- High Opt-out rate due to costs
- Spouses and children often uncovered
- Frustration about costs directed to Erica
Erica spends about $8,000 per employee per year on health insurance. That’s a lot of money, because Erica runs an assisted living facility, where her average worker earns about $30,000 per year. Erica offers health insurance to her employees because she cares about their wellbeing, and believes offering insurance is a really important benefit. But the cost is becoming a big problem. When Erica started offering health insurance, her cost was less than $2,000 per employee, and each year Erica is making less money in part because of this expense.
Yet, despite spending so much money, it’s increasingly clear to Erica that her employees are not getting $8,000 of value for this investment. When she started offering health insurance, almost everyone signed up, but today, about 1/3 of her employees are uninsured. And many of her employees who do sign up for health insurance through the company are not enrolling their families in coverage. Erica’s a little scared to ask, but she suspects these employees’ kids and their spouses are uninsured. She gets it. She pays for about 80% of the costs for the employees, but only half the costs for families. It’s all Erica has been able to afford, and she’s thinking she may need to pay less soon.
Until recently, good alternatives for her employees to get affordable health insurance were limited…But Erica’s starting to wonder if the new health law might actually provide a better option…
For Erica’s company, the Health Insurance Marketplace is an appealing alternative to her traditional employer-sponsored health Insurance plan. Significant subsidies are available for her employees to help make this insurance affordable. Erica’s learned that many of her employees can get complete coverage in one of these new marketplace plans for less than $3,000 per year, because of the new federal subsidies. And, what’s even better is this subsidized price covers both her employees and their families. And, Erica doesn’t need to choose a plan for her employees, each employee can choose the plan that best suits their family’s needs in the new marketplace. But, neither her employees nor their families can get these subsidies if she offers health insurance.
Many employers, including large employers such as Target and Home Depot, are already tapping into the new subsidized individual marketplaces to save money. But, Erica has a company to run, and she can’t deploy an army of HR specialists and consultants to figure out how to take advantage of this new individual market opportunity. That’s where Benefitter comes in. We bring Fortune 500-like technology and support to organizations of all sizes.
Capitalizing on the new individual market is clearly an interesting option for Erica’s company, but doing so in a smart way is not easy. The math for specific employee situations may be straightforward, but Erica has a diverse employee population, each of whom have different level of subsidies available in the individual market. And, Erica still wants to provide a health insurance benefit, even if she isn’t providing a health insurance plan. And, it’s really important to Erica that her employees have health insurance and that making this change is not seen as a take away. That’s where Benefitter comes in.
Benefitter provides a comprehensive program to help employers thoughtfully transition employees to this individual market. Our program includes an intelligent approach to allocating Erica’s health budget to maximize the benefits for her employees and minimize disruption.