3 minute read
Options for Delaware Employers
A HEALTH INSURANCE AND HEALTH BENEFITS UPDATE
BY NICK MORIELLO
Over the years, we have heard stories from Delaware State Chamber of Commerce members about their struggles with the ever-rising cost of healthcare and health insurance coverage for their workforce. It’s no secret that costs have been increasing at an unsustainable pace leaving healthcare unaffordable for many.
When I had the opportunity to join Highmark Blue Cross Blue Shield Delaware a few years ago, it seemed the time had come to explore the possibilities for innovation at the intersection of care delivery and care financing. At Highmark, we have a strategy called “Living Health” focused on what we can do differently to create a better health experience that is simpler, easier to navigate, and results in better outcomes. If we can achieve this, we can also lower the cost of care.
While we look to the future of what could be, it’s always a good time to look at what options exist for employers today. While this list does not encompass the many nuances of business ownership, the four main categories of purchasers are:
• Individuals
• Small Employers
• Mid-Sized Employers
• Large Employers
With regards to types of insurance or financing mechanisms, there are a few main options:
• Fully insured programs: employer pays a premium in exchange for an insurance company paying medical bills, minus any deductibles or cost sharing the covered person would pay
• Self-funded programs: employer pays the medical claims and pays a third party to administer the plan
• Level-funded programs: these combine aspects of fully insured and self-funded and vary employer to employer
• Association plans: these are programs administered through an association on behalf of members and can be any one of the above three categories, with governance laws that are defined by the state in which the employer is based
• Individual Coverage Health Reimbursement Arrangements (IHCRAs): these are programs where an employer provides a defined contribution to workers who in turn purchase individual insurance plans
While costs have been on an unsustainable trajectory for years, there are reasons for optimism. Fully insured programs for small employers in Delaware have experienced very low, single-digit premium changes year over year 2019 through 2023. Individual insurance policies available on the healthcare.gov marketplace have experienced rate decreases in recent years, along with expansions of government subsidies, and more insurance companies participating in Delaware in 2023, which means a more competitive market for consumers.
If you haven’t shopped in a while, it may be a good time to look at the options. There might be a more affordable option or one that better fits the needs of your team. Insurance brokers and consultants, including many who are Chamber members, stand at the ready to assist. Additionally, at Highmark, we are local and we’re ready to serve.
