You have five health plan options, all with double-digit premium increases, high deductibles, and exorbitant out-of-pocket costs for members. You need to figure out which one sucks the least. So what do you do? You create a fancy spreadsheet that details a side-by-side comparison.
There’s nothing wrong with a careful analysis of your options. In theory, a well-organized spreadsheet should help you compare apples-to-apples so you can select the best health plan for your needs.
Assuming such an option exists.
That’s the problem with spreadsheeting – or perhaps a more apt term would be “spreadshitting.” If all the options are terrible, breaking everything down into neat columns and rows doesn’t make them any better.
The Benefits Merry-Go-Round
Here’s what normally happens.
An employee benefits broker presents a client with several options. The broker has used a spreadsheet to compare them in detail, and it’s clear that none of them are very good. But the employer needs a health plan, so they pick the least horrible option and try to make it work.
The next year, prices go up again. The year after that, they go up again. Fairly quickly, the somewhat bearable option becomes intolerable, so the employer is ready to shop for a new plan, and the broker whips up another spreadsheet.
It’s a merry-go-round without the merry.
Trevor Baker, an employee benefits broker and physical therapist, calls it “healthcare hopscotch.” You pick a plan that sucks. Then a few years down the road, you switch to a different plan that also sucks.
Right now, an alarming number of employers are playing this game, and no one’s winning. The 2024 Employer Health Benefits Survey from McKinsey & Company found that two-thirds of respondents said they planned to switch health benefits carriers in the next four years or sooner. That’s a lot of employers who are unhappy with their coverage – but many of them will likely end up in new plans that are just as bad.
Getting off the Merry-Go-Round
Clearly, the status quo isn’t working for most employers. If it were, they wouldn’t be so keen to switch plans. Unfortunately, the merry-go-round keeps going for two reasons:
- Brokers don’t offer other options. Many brokers are used to spreadsheeting different health plans. It’s what they do, it’s what they know, and it’s not their fault if all the health plan options keep getting worse year after year. The system may be broken, but they’re still earning a nice commission, so there’s no real incentive to change.
- Employers don’t know what else to do. Applicable larger employers can face fines for failing to offer minimum essential coverage, and an employer only needs 50 full-time equivalent employees to qualify. Smaller employers can drop coverage, but if they go that route, they’ll have a harder time meeting their workforce goals. The simple truth is that people expect employers to offer health insurance, so they keep selecting the best option available, even if that just means picking the option that sucks the least.
They say, “If it ain’t broke, don’t fix it” – but this system is clearly broken.
Spreadsheets Don’t Show Everything
A detailed spreadsheet can show you the premiums, copays, deductibles, out-of-pocket maximums and other quantifiable details of various health plans, but there’s more to healthcare than numbers.
Imagine you’re a plan member, and you need a test your doctor has ordered. You’re worried about the cost and want to make sure it’s covered, so you call your insurance company. After waiting on hold and getting transferred multiple times, you still don’t have a clear answer.
Customer service is critical in health insurance, and it’s often lacking.
The consequences can be dire. According to KFF, 58% of insured adults say they’ve experienced a problem using their health insurance in the last 12 months, and only half of them say the problem was eventually resolved to their satisfaction, while 17% say they were unable to receive recommended care.
If employers want to boost employee satisfaction and obtain real value from their employee benefits investments, they need to know that their employees are going to be able to use their coverage. The experience matters, and spreadsheets alone don’t tell you what to expect.
There’s Another Option
Instead of using spreadsheets to identify the least sucky health plan, brokers and their clients can focus on alternative healthcare options that actually meet their needs.
Many larger employers have embraced self-funding, and this is a huge step in the right direction. Here at Health2Business, we’re helping employers and brokers go even further, with direct health plans that let employers contract directly with local healthcare providers to offer quality care that puts members first, with options that are suitable for smaller employers.
Instead of traditional spreadsheets, we provide a prospectus. While a spreadsheet breaks down the numbers for the next year, our prospectus shows what employers can expect two, three, four, even five years down the road. In addition to immediate savings, employers typically see cumulative benefits as they take control of their health coverage to lower costs while providing better benefits.
This isn’t another merry-go-round. It’s a long-term option that actually solves the problems that plague healthcare. Learn more about direct health plans.
