Keep the same health plan for 2017 or make changes to employee health insurance?
Midstate employers are asking themselves this question as they face rising health insurance costs for the coming year, much as they have for the last decade or more.
Over the years, companies have shifted more costs to employees, opted for lower-cost plans with higher deductibles, and done what they could to preserve benefits for employees.
"Our struggle is always to try to maintain the highest-level plan we can without imposing a lot more costs onto employees," said
"It's really a continued trend that we've been facing for a decade, of just trying to get the right mix," Shakelysaid.
Premiums in 2017 are increasing at a pace similar to years past, said
"It's similar to what we've seen over the last number of years," Glus said.
A double-digit jump
Despite the increases,
Most fully-insured employers are dealing this year with double-digit rate increases, said
In the past,
When employers opt for self insurance, they share the risk with insurers by paying a portion of their own claims. On the plus side, the arrangement gives employers more control because they can gather employee information in an effort to predict health care costs. Healthy employees can result in lower costs for self-insured employers, whereas sick employees who require high-cost prescription drugs, for example, could increase costs.
"Individual situations are driving so much of the trend now," Glus said.
Self-insured companies typically see lower increases in health insurance costs, because they have more control over health plan designs, said
Self-insurance is most common among large companies, but changes because of the Affordable Care Act prompt smaller groups to look at self-insurance options, Scott said.
Employers who are fully-insured are essentially purchasing a generic plan that doesn't reflect actual employee health care costs.
Insurance companies used to be able to collect employee health information to estimate costs for employers, but the ACA restricts that practice, resulting in less control over health insurance costs for both employers and insurers.
In addition to choosing health plans for 2017, employers must continue to adjust to ACA new reporting requirements.
Large businesses and selfinsured small businesses are required to report health coverage information on each individual employee to prove they have satisfied the ACA's health insurance requirements.
Although reporting requirements under the AC A are in their second year, this is the first year that employers could be fined if they are not complying, Glus said.
Last year the government didn't enforce penalties, giving companies time to get systems in place.
This year, employers must report employee health information electronically to the government by
Failure to file reports could lead to fines reaching up to
Individual fines for each employee form not filed are set at
"I think over the next six months or so, as people are reporting for 2016 and we start to see what the government's doing in terms of enforcement, that's when it's goingtobecomeveryrealforpeople," Glus said. *