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December 2020 edHEALTH Newsletter

Find out:3 Proven Ways to Help Members Navigate the Pandemic – published in the December 2020 edition of Risk Retention ReporterHow Plan Designs were Informed by High-Performance AnalysisTips for Surviving the Pandemic from the edHEALTH TeamWhat the Team is Doing for the Holidays in Place of Exchanging GiftsHow to Effectively Engage Your EmployeesRead the December 2020 digital edition of our newsletter.Download the December 2020 Newsletter.pdf.

How to survive the pandemic: The team shares our strategies and supports local food pantries

Food, binging favorite shows, self-care, appreciating what we have, and giving back are some of the ways the edHEALTH team is getting through these difficult times. All of us are missing in-person interaction with family, colleagues, and friends. New demands and increased anxiety are draining. edHEALTH president Tracy Hassett’s first grandchild was born in April and lives on the West Coast. Operations Manager Cindy Bartelson is juggling full-time work and family responsibilities. Her children are ages 2, 9, and 14, and she and her husband are managing remote learning. Executive Assistant Claire O’Sullivan’s son is a first responder, which causes worry. Marketing Communications Strategist Cindy McGrath’s parents live in a large retirement community, and she’s only been able to see them in fits and starts. Like all of us, Business Development Executive Nancy McConaghy misses spending ti...

For the First Time, Plan Designs Informed by High-Performance Analysis

One of edHEALTH’s strategic initiatives is population health – working together to improve our member schools’ faculty, staff, and family health outcomes to bend the healthcare cost curve. Almost three years ago, we contracted with HCMS, our data warehouse now called Workpartners, to provide a person-centric clinical program for patients with complex healthcare needs. This year, Workpartners began analyzing edHEALTH’s data for plan design purposes. These initiatives are translating into quantifiable results for our member owners and their employees.“What started as a need for data warehouse capabilities has grown into a strategic partnership for making data-driven decisions,” said A. Tracy Hassett, edHEALTH’s president and CEO.2021 Plan Designs Informed by In-Depth AnalysisIn the spring, Workpartners conducted a deep dive into edHEALTH’s suite of plan design options. This analysis com...

To Effectively Engage Your Employees, Focus on The Message

It’s a challenging, yet critical, time to increase your employee engagement efforts. The education sector is facing significant challenges due to enrollment drops and the costs of COVID prevention and monitoring. The usual ways of communicating – in-person meetings and quick chats by the water cooler – are no longer possible with many employees working from home. At the same time, many employees are trying to juggle work and family life. Childcare is in short supply, and many school-aged students need help navigating online classes. Social isolation is adversely affecting employees’ mental health; anxiety is 51% higher and depression is 65% higher than pre-COVID, according to the National Alliance of Healthcare Purchaser Coalition’s October 2020 Mental Health Index.“Before developing any employee communication, focus on the message,” says Bob Simpson, Director and National Practice Le...

November 2020 edHEALTH Newsletter

Find out:About the hidden effects of reduced 2020 healthcare costs and bold solutions that can help address the financial challenges aheadWhy educational institutions with fully insured health insurance arrangements for their employees are leaving money on the tableAbout edHEALTH’s new employee engagement communicationsRead the November 2020 digital edition of our newsletter.

Actuaries’ Advice: Don't Leave Money on the Table

Educational institutions with fully insured health insurance arrangements for their employees are leaving money on the table, according to Steven Keshner, Senior Vice President and Chief Actuary with Spring Consulting Group. Moving from a fully insured to a self-insured model creates the lowest possible margin for health plan administration. “By moving from a fully insured to self-insured arrangement, you retain any profits and gain claims transparency so you can bend the cost curve,” said Steven, who leads edHEALTH’s actuarial consulting team.The pandemic has shined a light on the importance of shifting to self-insured arrangements as insurers report record profits due to dramatic drops in healthcare utilization while self-insured purchasers realize lower healthcare spending. A recent Employee Benefit News article authored by the President of MagnaCare concurs: “Self-insured plan arr...

October 2020 edHEALTH newsletter

Find out why the mental health crisis could get worse and how HR can respond; why edHEALTH chose Vermont for its stop-loss subsidiary, Educators Health Insurance Exchange; and about edHEALTH’s first Thought Leadership seminar on employee engagement trends, best practices, and insights in the October 2020 digital edition of our newsletter.

Why Vermont? edHEALTH’s Captive Management Leader Explains the Benefits

Inquiring minds want to know: Why is edHEALTH’s stop-loss subsidiary, Educators Health Insurance Exchange, based in Vermont? David White, Vice President for American International Group’s (AIG’s) U.S. Captive Management Services, filled us in. “Vermont was one of the first states in the nation to establish captive-enabling legislation, and as a result, the regulators have deep expertise in the industry,” he said. “Vermont state employees are helpful to the captive industry, offering support, guidance, and a quick turnaround.”Vermont’s responsive and business-friendly philosophy helps promote a captive insurer’s agility. “When a captive wants to make a material change to its business plan, state regulators and captive managers work together to get it done,” said David. New lines of business, changes in investment policy, increased stop-loss limits, and service provider changes all requ...

August 2020 edHEALTH newsletter

Find out how Salve Regina University has realized strong results and valuable HR support; the 5 reasons healthcare costs could accelerate and how edHEALTH is responding strategically; Boston College's Walking Challenge win; how edHEALTH's social media communication has expanded, and more in the August 2020 digital edition of our newsletter.

Salve Regina Realizes Strong Results and Valuable HR Support

With compensation and benefits comprising 60% of Salve Regina University’s budget, Vice President for Administration and Chief Financial Officer, William Hall is always evaluating ways to keep costs in check while continuing to attract and retain top-notch faculty and staff. In the late 1990s he  moved the health insurance benefits from an insured to a self-insured program where the university takes the responsibility for paying medical claims plus stop-loss to protect against high-cost claims. This approach creates the lowest possible administrative costs and means that the employer isn’t paying profits on top of claims. This was a bold move, especially at the time, as some small colleges and universities worry about the higher risk of a self-insured arrangement.“We were already self-insured and had been pleased with that decision,” said Mr. Hall. “However, healthcare costs were stil...

Healthcare Costs Have Plummeted; What’s Next?

As the medical community sought to increase hospital capacity to serve COVID-19 patients, reduce the spread of COVID-19, and follow social distancing mandates, medical claims volume dropped precipitously. Many patients elected to forego or delay medical care. Colonoscopies, knee and hip replacements have almost disappeared. A May 2020 Kaiser Family Foundation Tracking poll found that nearly half of adults (48%) say they or someone in their household have postponed or skipped medical care due to the coronavirus crisis.edHEALTH claims data reflect these trends. Pre-COVID, medical spending was running 14% ahead of 2019. During the pandemic, spending is down approximately 40% year over year.The KFF poll estimates that as stay-at-home restrictions ease, most (68% of those who delayed care, or 32% of all adults) expect to get the delayed care in the next three months. However, this timing c...

Share-it Employee Engagement Communications

edHEALTH provides share-it employee engagement communications to help member school employees navigate and maximize their healthcare benefits. Check out these helpful communication tools:What You Need to Know About Your January 1 Benefit Changes: January 1 2021 Rx Benefit Changes.pdf; Online VersionHow to Save Money on Prescription Drug Costs: How to save money on Rx share-it communication.pdf; Online VersionHealthcare Terms You Need to Know to Understand Your Options: Healthcare Terms - Share-it Communications.pdf; Online versionTips for Navigating COVID-19: Tips for Navigating COVID-19.pdf; Online versionTake advantage of telehealth convenience Tufts Health Plan and Trustmark Health Benefits: Telehealth Tufts Trustmark.pdf; Online version Harvard Pilgrim Healthcare: Telehealth Harvard.pdf; Online versionTelehealth Benefit Details: telehealth benefit details.pdf; Online versionTips f...

How edHEALTH’s Captive Risk Financing Options Work

Under edHEALTH’s captive, member organizations pick their own self-insured retention level based on their risk tolerance, philosophy, financial status, and experience. In addition to the stop-loss coverage schools automatically receive, they can purchase aggregate stop-loss coverage to further protect their risk. Here’s how the risk financing works:If a school picks a Self-Insured Retention (SIR) of $100,000 per claim:The college will pay any single claim up to $100,000.The Educators Health Insurance Exchange captive will pay the next $1-$650,000 for each individual claim from this school.edHEALTH purchases excess protection from a stop-loss insurer. This insurer reimburses edHEALTH for any part of a particular claim that exceeds $750,000.Members work with the actuaries to pick a Self-Insured Retention amount that balances their claims experience with the risk of paying claims and sto...

The ABCs of Captive Insurance

Twenty-two colleges, universities, and educational institutions own Educators Health, LLC (edHEALTH), a healthcare collaborative formed to address rising healthcare costs that were straining school budgets. By bypassing commercial insurers and pooling resources, edHEALTH leverages the combined schools’ purchasing power, thereby saving on healthcare costs for faculty, staff, and family members. But, did you know that edHEALTH’s wholly-owned subsidiary, Educators Health Insurance Exchange, is a group captive insurer?The captive insurance company’s main purpose is to insure its own risk. By joining colleges and universities together as a single purchaser, the schools gain market leverage. The captive manages its own risk through claims management, innovative programs aimed at loss control, and collaboration with strong business partners.Here are the ABCs on how the Educators Health Excha...