Nelson’s in a pickle.

He’s paying $162K for a group health plan covering his 17 employees. That’s net of a 60/40 premium sharing arrangement for a ‘Silver’ level of benefits.

The pickle?

Nelson’s Office Manger walked out the door two weeks ago for greener pastures. And, the rest of “the natives are restless” thanks to a tight labor market with many employers paying way more than 60% of the premium for ‘Gold’ coverage.

He has to halve his employees’ premiums and enhance their benefits without torpedoing his bottom line.

Mission Impossible? (Nyet!)

First, move from a fully insured plan to ‘Level Funding’ (i.e., self-funding ‘Lite’) with a $15,000 “Specific Stop Loss.” (Billed premium goes from $291K to $249K).

Then, he changes the ‘insured’ plan design to a high ($6,000) deductible co-pay plan BUT, back fills 80% using an HRA. Result: employees have ‘Platinum’ benefits but the ‘premium’ drops another $60K (~ $14K of which will be spent on ‘expected’ HRA claims).

The frosting on the cake?  Add accident and critical illness insurance, providing a new element of coverage even the “Jones’ will want to keep up with!” (Costs only $20/employee/month.)

Can’t wait to do this employee meeting!