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Changing the Way We Think about Health Insurance


Episode 2: Welcome to this episode. JP Barta, CEO of The Legacy Benefits Group addresses an important question: Why Is Changing the Way We Think about Health Insurance so Difficult? He’ll review some interesting statistics for business owners and their employee benefit plans.


Many people understand we are dealing with significant challenges in healthcare. Unfortunately, some of our attitudes and behaviors have lead us to simply accept many of them. The cost of health insurance benefits is out of control for many small businesses. It can place some of these benefits out of the reach of the employees they’re supposed to help.



Surprisingly, when JP engages business owners about the topic of health insurance, even after those owners describe the high-level of dissatisfaction, they often decline to consider alternative solutions. There’s a significant resistance to change for most people.


For some business owners, they common understanding is that the big health insurance providers are “safe.” And with that, they continue to put up with the rising costs and increasing levels of dissatisfaction. Changing the way we think about health insurance is difficult.


According to a 2020 Kaiser Family Foundation study, 157,000,000 Americans have use employer-provided healthcare. The 2020 median annual income in the US is $79,000. The Kaiser study indicated the 2020 average health insurance premium for single insurance was about $7,500, not including co-pays, deductibles, etc. For family plans, it was over $21,000. Roughly ¼ of the median average income goes just for healthcare premiums, although a portion of that cost is covered by the employer. This isn’t a sustainable model.


Innovative Healthcare Solutions for Small to Medium Sized Businesses

The Legacy Benefits Group focuses on small to medium sized businesses. It’s where they can have the biggest impact. The small group market typically doesn’t have the buying power larger group employers enjoy.


The option of having a self-funded program is more realistic today than it’s ever been. Going back to the Kaiser Foundation study, the data indicated nearly 20% of employers from with 3-200 employees now offer some form of self-funded plans. These plans are gaining steam.


Addressing the Real Cost Drivers

However, just changing the type of plan structure isn’t the answer. There a cost drivers in healthcare that must also be addressed. Unfortunately, many small groups don’t have the same access to claims data. They lack a better understanding of the variables driving their costs, related to how their employees are utilizing healthcare benefits.


The Legacy Benefits Group can help to provide, interpret and engage in strategies to help the self-funded small group employers. This is an important step.


Understanding the Cost of Facilities

Education is a critical part of delivering high-quality healthcare benefits, at a more economical cost. By helping the group to understand the difference the cost of a procedure at two or more medical facilities, it enables the group to make better care-related decisions.


What is Reference-Based Pricing for Healthcare?

Reference-Based Pricing (RBP) uses Medicare as a reference point. Many hospital procedures are significantly marked-up, based on RBP. In some cases, it can be 8-10 times as high as what the government Medicare price is, for the exact same procedure at the same facility. The system can be handled differently.


The Legacy Benefits Group can explain how small, incremental changes in how we think about and choose providers can begin to yield significant cost savings. But thinking about it isn’t enough. It’s also about realizing the need for a change in our behavior, as it relates to consuming healthcare.


In Episode 1, JP explained how the cost of a procedure in the current year, can impact the company (and thus the employee) premium costs in the upcoming year. There are a lot of factors, but it all counts. Innovative solutions, such as the ones provided by JP and the brokers he supports, can help the business owner make more informed decisions about the employee benefits the company provides.


Changing the Status Quo

It’s an issue The Legacy Benefits Group and health insurance brokers grapple with on a daily basis. Opportunities, such as leveraging direct-contract facilities and providers can significantly reduce costs. In some case, it can actually eliminate some co-pays and other out-of-pocket expenses.


The status quo often results in the belief that as bad as our benefits package is, it’s still great. That doesn’t seem to make sense when you read it, nor when people actually say it. There are innovative, effective solutions available, if companies are willing to step away from the status quo and the dissatisfaction it brings.


The Legacy Benefits Group brings buying-power to the small group employer. You don’t have to accept the status quo plan you’ve had in the past.


Challenge Your Broker to Bring Innovation

The Legacy Benefits Group works through brokers. Some are more solutions-oriented than others. For this reason, JP encourages you to challenge your brokers to do more that the status quo. Don’t accept the path of least resistance during your renewal period.


Fixing healthcare in one major swing isn’t reality. The way to achieve optimal results is to focus on the incremental changes, many of which are already available to you. JP’s team provides those types of opportunities. Education is the key to beginning to change behavior.


Reducing the Cost of Group Healthcare Premiums

Many people look at the cost of healthcare insurance premiums as out of reach. As individuals, we look at our premiums, deductibles and out-of-pocket expenses matters of individual choice. However, those individual choices impact the group. Unfortunately, employers may not have taken step to educate their employees about how their day-to-day decisions drive plan costs, especially in the upcoming years. Those decisions have a direct impact on the cost of next year’s premiums.


Over the years, The Legacy Benefits Group has pursued solutions that provide a health insurance program with full access to quality medical care at quality medical facilities. As a result, employers now have access to extremely competitive rates to benefit the members (i.e. your employees).


The goal for the Legacy Benefits Group is to be able to offer comprehensive, major medical coverage without restricting access to quality care. Again, part of that capability is proven by educating people about how to be better consumers of healthcare.


Are You a Proactive Health Insurance Broker?

It costs you nothing to get a quote. It may enable you to offer much needed solutions to your clients and their employees.


Contact Us via Our Website: www.TheLegacyBenefitsGroup.com

Call Our Phone Number: 855-321-0741

Email JP: JPBarta@TheLegacyBenefitsGroup.com


Thank you for listening. We’ll be back in 2 weeks with another episode. In the meantime, please SUBSCRIBE to our podcast to avoid missing upcoming episodes.


The Legacy Benefits Group is here to help you to get the most benefit from your benefits.

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