Open Enrollment

Nobody loves the phrase, “it’s that time of year again“ more than brokers and human resources leaders. Of course, they are referring to annual open enrollment. That means summer is over and winter is coming. And this year, things look a little different for most of us.

Here in the US all kinds of winds are picking up… literal hurricane winds, inflation, Trend, (un)employment, and the big topic that we’re not supposed to talk about at work involving one red person and one blue person.

There is no doubt that the premium increases are the same or larger than they have been in the last few years. That has everyone scrambling, as it should. And with health insurance premiums still managing to be the second largest expense for employers, just behind payroll, it has a way of taking all of the oxygen out of the room.

The main levers available to employers remain the same.

~ The way to finance premiums: fully insured, self-funding, and level-funding

~ benefit levels like co-pays, deductibles, coinsurance, and MOOPs

~ premium splits between employers & employees

~ provider networks

~ population health mgmt

~ marketing, shopping, RFPs

~ group, ICHRA, PEO, AHP, coop

But some things are new.

If you’re shopping for a new broker or insurer, expect fewer options because of continuing consolidation.

If you’re increasing employee premiums, prepare for pressure from employees and your competitors.

When you consider your PBM and Rx list, get ready to know all about GLP – 1Ss.

1. As always, the more time you have, the better.

2. The more communication, the smoother things will go.

3. Finally, have a strategy. Over 30 years ago, my very first SVP used to say, “In the beginning, God had a plan. Then the plan was implemebted. And it was good.” Good ol’ Bob Kavanaugh. He was right. Start with the end in mind. Read the map. Ask for directions.

In the last week, I saw an article from benefitspro. The headline read something like, “over 50% of employees regret their open enrollment decisions.“ The tone took me back to the movie “Bowling for Columbine, seemingly pushing an agenda of ‘fear and consumption’ to decision-makers in the employee benefits arena. Don’t take the bait. It’s insurance. It’s risk. If employees knew exactly what to pick, we’d call it something else. And the prices would go up even faster.

(Shhhh. Nobody say the letters A. I. )