Feedback: April 2015

Question: What new healthcare policies or programs are you able to offer employers, to include in their employee benefits for their employees, that have been created since the implementation of the Patient Protection and Affordable Care Act?

Paul Breslau

President
Breslau Insurance & Benefits, Inc.
Sector: Employee Benefits

There is a new, exciting healthcare development for employers in Metro Phoenix — Redirect Health. Using its private network, a low-cost Minimum Essential Coverage (MEC) plan has been created. Requiring no co-pays or deductibles, this plan includes unlimited primary care visits, physical medicine and injury visits, and rehabilitation (including chiropractic). Labs, X-rays, immunizations and pain management are also covered.

Facilities are located throughout the Valley and they are impressive. They offer same-day or next-day appointments, and promise patients a less-than-15-minute wait in the waiting room. And a 24/7 Concierge Visit-by-Phone service with access to complete medical records often means even an office visit can be avoided.

The Redirect Health plan combines well with other self-funded or fully insured PPO options. Any employer can benefit from this customized strategy. Starting the process now is ideal for employers with 50 to 99 employees who are obligated to offer insurance starting January 2016. Finally, larger employers who implemented wellness-only MEC plans last year would be wise to consider this option.

Breslau Insurance & Benefits, Inc. helps employer groups with health insurance and benefits, offering prompt service, expert knowledge, and value-added services such as employee benefit websites. The company represents the major insurance companies for medical, dental, vision, life and 401k. Customizing solutions based on the needs of each employer situation, the company also specializes in solutions for compliance with the Affordable Care Act. 

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Kristine Kassel

Owner
Benefits by Design, Inc.
Sector: Insurance

There are a few policies that were already around prior to the ACA, but they have become more expanded to work with the employer health plan that currently exists. One of the plans is a wellness program employers can offer their employees. Almost all of the health insurance carriers offer wellness benefits to their policyholders, but now there are separate plans employers can purchase that can sometimes even enable the employees who participate in the programs to save money. There are also some discounts through the ACA program that are available to the employers who offer these wellness plans.

In addition, telemedicine plans have become very popular. An employer can add these to the group health plan. The main benefit is, most of the health plans today have high deductibles — but if a telemedicine plan is also in place, the employees can utilize access to physicians and nurses by phone or online to discuss minor symptoms. And some of the plans have access to prescriptions at a reduced cost without the patient having to physically go to the doctor.

Kristine Kassel is the owner of Benefits by Design, Inc., an insurance brokerage company that represents several insurance carriers for diversified lines that include health, dental, life, long-term care and disability insurance. Her industry involvement includes serving on the Arizona Department of Insurance Stakeholder Group, the Uniform Health Application committee and the Arizona Exchange Committee and Rate Review committee. She has been on the advisory board for Blue Cross Blue Shield, Lifewise Insurance Company and AFLAC. 

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Stephanie R. Waldrop

President
Employee Benefits International
Sector: Employee Benefits

The healthcare industry has seen a veritable wave of innovation in response to the legislation. These are just a few:

Alternate Funding Solutions provide a 4 to 6 percent savings in the taxes/fees due to healthcare reform. Many programs provide financial protection comparable to traditional plans. The employer may receive money back if the plan performs well.

Pooled Purchasing Arrangements allow employers who have from 10 to 300 benefit-eligible employees to leverage the buying power of an entire industry, achieving lower administrative cost, lower renewal increases and much stronger stability in their healthcare benefits.

Accountable Care Organizations (ACOs), now offered by many insurance carriers, provide savings ranging from 8 to 15 percent. Although they limit access to care over traditional PPO models, they can be offered alongside traditional PPO plans to give employees another option.

Alternatives to traditional primary care providers and enhanced wellness programs that truly engage employees in healthier lifestyle choices round out the top five trends.

Stephanie Waldrop brings 16 years of executive-level insurance industry experience to her role as Arizona President of EBI. She specializes in providing employee benefit consultative and brokerage services for mid-size to large employers. Her strategic planning with employers is aimed at long-term employee benefit solutions, enabling employers to offer competitive benefit programs, control cost and offer compliant programs. Waldrop is passionate in her endeavor to bend the healthcare trend.