Widget Industries had a robust health plan for which they contributed 80% of premiums; 55 of 65 employees enrolled.

Annual renewals averaging 12% forced Widget to periodically reduce benefits and the premium contribution. Enrollment dropped.

Widget’s growth continued, albeit with razor thin margins. Unfortunately, with a couple of serious illnesses, renewals worsened. 

Despite switching insurers and even more pruning of benefits, etc., etc., Widget’s premium contribution eventually fell to just 65% for employees and 0% (!) for dependents.

Younger healthy employees did their own ‘shopping.’ Some found other work. Others enrolled in a spouse’s plan. (Guess who stayed enrolled, nonetheless?)

Recently their Broker recommended the penultimate ‘solution’; i.e., a Reference-Based Pricing Health Plan. 

BIG mistake.

Sick employees are being turned away by Health Systems.  And that’s only the tip (pun intended) of the iceberg; click HERE.

With enrollment now well below the required 50% minimum and a 250% + loss ratio, no group insurer will touch this case.

The final ‘scene’ in all likelihood; terminating the group for Individual Coverage Health Reimbursement Arrangements (ICHRAs).

Arthur Miller’s play had just two Acts. But there was a Requiem.

Widget’s ‘Requiem?’

Employees with acute/chronic conditions might lament losing the flexibility of PPO coverage.