How To Lower Healthcare Costs While Improving Benefit Offerings

The ideal for anyone managing a group health plan is to enhance the organization’s employee benefits program while somehow also lowering healthcare costs. Alera Group can show you how that’s done through actuarial analysis of health-related data. 

Join us on June 20 for a one-hour webinar designed to help you eliminate wasteful spending while providing your employees with benefits that attract and retain talent. We’ll take you through our three-step solution for: 

• Leveraging services that improve employee health;  
• Reducing medical and pharmacy spend waste; 
• Produce measurable savings by reducing dependence on the healthcare system.   

You’ll come away with a deeper understanding of how to leverage data and analytics to drive your employee benefits strategy.  

Reconciling conflicting needs 

Attracting and retaining talent remains a challenge, and while lifestyle, and societal considerations rank high in surveys of what is most important to workers when weighing whether to stay with their current employer or seek a new job, income and benefits are still at or near the top. 

As Alera Group V.P. Tina Santelli recently wrote in an article for HR Executive, “Offering the right voluntary benefits can be a game-changer for employers in attracting and retaining top talent,” and that strategy is generally cost-effective. But health insurance – including Medical, Dental and Vision coverage – remains paramount.  

Fortunately for employers and employees alike, offering health insurance is a worthwhile investment. According to an Avalere Health report commissioned by the U.S. Chamber of Commerce, employer-sponsored health insurance was expected to provide employers with 100 or more employees a 52% return on investment (ROI) by 2026. 

But whether you call it “employer-based health insurance,” “employer-funded health insurance,” “employer-provided health insurance” or “employer-sponsored health insurance” it’s increasingly expensive.  

KFF reported last October that annual family premiums for employer-sponsored health insurance rose 7% on average in 2023, to $23,968, with employees contributing an average of $6,575. With healthcare costs continuing to increase annually, the net effect is greater strain on companies and their employees. 

Applying data to drive insights 

Determining what’s driving your healthcare utilization and understanding the impact of solutions are the keys to designing a benefits program that’s better for your employees and better for your company’s bottom line. Collecting, reading and interpreting data enables you to determine your organization’s foremost medical conditions, which in turn enables you to target those issues. 

Let’s say, for example, data shows that illness related workplace-related stress has been a primary driver of your healthcare spend. In such a situation, your solution is likely to involve: 

1. Getting to the bottom of what’s creating all that stress and enacting a plan to reduce it; 
2. Increasing support for employee mental health. 

Ah, but if only it were that simple. Getting to the bottom of what’s causing workplace stress requires expert analysis of your data ― and not just data, but the right data. And once you have the right data, it’s essential to know how to read it.  

Implementing data-based solutions 

Data tells a story, but you have to make sure you interpret it correctly. If the primary cause of stress is substance abuse among your workforce, for example, your solution to the problem is going to be very different from what it would be if the main cause is an incompetent or abusive supervisor.  

So what kind of data are we talking about? Here are two examples: 

• Population health data – information about health status and outcomes within a group of people, rather than on an individual, case-by-case basis, enabling you to get to the root of problems and implement risk management solutions; 
• Pharmacy data – information that enables you to identify which medications are effective and which are not, enabling you to eliminate wasteful spending and redirect your dollars toward solutions that work. 

During the webinar, we’ll discuss how an actuarial focus can strengthen your understanding of your healthcare costs, implement solutions that provide your employees and their families with access to the care they need and ensure your plan design is curated in a way that improves the wellbeing of your people and protects your bottom line. You’ll see that the program that’s right for your organization may cost a fraction of what you’re paying for a program that’s less successful. 

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About the authors 

Robert Eisendrath 
Managing Partner  
Alera Group Pharmacy Solutions (AEC Rx)  

With more than 25 years of pharmacy benefits management (PBM) and pharmacy consulting experience, Bob Eisendrath is nationally known for his contract analysis skills and strategic thinking. Prior to joining the pharmacy consulting world, he spent almost 20 years at CVS/Caremark in various leadership roles, with responsibility for large employer and labor coalitions and high-profile large national clients. He previously served as national PBM practice leader for EPIC Brokers & Consultants.  

Contact information:  
bob.eisendrath@aleragroup.com  
(847) 971-7528  
Connect with Bob on LinkedIn  

Harindra Sebastian  
Vice President and Senior Consulting Actuary  
Alera Group  

Harindra Sebastian has two decades of actuarial consulting experience, having served some of the largest and most complex clients in both the U.S. and Canada, across a wide range of industries. His prior roles have encompassed client relationship management, sales growth leadership, financial management, intellectual capital development and actuarial leadership. His experience spans group benefit plan strategy, pricing, financial management, program design and vendor management, including projects on due diligence for M&A deals, union negotiations, settlement of unfunded retiree benefit obligations, and guidance on cost reduction, and talent attraction and retention through plan redesign.  

Contact information:  

• harindra.sebastian@aleragroup.com  
• Connect with Harindra on LinkedIn