For employers and employees who are looking at options regarding health care coverage, finding a plan that offers predictable and stable costs is important.
Joel Allumbaugh, CEO of Allumbaugh Agency, has been working with employers on a new approach to their health benefit that lowers costs and expands access and value for employees. The agency is an employee benefits organization that serves as a broker and administrator of employee benefit programs for mid-sized employers.
"We have seven full-time staff and operate out of Augusta," Allumbaugh told Maine Business Daily. "We have been in business for more than two decades. We are a Health Access Solutions partner agency focusing on creative health benefit solutions that combine access to day-to-day care for all employees with more affordable protection from larger unexpected medical bills."
He added that they have seen health care costs rise and coverage depreciate as their clients attempt to maintain quality health benefits.
More than 155 million employees get health insurance through their employers, a recent report issued on the Kaiser Family Foundation website said.
"We were motivated to find more cost effective, sustainable strategies to deliver high-quality health benefits," Allumbaugh said. "We specifically witnessed several clients experience premium increases in excess of 30% in a single year. The frustration is significant and the value of the benefit has depreciated as employers have been forced to increase deductibles and employee premium contributions."
He said their new health care benefit provides employees access to preventive and primary care without limits, co-pays or the inconvenience of an insurance company standing between patient and doctor.
"Employees appreciate the cost savings with lower payroll deductions each paycheck and the flexibility to see any doctor that they choose," Allumbaugh said. "Many have expressed appreciation for the ability to see a direct primary care doctor where they experience a more satisfying doctor-patient relationship; more time with their doctor in appointments; more convenient access through phone, email, and video chat when appropriate; same-day or next-day appointments when needed and no co-pays or limits on the number of visits they have."
Allumbaugh added that medical cost-sharing is an affordable alternative to traditional health insurance, especially for employees who don't find value or tend not to participate in their employer's health benefit program, with many employers saving money.
"Of course, many employees and their dependents have a need for traditional health insurance plans and the ICHRA provides the financial assistance they need while preserving their ability to choose any available health plan that best meets their needs," he said. "Some may choose a lower deductible or particular networks that cover their doctors, others may choose a higher deductible plan that is Health Savings Account-compatible if they value the ability to save for future health care expenses. The employer sheds the responsibility and challenge of picking a single plan or limited number of plans to meet the diverse needs of their employees and their dependents and instead makes a tax-free financial contribution that puts many options in front of employees to choose what fits best."
Employers are having a difficult time with rising health premiums, with an average annual price of $7,739 for single coverage and $22,221 for family coverage last year, the KFF report said.
In some cases, Allumbaugh has seen clients with significant numbers of employees waiving their health benefit and going without any access to health care or financial protection.
"We also have heard many employees say they avoided or delayed care even with their health insurance plan because high deductibles and co-pays acted as a financial barrier to care," he said. "The health access benefit eliminates those barriers to day-to-day care and has been a huge asset for many employees that are now getting the routine preventive care they need to stay healthy.”
Nevertheless, employers continue to provide health care benefits at a high rate, with just under half of small employers providing health care plans and the vast majority of medium-sized and larger employers providing benefits, a 2020 report from the Agency for Healthcare Research and Quality said. Despite the increase in costs, 72% of employees enroll in coverage.
Allumbaugh noted that no single benefit strategy is perfect.
"As a broker and advisor, our job is to advise our employer clients and try to provide options that meet their needs," He said. "Traditional group health insurance plans have been failing our clients for years with high, unpredictable costs and depreciating value to employees. Though no benefit strategy is perfect or the right fit for everyone, we appreciate having more options."