For small businesses, reduced competition means fewer cost-effective health plan options. This puts additional pressure on already tight budgets and makes it harder to offer valuable employee benefits. Fewer health insurers are selling U.S. employers coverage, according to a new U.S. Government Accountability Office report. The GAO is an arm of Congress that helps lawmakers oversee government programs and spending. 1. Decline in Market Competition: Between 2011 and 2022, the number of issuers operating in the large-group market dropped significantly, with the average state seeing a decline from 12 to 8 issuers. Similarly, the small-group market experienced a sharper decline, from 13 to 6 issuers on average per state, indicating reduced competition. 2. Increased Market Concentration: The number of states with highly concentrated markets—where a single issuer controlled over 80% of enrollment—doubled in the large-group market (from 6 to 12 states) and quintupled in the small-group market (from 3 to 15 states), signaling a trend toward monopolistic market structures. 3. Impact on Consumer Choices and Costs: According to the GAO, these high levels of market concentration may limit consumer choice and potentially drive up premiums, contrary to the Affordable Care Act’s original goal of fostering competition in private health insurance markets. The GAO’s findings show how market concentration can limit consumer choice and potentially drive up premiums—challenging the Affordable Care Act’s original goal of fostering competition. Thanks to #AllisonBell and #BenefitsPro for shedding light on this important issue! Read their full article here: #getdecisely #insuretech #employeebenefits https://lnkd.in/eHiCHiB3
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The current structure of the healthcare insurance market favors a one size fits many approach. Some beneficiaries pay for benefits they would never use while lack access to benefits they need. The folks at Tradeoffs highlight one smaller employer who took a unique and engaging approach to allow employees to decide what benefits they pay for and what ones they won’t. It you have time, give it a listen. https://lnkd.in/eE6G-DM9
How One Company Gamified Health Insurance
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The Hidden Gaps in Employee Health Coverage Is your employee health insurance truly serving its purpose? Consider these startling facts: 1. Medical debt leads bankruptcy causes in America—even for the insured. 2. High deductibles and co-pays deter many from seeking necessary care. 3. Increased insurance coverage isn't necessarily improving health outcomes. These realities challenge our traditional view of health insurance as a simple "financial transfer of risk." It's clear that coverage alone doesn't guarantee better health or financial security for employees. As business leaders and HR professionals, we must ask ourselves: Are we providing true health security, or just the illusion of it? It's time to reevaluate our approach to employee health benefits. Let's move beyond mere coverage and focus on creating meaningful impact on our employees' health and well-being. What strategies have you implemented to address these gaps in your health benefits program? Share your thoughts and experiences below. Learn more on our website - https://lnkd.in/gV9a-8qx #EmployeeBenefits #HealthcareReform #HRStrategy #WorkforceWellness
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The truth is that a significant number of Americans are burdened with rising medical debt. This debt has a direct negative impact on the overall well-being of employees, causing increased stress, lower productivity, and a higher likelihood of deferring necessary medical care. It's time to break the vicious cycle. Join us tomorrow for a webinar where we discuss why traditional health insurance isn't working the way it should — and share solutions for Texas employers and brokers to help bridge the gap. https://lnkd.in/g3ycqHKh #Webinar #EmployeeBenefits #Healthcare
WEBINAR: Bridging the Gap in Texas Employer-Based Health Insurance | LinkedIn
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The Hidden Gaps in Employee Health Coverage Is your employee health insurance truly serving its purpose? Consider these startling facts: 1. Medical debt leads bankruptcy causes in America—even for the insured. 2. High deductibles and co-pays deter many from seeking necessary care. 3. Increased insurance coverage isn't necessarily improving health outcomes. These realities challenge our traditional view of health insurance as a simple "financial transfer of risk." It's clear that coverage alone doesn't guarantee better health or financial security for employees. As business leaders and HR professionals, we must ask ourselves: Are we providing true health security, or just the illusion of it? It's time to reevaluate our approach to employee health benefits. Let's move beyond mere coverage and focus on creating meaningful impact on our employees' health and well-being. What strategies have you implemented to address these gaps in your health benefits program? Share your thoughts and experiences below. Learn more on our website - https://lnkd.in/gQGKhj-Y #EmployeeBenefits #HealthcareReform #HRStrategy #WorkforceWellness
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In today’s rapidly evolving benefits landscape, personalization is no longer a luxury—it’s essential. When it comes to health insurance, one-size-fits-all just doesn't work. Every employee has unique needs, preferences, and circumstances. Employers who offer personalized solutions not only show they care, but also empower their workforce to make smarter, more informed decisions about their healthcare. This is why flexible options like ICHRA (Individual Coverage HRA) are gaining traction. They allow employees to choose the plan that’s right for them, while employers can better manage costs. It’s a win-win 🏆 ! Personalized healthcare plans = happier, healthier employees.
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Cigna + Oscar, one of the few remaining traditional players in the health insurance market, has recently announced their decision to cease providing coverage to businesses with fewer than 50 employees, effective December 15, 2024. This development highlights an emerging reality: the future of group health insurance is no longer confined to the traditional carriers that have dominated the recent past. It’s becoming increasingly clear that both Benefits Advisors and Employers need to expand their perspectives. I believe there is value in exploring beyond the conventional, which is proving to be insufficient. A new generation of transparent carriers are emerging, prioritizing the welfare of your employees and diligently crafting solutions tailored to companies of all sizes. If your organization employs more than 25 individuals and is interested in adopting a strategic approach to benefits, I invite you to connect with me. Together, we can ensure your business transitions from being a reactive participant to a proactive leader in this ever-evolving environment.
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As I have repeatedly pointed out, the problem with the health insurance--or more accurately described, the health benefits administration--industry lies with those who purchase their services--the numerous employers who have hired these companies as vendors. As research conducted with my medical school colleague Sara Singer demonstrates, most employers measure and manage almost nothing about benefits administration. No wonder there is so much frustration with prior authorization and denied claims. The anger directed at health insurers needs to be redirected, if you are an employee getting your health care through benefits provided by your employer, to the people overseeing benefits and human resources. When they begin to hold their vendors accountable for things other than spending--such as denied claims and denied services--the health insurance industry will respond accordingly. Meanwhile, employers will increasingly confront class action lawsuits based on their fiduciary responsibilities under ERISA because in few cases are they doing their duty to their employees. #ERISA #healthbenefits #healthinsurance #health
Torrent of Hate for Health Insurance Industry Follows C.E.O.’s Killing
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📊𝐑𝐞𝐟𝐨𝐫𝐦𝐢𝐧𝐠 𝐇𝐞𝐚𝐥𝐭𝐡 𝐈𝐧𝐬𝐮𝐫𝐚𝐧𝐜𝐞: 𝐀 𝐁𝐢𝐩𝐚𝐫𝐭𝐢𝐬𝐚𝐧 𝐎𝐩𝐩𝐨𝐫𝐭𝐮𝐧𝐢𝐭𝐲🔄 The ongoing debate about health insurance reform is heating up as the presidential election approaches. Here's a breakdown of the current landscape and potential bipartisan solutions: 🔹 𝐀𝐝𝐝𝐫𝐞𝐬𝐬𝐢𝐧𝐠 𝐭𝐡𝐞 𝐁𝐫𝐨𝐤𝐞𝐧 𝐒𝐲𝐬𝐭𝐞𝐦 𝐂𝐮𝐫𝐫𝐞𝐧𝐭 𝐒𝐭𝐚𝐭𝐞: Both Democrats and Republicans agree that the current health insurance system is flawed. 𝐒𝐡𝐚𝐫𝐞𝐝 𝐁𝐞𝐥𝐢𝐞𝐟: The root cause is the financing system where employers choose plans for employees, driving up costs. 🔹 𝐄𝐦𝐩𝐨𝐰𝐞𝐫𝐢𝐧𝐠 𝐂𝐨𝐧𝐬𝐮𝐦𝐞𝐫𝐬 𝐇𝐢𝐬𝐭𝐨𝐫𝐢𝐜𝐚𝐥 𝐂𝐨𝐧𝐭𝐞𝐱𝐭: The ACA made individual health insurance accessible but with limitations. 𝐑𝐞𝐜𝐞𝐧𝐭 𝐃𝐞𝐯𝐞𝐥𝐨𝐩𝐦𝐞𝐧𝐭𝐬: The introduction of the ICHRA allows employees to purchase individual policies with pretax dollars, a significant shift in policy. 🔹 𝐌𝐨𝐯𝐢𝐧𝐠 𝐅𝐨𝐫𝐰𝐚𝐫𝐝 𝐋𝐞𝐠𝐢𝐬𝐥𝐚𝐭𝐢𝐯𝐞 𝐏𝐫𝐨𝐩𝐨𝐬𝐚𝐥𝐬: The Personalized Care Act aims to make individual health insurance a pretax expense, further empowering consumers. 𝐂𝐡𝐚𝐥𝐥𝐞𝐧𝐠𝐞𝐬: Ensuring that any new system does not disproportionately benefit higher-income individuals and maintains equitable access for all. 💡 𝐊𝐞𝐲 𝐓𝐚𝐤𝐞𝐚𝐰𝐚𝐲 The path to a more cost-effective healthcare system in America lies in empowering consumers and reducing the control employers have over health insurance choices. This bipartisan approach could lead to significant reforms regardless of the upcoming election results. Read more in comments below 👇 #HealthcareReform #ConsumerEmpowerment #PolicyChange #benefitsguyatusi
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With the recent exits of Cigna + Oscar and Humana from the health insurance market, small employers are faced with a shrinking pool of options. Employee Benefits Client Advisor, Jeb Blazevich, says "For small employers looking to rein in their healthcare costs, the journey begins today. By taking proactive steps to enhance their benefits offerings and empower their workforce, they can pave the way for a healthier and more sustainable future." Here's what Jeb suggests...
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U.S. employers expect health insurance costs to rise an average 5.8% in 2025, largely due to increased cost of medical services as well as higher use, according to a survey released by consulting firm Mercer. What does this mean for you and your brokerage? It's crucial for businesses to leverage tools and strategies that align with their workforce needs, ensuring they offer value-driven health benefits while mitigating rising expenses. Find out more from Reuters: https://lnkd.in/gheQDXPY #EmployeeHealthBenefits #InsuranceBrokers
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