Easing Pain for Older EE's on Group Renewal?

[yorkriver1]

What are your employer groups doing about age banding? Going self funded if they can? Can the ER disproportionately help older EE's with rates? I don't think they can with contributions. Maybe bonuses or pay increases.

I have a small group renewal (23 on plan, 40 EE's) with about half of the EE's getting age related decreases in rates, the other half getting increases from 10% to 75% based on age.

I calculated how the ER could offer to put the difference in ER contribution from the rates for their current plan and the $5k deductible HSA plan into an HSA account for them. It's OK, but only cuts their increases in half at best.

Since it's a small company, there will be lots of pain all around if increases for some are so bad, while others get an equal amount of premium decrease.

Upside, no health questions for new employees. Downside of ACA rating rules, unintended consequences, this type of group premium arrangement is going to discourage employment of EE's over 50.

 

[kgmom219]

What's the subsidy eligibility look like? This may be a group that needs to give everyone a raise, terminate the group plan, then bring you in to write indy policies.

Have you looked at averaging the age banding? Just because the carrier said Mark costs $200 and Jimmy costs $500 doesn't mean you have to pass that rate to the employee. Do an average.

And by all means, look at a self funded option.

Good luck!

 

[yorkriver1]

Thanks for responding. Do you mean the employer would average their contribution per employee based on averaging the employee only rates on the renewal?

Since the overall rate went up just 6.4% (which I found out after talking to the ER briefly), it seems like a good idea to try to keep the plan as close as possible to current one, per the employer's wish.

Self funded quotes seem wise. Pre-ex inquiries involved, will just have to take the plunge. Comparing networks between carriers will also be key.

Big cost increases for some EE's just isn't going to work, however. I did check Silver plans with subsidy based on oldest EE's salary, it could work because their monthly would be really good, but would take some planning/negotiation.

Owner would have to find a way to keep EE's happy if they disbanded the group.

Thanks again for your time.

 

[kgmom219]

Thanks for responding. Do you mean the employer would average their contribution per employee based on averaging the employee only rates on the renewal?

Since the overall rate went up just 6.4% (which I found out after talking to the ER briefly), it seems like a good idea to try to keep the plan as close as possible to current one, per the employer's wish.

Self funded quotes seem wise. Pre-ex inquiries involved, will just have to take the plunge. Comparing networks between carriers will also be key.

Big cost increases for some EE's just isn't going to work, however. I did check Silver plans with subsidy based on oldest EE's salary, it could work because their monthly would be really good, but would take some planning/negotiation.

Owner would have to find a way to keep EE's happy if they disbanded the group.

Thanks again for your time.

Yes. Just average it out and see what it looks like. Have fun with the network comparison. Yuk!

One of the best (and few good) things about ACA is that employees now have a choice. The owner doesn't pick a plan that the employee doesn't want. Some of the ee's may want an HSA compliant plan. Some may want silver. Some may want gold. By giving the ee's a raise and letting them choose, you may be OK. Happy employees and keeping the owners cost under control.

 

[yorkriver1]

"Have fun with the network comparison. Yuk!"
I know, right? Agreement on just one, not likely.

Yes, dismantle plan is radical, and we have some narrower networks with mostly all HMO's on Marketplace, but, could give families a better break.

So the execs can give themselves a raise, too. Corp structure makes them EE's.

Yes, at least there are options. Will do the average EE rate, see what happens. It's the family rate increases that are killer, too.

Glide like a swan, paddle like heck.

 

[Two Rivers]

Something I'm looking at with my groups are the low income EE that may qualify for their expanded state medicaid program. There would be no penalty to the employer if the EE went with family on medicaid. There is a program out there that is new that also charges the ER for the services and agent gets a bit of comp.

 

[NWBenefitProvider]

Something I'm looking at with my groups are the low income EE that may qualify for their expanded state medicaid program. There would be no penalty to the employer if the EE went with family on medicaid. There is a program out there that is new that also charges the ER for the services and agent gets a bit of comp.

KGMOM hit the nail on the head. ALL my groups are averaging the premium to avoid any potential issues among employees. Everyone pays the same. If they don't like it they can waive coverage if they think they can do better. Believe me, at the end of the day they can't for a variety of reasons.

Come in with this as a solution for your group and they will thank you.

2 rivers, what is this "Program" you speak of?

 

[rayluk]

I am somewhat new to group benefit. Am I reading correctly that employees can opt to pay avg group premium (block rate) instead of individual age band premium? Considering it is under 50 group and employees are to pay part of the premium.

Thanks for the info.