabled farmers, in Minnesota, to form health care cooperatives to provide a LONG TERM SUSTAINABLE HEALTH PLAN option for farmers. The rule paved the way for 40 Square Cooperative Solutions to begin offering a self-funded health plan to Minnesota farmers.

Farmers who are considered an ‘employer’ with at least one common law employee and work in production agriculture in MN are eligible. Once part of the co-op, employees can register for 40 Square Consortium self-funded health plan. Those interested will work with a broker to make sure the best individual or family plan is chosen.

EBSO, who is based in St. Paul, MN, is proud to have been contracted as the third party administration (TPA) firm to design and administer the new self-funded health plans.

“Flexibility and cost control have long been advantages of self-funded group health plans and the 40 Square Cooperative plan is no exception,” stated Terri Moxley, Senior Sales Specialist with EBSO. “To meet the specific needs of Cooperative members and their families, six different plan designs will be available when open enrollment begins on November 1, 2017,” Moxley added.

For more on the member-owned health care cooperative, visit www.40square.coop online, call 800.643.5822 or speak with your insurance agent.

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Patient Satisfaction Goes Public

healthWhile the University of Utah Health Care System began publishing data from patient satisfaction surveys 5 years ago, dozens of hospitals and health systems are following suit. One Midwest-based system is listing Yelp-like reviews and a star rating next to each qualifying physician’s name. Research shows that 45% of consumers have looked at online provider reviews, with nearly two-thirds saying their selection or avoidance of a certain provider was based on a review.

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Healthcare Tech Sector Hot

ebso-mobile-marketing-blogMention healthcare startup and you probably think of Silicon Valley. Surprisingly, there’s plenty of healthcare technology happening in the Midwest, with Minnesota leading the way. According to Twin Cities magazine, 98 health technology startups raised more than $420 million in capital in 2016 alone, bringing the total to $2.75 billion since 2009. From mobile app developers to medical device manufacturers, more than 430,000 Minnesotans are employed by healthcare-related companies.

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Doctors Go Retail

healthIf you live near a large shopping mall, chances are you’ve noticed vacant stores, thanks to the rapid growth of online shopping. Many retail vacancies are being filled by doctors, dentists, physical therapists and other healthcare professionals looking for ways to become more accessible to their communities. To generate more foot traffic, one dental network will open clinics in 36 retail centers this year.

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Rapid Growth for HSAs

hsa-piggy-bankHealth savings accounts are hot, with nearly two-thirds of respondents to a Plan Sponsor Council of America survey saying they believe that even those without a high deductible health plan should qualify. A benefit often cited by employers and employees alike is that HSAs can be a valuable part of one’s retirement strategy, since healthcare expenses are viewed as one of the largest people face in retirement.

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