Savings Drive Consultant Recommendations to edHEALTH
The primary reason a health insurance consultant recommends edHEALTH to their higher and secondary education clients is when the pricing estimates support the change. Healthcare puts a huge strain on college, university, and private secondary school budgets, which drives up tuition costs. “Higher education is struggling with drops in enrollment and controlling costs is critical,” said Ben Lewis, Partner, Strategic Healthcare Practice Leader, Consiliarium Group, LLC. “Employee compensation and benefit costs represent the lion’s share of college budgets.”
Through our purchasing clout, edHEALTH can negotiate lower administrative fees with less healthcare cost volatility than schools can generally realize on their own. The seven-year average health insurance premium increase is 2.9%, well below the industry average of 7.9%. “Self-funding is a long-term solution and being part of the edHEALTH coalition provides stop-loss economies of scale that small- and medium-sized schools aren’t able to achieve on their own,” said Dave Montville, Managing Consultant, Employee Health & Benefits, Marsh & McLennan Agency.
edHEALTH’s pharmacy carve-out has saved member institutions an estimated $50M-$60M between 2017 and 2020. “The captive provides purchasing power for stop-loss coverage, and the prescription drug carve-out program has provided significant savings for our clients,” said Karen Bacon, Assistant Vice President, Corporate Benefits, NFP.
Captive member owners may also share in any surplus the captive earns. To date, edHEALTH has awarded over $3.2 million in dividends to its member schools. “edHEALTH’s model where all the savings generated by the captive are returned to member schools is unique and a valuable benefit for our clients,” said Tim Tracy, Managing Director, Risk Strategies.
Brokers Become Advisors When Client Joins edHEALTH
With a self-insured health plan, a school’s broker becomes an advisor. The school pays the advisor on a fee-for-service basis instead of on a commission that’s built into the health insurance carrier’s rates. This arrangement improves pricing transparency as the school pays the advisor directly for their advice and representation. “Our role as an advisor becomes more strategic when a client joins edHEALTH,” said Ben Lewis of the Consiliarium Group.
edHEALTH provides several collaboration opportunities that increase advisors’ visibility and knowledge while enhancing their strategic role. “As an advisor to an edHEALTH school, we show our value separate from edHEALTH,” said Chris Powers, Senior Vice President, Risk Strategies. “Advisors drive strategy for their clients. It’s helpful to have insight into what other member schools are looking to do.”
Collaboration Forums Provide Valuable Insight
edHEALTH has an active Plan Design Committee made up of representatives from each member institution and their advisors who work with the Third-Party Administrators (TPAs) to determine plan designs customized to meet the needs of edHEALTH members. These and other all-member forums enable educational institutions and their advisors to compare cost utilization, trends, and best practices with other member schools.
“We have a very collaborative partnership with the edHEALTH staff and their medical consultant,” said Dave Montville of Marsh & McLennan. “They are responsive and dedicated to our client’s needs, such as modeling different alternatives.”
“The participation in plan design meetings is strong, and member school advisor perspectives are openly sought,” said Charlie Baldelli, Principal, Strategic Benefit Advisors. “The collaboration with other schools is valuable for our clients. For example, there’s been a lot of discussion on how different institutions are handling paid family and medical leave regulations.”
Streamlined Processes and Strategic Tools Help HR Staff and Their Advisors
When a school becomes a member-owner, edHEALTH staff works with the educational institution staff, their advisor, and the plan administrators to help ensure a seamless transition. Advisors and their clients work with edHEALTH staff and its consultant to determine the best suite of plan design options. “The consolidated plan design options make it easier to make selections for our clients,” said Karen Bacon of NFP.
The implementation team uses disruption reports to identify any affected employees by the change so customized communications can go out to those faculty and staff, if applicable. edHEALTH also provides open enrollment communications templates to make it easy to communicate with new member school employees. “The implementation process for our clients has run very smooth, and the edHEALTH team and its consultant are very responsive to client needs, said Sheena Tracy, Managing Director, Risk Strategies. “Implementation is a team process with our organization, our clients, the edHEALTH team and their consultant.”
Health insurance works when member educational institutions and their advisors have the data they need to make informed decisions. “Moving to edHEALTH improves medical and prescription drug cost transparency for us and our clients,” said Sean Carney, Partner, 360 Corporate Benefit Advisors. “The data mining helps us create strategies to bend the cost curve.” Ben Lewis of the Consiliarium Group concurred. “edHEALTH’s population health management program emphasizes data mining and early identification of high-cost claims, which allows us to be proactive.”
The People Make Meetings More Fun
There’s no shortage of business to attend to and collective expertise at edHEALTH meetings, but the collegial atmosphere makes them – dare we say it? – enjoyable. “Tracy Hassett (edHEALTH’s president and CEO) is effective at building relationships and making people feel heard,” said Teri Weber, Senior Vice President, Spring Consulting Group. “Being part of a group is at the heart of a captive, and the membership provides a collegial atmosphere,” said Dave Montville of Marsh & McLennan. “It’s a great group of people to work with,” said Sheena Tracy of Risk Strategies. “Everyone is enthusiastic, collaborative, and well-versed.”
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