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February 10, 2022

Save on Employee Benefits Now

Group Benefits
5 min read
Jarid S. Beck, ACI, ARM; Managing Director, Risk Management Advisors
Jarid S. Beck, ACI, ARM; Managing Director, Risk Management Advisors
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Save on Employee Benefits Now

 

 

In this article, we'll showcase how our clients can save up to 30% on health insurance using a captive insurance company and the concept of reference-based pricing. Those familiar with captive insurance know there are two fundamental ways to use 831(b) captive insurance companies. Clients can use them for either enterprise risk and exclusions or traditional insurance risk.

Ideally, business owner clients with more than 100 employees and offer group medical benefits to the employees will benefit the most from these savings.

What Is the Cost of Health Insurance?

For an average firm with around 100 employees, group benefits can cost approximately $1,000,000 per year. If you increase that number to 300 employees, it will cost $3,000,000 per year, and for 500 employees, it'll go up to $5,000,000 per year. A lot of business owners state that their second-highest expense after payroll. As a result, reducing the cost by 30% represents significant savings and will positively benefit any business.

The Typical Structure

Traditionally, a typical captive insurance structure for group medical benefits would go through the traditional route. Then the employee will take on a particular portion of the risk themselves. This is typically known as the employer's loss fund. The employer then pays a premium to the captive insurance company concerning the employer's loss fund.

In the traditional structure, the premiums stay deductible, and the underwriting profits accumulate in 831(b) captive insurance companies. The issue since 2016 has been that the average cost per employee has been steadily increasing. The main reason behind this increase is that the models that most businesses are still following gained popularity during the 80s and 90s.

It's startling that we still use the same models for insurance solutions while other avenues have seen so much technological development.

Why Is Healthcare So Expensive in the US?

One of the main reasons is that, due to a law, 85% of all the dollars must increase the number of claims that their clients make. As the number of claims increases, their profit rises significantly. While there's a limit on the percentage earnings, there's no limit on the number of claims that the health insurance companies can make.

Additionally, it's not just the health insurance companies. Even though attempts have been made to curtail the increasing costs of healthcare, they've still been increasing steadily.

Understanding Healthcare Costs

There are three essential tips that all business owners need to know to lower your health insurance costs:

90/10 rule

The 90/10 rule dictates that the sickest 10% will spend 90% of your dedicated portion of healthcare costs. As a result, companies need to make strategic decisions about how they can reduce the need for healthcare costs among the 10%. Encouraging healthy habits or contributing to reducing workplace stress or two things that can prove helpful.

Hospital 50% rule

Half of all healthcare costs occur in hospitals. By controlling hospital costs, we can help organizations provide more free benefits to their employees while simultaneously reducing their costs.

Varying Medical Costs

Most business owners fail to realize that in addition to Medicare, hospitals and healthcare facilities can charge 500% markups over the Medicare price. Health insurance companies typically negotiate higher prices on purpose to earn more profit. This is a widespread practice, and hospitals won't say no to earning significantly higher margins. That's where we introduce clients to the reference-based pricing system.

What is Reference-Based Pricing?

While we are not the pioneers of reference-based pricing, many businesses are using it to reduce their health insurance costs. Under reference-based pricing, we take the Medicare prices that healthcare facilities accept and offer a 40% markup on that price.

Even with the 40% mark-up, we can report a 99.5% acceptance rate with healthcare facilities. By using this method, we ensure that our clients get access to significantly lower claims than health insurance companies that work the traditional way.

At the same time, third parties negotiate contracts with healthcare providers to ensure that costs don't increase incessantly over time. By employing these tactics, we can help significantly lower a business's health insurance costs.

Cost Reduction Strategy

For most large businesses, the highest cost that they encounter after payroll is health insurance. Reducing 30% of these costs results in significant savings for the company and allows them to improve their profits. By signing up with our services, businesses can ensure that they save significantly while still providing group benefits.


Would you like to lower costs while simultaneously improving benefits to your employees?

Take the assessment and learn how:

https://www.riskmgmtadvisors.com/group-medical-benefits-assessment 

The contents of this article are for general informational purposes only and Risk Strategies Company makes no representation or warranty of any kind, express or implied, regarding the accuracy or completeness of any information contained herein. Any recommendations contained herein are intended to provide insight based on currently available information for consideration and should be vetted against applicable legal and business needs before application to a specific client.

Jarid S. Beck, ACI, ARM; Managing Director, Risk Management Advisors

Jarid S. Beck, ACI, ARM; Managing Director, Risk Management Advisors

Jarid S. Beck is a Managing Director at Risk Management Advisors. He is a career specialist in the design, implementation, and management of alternative risk management (ARM) strategies, including self-insured plans and captive insurance companies. Jarid's diverse insurance background allows him to deliver technical insurance solutions to clients in a wide variety of industries, including construction, real estate, staffing, manufacturing, trucking, and finance. Jarid was awarded the Associate of Captive Insurance (ACI) designation from the International Center for Captive Insurance Education (ICCIE) and the Construction Risk Insurance Specialist (CRIS) designation from the International Risk Management Institute (IRMI). He is a noted authority on using self-insurance and captives as a tool for companies to reduce the cost of providing group medical benefits. Jarid graduated from the University of California, Riverside, with a degree in Business Administration.

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