Are You Utilizing Your Claims Data?

Self-funded and alternative funding arrangement benefits plans have been a hot topic for employers who are looking to make a change from the constant rate increases of a fully insured plan. This has been great for employers who are willing to take on more risk. A perk of being in the self-funded environment that is often overlooked is owning your own claims data.

While fully insured, each year you get a rate increase and while you may be able to negotiate it down, you’re stuck with an increase with limited knowledge about why you got it. This has been the norm for so long now that it doesn’t seem as unfair as it really is. Especially with the idea of wellness plans being so prominent, it would make sense for employers to know what types of claims are occurring. This way wellness plans can focus on what would really benefit your employees. Keep in mind, to have this data you’d need to be in a somewhat self-insured environment, and therefore healthier employees would lead to fewer costs associated with your benefits plan.

Having this data can allow you to set up realistic and achievable plans to help lower your benefits costs while trying to provide your employees with a healthier life. If you’re fully insured or in an alternative funding arrangement plan and not taking advantage of your claims data, you're missing out. Feel free to reach out to discuss how this could benefit your company.

Written by: Xavier Bodnar

G. Kevin Nemith , Hilb Group Delaware