In Data We Trust
Health Insurance Renewal Decisions
As your organization prepares to renew employee health insurance benefits, remember your SET SEG employee benefits expert is here to help simplify the process!
While analyzing market trends helps to manage expectations, there is no one-size-fits-all approach to health insurance. Each of our members is unique and faces a different set of opportunities when it comes to providing quality health insurance plans for employees. SET SEG works to structure the best health insurance coverages to meet the individual needs of our clients while working within their budget.
Trends in the Market
Identifying and evaluating trends in the market will provide guidance and insight into your health insurance plan. Though the full impact of COVID-19 has yet to be realized, many insurance pools and carriers are anticipating an increase in claims and an increase in healthcare costs.
Understand Your Renewal
Many factors contribute to an organization’s health insurance renewal process – from the group’s size and geography to its demographics and the overall health of the employee population.
When faced with an increase, districts should utilize SET SEG’s employee benefits expertise for a comprehensive market analysis. The benefits of this may result in:
- A more effective insurance plan design
- Utilization of additional carriers
- Industry-leading consultation services to contain costs
Assess Your Renewal
Although evaluating your renewal and market options is important, the following examples are additional areas to consider as you move forward in renewing your health insurance plan.
- PA 579: Transparency and access granted to Michigan’s public schools
The passing of this amendment in 2019 has allowed districts to have increased visibility and accessibility to their claims data, which can be critical to the bidding process when comparing health plans from competing carriers. Click here to access information as to what PA 579 means for Michigan school districts. - Claims versus Premiums
While you may be fully aware of how much premium your district is paying on an annual basis, evaluating your claims data allows the organization to see just how much the carrier paid on the district’s behalf. Your SET SEG Employee Benefits expert will lead you through this crucial process of evaluating all market options. - Medical Loss Ratio
Medical Loss Ratio (MLR) is a formula that provides a vital metric when evaluating your claims paid versus the premium paid. Your SET SEG employee benefits expert will help you evaluate whether your organization’s health insurance plan is performing within acceptable industry standards.
An acceptable MLR of claims paid to premium paid typically ranges between 75% and 85%. Click here for information related to calculating your organization’s MLR.
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- If an organization’s MLR is below this threshold, your SET SEG employee benefits expert can guide you through the bidding process to obtain alternative cost-saving options.
- If an organization has an MLR higher than this threshold, additional options other than bidding can be reviewed by your SET SEG employee benefits expert.
