Solutions to the Rising Cost of Health Insurance

Episode 1: Welcome to the first episode of our podcast. JP Barta, Founder and CEO introduces us to the Legacy Benefits Group. If you’re an insurance broker or employer dealing with health insurance and other employee benefits, this podcast will be of interest to you.

JP Barta grew up in the insurance field. A large number of his relatives worked in insurance. His dad was a broker who introduced him to the profession early on. Initially, JP focused on benefits communication. He started a company to help employees better understand their insurance and related benefits.

Over time, he noticed how companies were forced to deal with increasing premiums. Those increases often lead to higher deductibles and fewer, usable insurance benefits. At times, the managers making these decisions may not have fully understood the financial impact on their employees.

David vs. Goliath

The Legacy Benefits Group is competing against the large players in the health insurance market. In Kentucky, that primarily means United Healthcare, Anthem and Humana.

While some amount of insurance premium is typically deducted from paychecks each period, employees can be hesitant to utilize their benefits. It’s a question of confusion and concern regarding bills related to their medical treatment not fully-covered under their plans.

JP comments about the rising trend in deductibles and out-of-pocket expenses. We’ve been conditioned to expect them. Many employers feel they really have limited or no options beyond accepting those increases.

Factors Driving Increases in Insurance Expenses

There are many factors impacting insurance costs. Some of them are:

· Employee lifestyle choices and behaviors

· Brokers who present the status quo options to their employer-clients

· Employers who want to avoid disrupting employees by trying something different

Unfortunately, it’s a cycle that just keeps repeating, even if people know it’s a broken system. It can be frustrating for everyone involved.

Departing from the Status Quo

The Legacy Benefits Group primarily serves insurance brokers. They provide options a broker could present to their employer-clients to help limit or eliminate insurance cost increases. They utilize innovative, cost-containment strategies that ultimately benefit the employer and employees.

One example of these cost-containment strategies is a direct contract arrangement established with a provider or facility. This enables the Legacy Benefits Group to offer its brokers and their employers. Instead of “renting networks,” the Legacy Benefits Group is able to provide its own contract pricing.

Another successful strategy is how they work to educate members on the cost difference in healthcare. Some hospitals and facilities perform the same procedures for significantly less cost. The average employee hasn’t been informed about the vast differences in costs, even between two facilities in their own communities.

Know Before You Go

JP comments that the average consumer looks for lower-cost alternatives when shopping for various day-to-day items, but doesn’t really think the same way about cost, when it comes to an expensive medical procedure such as an MRI. In most cases, the consumer doesn’t realize there’s a difference. They have options.

For the employer with a number of employees who have to seek medical treatment, the difference in cost is substantial. This higher cost of claims also impacts the upcoming year’s premiums. Employee education can help to limit and/or avoid these increases. JP is an advocate of the “Know Before You Go” approach.

Not All Brokers Are Created Equal

The Legacy Benefits Group works directly with brokers. It’s how they go to market. Unfortunately, as JP explains, not all brokers approach the job in the same way. Some are more forward-thinking than others. There’s a population of brokers within the industry who feel okay staying with the status quo options. However, there’s another population of brokers who are looking to be disruptors and to deliver different solutions for their employer-clients.

More than Health Insurance

The Legacy Benefits Group is located in Louisville, KY. It serves as the sales organization servicing brokers. However, they also have a third-party administrator (Advisory Health Administrators). They have a group offering fully-funded and level-funded plans. Finally, there’s also clinical management company.

This vertical integration enables JP’s organization to influence cost control and behavior, resulting in better health insurance outcomes. They can effectively communicate with and educate their members and providers. Rather than the tradition status quo, the Legacy Benefits Group takes a very proactive approach in the marketplace.

Healthcare Innovation is Badly Needed

One factor that sets the Legacy Benefits Group apart from its competitors is that it can be very nimble. There are options and solutions available, but you won’t always find that with the status quo carriers. Those other organizations are too big to turn on a dime or realize the need to do so. That’s not the case with team at the Legacy Benefits Group.

Take specialty medications, for example. JP comments how approximately 50% of the pharmacy spend in the US last year was for specialty medications. However, those medications are used by less than 2% of the population. Targeting these expenses, and providing alternative solutions, is extremely impactful.

If an employer can attack those medical cost drivers, it can realize a much better claims history, which impacts plan costs in the immediate, future years.

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:

Call Our Phone Number: 855-321-0741

Email JP:

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.

181 views0 comments

Related Posts

See All