Hauser Insurance Group recently announced HAUSER Transparent Health Benefits (THB), encouraging employers to radically transform their health benefits. Hauser reported, “Our fresh approach to employee health benefits lowers costs by an average of 20% while increasing the quality of care.” Hauser Insurance focuses on unique insurance solutions for organizations of all sizes, from multinational enterprises to founder-led businesses. They specialize in insurance solutions for private equity portfolios, so those fund managers understand and are protected from the complex risks of today and tomorrow.
Hauser Insurance Group operates the Transparent Health Benefits (THB) program. It is a service/product that revamps employee health benefits, designed to give organizations a more evolved option for their employees. HAUSER THB specializes in helping businesses move beyond traditional health plans, guiding them through their self-funding process using trusted and proven methods at every stage.
According to Hauser, “Self-funding is a newer alternative allowing employers to take full control of their workforce health benefits. While more risk is introduced through this method, significant cost savings can be achieved through a properly self-funded plan.”
Unlike traditional plans, which have represented the majority of health plans in the insurance industry for decades, self-funding plans often better meet the needs of employers and employees. Traditional plans require companies to pay high premiums whether or not employees are visiting a doctor and offer minimal customization to meet the needs of the individual. Self-funding plans, however, can aid businesses in overcoming these challenges while reducing the amount of money spent on healthcare.
“With a self-insured plan, employers will pay for their employees’ health claims as they come up instead of prepaying for claims through insurance premiums. Employers run the numbers on what they expect their workers to pay for healthcare, and after an accounting of the fixed costs, like administrative fees, and variable costs, like the amount paid in claims, employers can design a plan that will provide the benefits their employees are actually using.”
How Does HAUSER THB Work?
HAUSER THB consists of a “network of expert employee benefits advisors who serve as a consultant to companies … enabling them to establish their own self-funded benefits programs.” An advisor will work with a company through four stages until the company plan has been identified and deployed.
- Utilization Management: The advisor will work with the company to help them identify areas of inefficient spending and define custom solutions. They will review medical management to ensure the right healthcare is being accessed at the right price at the right time, oversee care navigation to ensure members are guided to the highest quality healthcare at the best cost for all services, and offer advocacy to reduce confusion and expenses while optimizing outcomes for employers and employees. Companies can expect to receive few claims, pay less, optimize Rx drug costs for employees, and implement cost control to mitigate risks.
- Alternative Reimbursement: The advisor will work with the company to renegotiate better terms. They will introduce three methods to help reduce costs: reference-based pricing, which helps companies move away from the opaque bill charge discounts and establish a reimbursement model that utilizes a transparent reference point instead; direct contracting, which promotes companies to create a direct relationship with their healthcare provider; and bundled payment, which is generally created for a service such as surgeries. Companies can expect to establish care-based improvement metrics, create transparency, and foster beneficial relationships with providers.
- Rx Drug Optimization: The advisor will work with the company to remove wasteful spending and improve transparency. Rx drug costs typically account for twenty to twenty-five percent of an employer’s total healthcare spending. However, that cost can be significantly reduced for both the member and employer with the right strategy. Companies can expect to optimize procurement strategy, focus on specialty drug utilization, and receive up to 867% off pharmacy costs.
- Enhanced Access to Care: The advisor will work with the company to introduce the best providers with no red tape. HAUSER THB helps companies improve employee quality of care and say goodbye to networks, all while providing each plan member with a dedicated care advocate. Companies can expect to eliminate expensive trips abroad for major procedures and offer access to the best providers, all of whom are now in-network.
Today, HAUSER THB works with several companies, the largest of which employs over 3,500 workers. Their median group size is 180, and with every customer, their ideal employee-out-of-pocket expense remains $0.
What Can Companies Expect with HAUSER THB?
HAUSER’s THB “self-funding strategy is a practical approach built on what the most successful purchaser of health insurance [is] already doing and can work for all types of companies, small or large, blue or white collar.” According to their website, here’s what is included in every HAUSER THB solution:
- Dedicated Ambassador: Think of your THB ambassador as a dedicated advisor who guides your organization every step of the way.
- Impact Analysis: Each relationship with THB begins with their customized impact analysis, a multi-step appraisal of a company’s current benefits offerings versus actual needs.
- Industry Smarts: THB’s network of ambassadors has all worked with the big national carriers, so they know their shortcomings and how to build a better plan.
- Ongoing Education: From thought-provoking monthly webcasts to insurance minds to behind-the-scenes podcast interviews, THB’s wealth of proprietary content is available for every client for learning.
- Plan Advocate: Every company has an advocate who is their dedicated support personnel. They can answer questions about the plan, self-funding, access to the best doctors, and more.
- Complete Transparency: Everything they do – and everything the ambassadors will do – is backed by THB’s commitment to honesty, integrity, and proactive cost disclosure.
Services do not end when the plan has been fully realized and implemented. Instead, every relationship with the advisor continues for the lifetime of the plan.
Pros of Self-Funding
To determine if a self-funded plan is right for your company, Hauser Insurance outlined the benefits a self-funding plan can bring to any business in their blog, A Get-Started Guide to Self-Funding. They concluded self-funding insurance options offer:
- Less regulation. The Health Care Administrators Association points out that self-funded plans don’t fall under the purview of state health insurance regulators. Instead, they’re regulated by federal laws like ERISA. They also don’t have to pay state health insurance premium taxes, which HCAA estimates are between two and three percent of their premiums.
- More control. Employers can build a plan based on exactly what their workers need, instead of choosing a carrier plan that has most of what they need and a lot of what they don’t. Case in point: A Kaiser Family Foundation study found that insurers continued to collect premiums during the pandemic, even as consumers delayed care, leading to a twenty-four percent increase in margins for fully insured plans.
- Lower costs. It may seem daunting at first to take on the cost of all your workers’ health claims, but the ability to customize plan coverage means employers only have to pay for what’s actually used. They’re not paying insurers’ administrative fees or padding their bottom lines with interest earned on premium investments, HCAA notes.
Overcoming Myths Regarding Self-Funded Insurance
There are numerous myths surrounding self-funded insurance, and in their blog Debunking Common Self-Funded Insurance Myths, Hauser Insurance Group reviewed and explained the truth behind the myths. The blog revealed:
- Self-funded insurance can work for small companies. “Partners like stop-loss carriers, TPAs, and brokers are making it easier for small firms to benefit when they break away from fully insured plans.”
- Self-funded insurance is not too much work. Instead, “Advisors and plan design specialists help employers identify which benefits their employees will value most, and a TPA can administer and manage the plan, letting the employer focus on actually running their business.”
- Self-funded insurance is not too risky because stop-loss insurance puts a cap on what employers will pay for health claims; employers cap what they will pay per participant (or per family) or year.
HAUSER THB Case Studies
HAUSER reports, “The number of employers seeking out these plans is increasing annually. Over 2/3 of insured workers are getting coverage from their employers on a self-funded plan, up from 61% in 2019, according to Kaiser Family Foundation. Innovative companies are finding that this method is leading to lower healthcare costs across the entire workforce.” On their website, HAUSER disclosed their client’s savings through HAUSER Case Studies.
The business faced soaring costs due to the company’s multiple employee “hubs,” diverse range of employees, and low benefits savviness. Working with a company with more than 600 employees, HAUSER THB implemented Medicare-like rates, transparent pharmacy benefits manager PBM, PPO with full Transparent Health Benefits, and incentives to high-quality facilities.
As a result, the company saved $3,912,129 over four years.
Communications Tech Company
With 200 employees, the company faced a 10% year-over-year rise in costs, which had become untenable. HAUSER THB conducted an analysis and proposed the following: National PPO with a custom wrap to fill gaps; open network for facility-based claims; reimbursements based on Medicare; and a transparent Rx program eliminating both member and plan costs. “The resulting plan [established] greater ease of access to more qualified positions for members willing to be flexible, [eliminated] out-of-pocket Rx costs for everyone, and [provided] service that is collaborative, non-litigious, and which increases member engagement.”
Following the first year, the company saved $1,020,904; by year four, the company saved $4,738,015.
A Medical consulting company with 50 to100 clients residing in 40 states was “experiencing dramatic sticker shock over the annual price increases of their commercial PPO.” After consulting with Hauser regarding self-funded insurance, a solution was developed that included rates closely aligned with Medicare pricing, eliminated member and plan Rx cost, directed contracting and bundled payments, and offered financial incentives to redirect members within PPO.
The solution allowed employees and their families to “pay lower contributions on a monthly basis and [waived] all out-of-pocket costs when members [went] to high-quality providers.” For the company, the plan saved $1,021,877 the first year and $1,203,564 over three years.
Transition to a Self-Funded Insurance Plan
For companies considering implementing a self-funded plan, working with an expert can bring benefits. According to their post, 3 Keys to Unlock Self-Funding for Any Size Employer, working with a specialist can save time and money.
“You need someone who understands self-funding and will be proactive about finding vendors whose interests are aligned with yours. An advisor will review your claims history to determine what kind of coverage you need and help you design a plan that will address your employees’ healthcare needs.”
“Administering a health insurance plan is a full-time job. That’s why there are TPAs who can do that for you while you focus on your own business. Administrators will handle the day-to-day running of the plan, including processing claims, servicing plan members, and issuing payments.”
The self-funded insurance plan announced by Hauser can be accessed by contacting Hauser directly. They reported companies could “Speak to a health benefits ambassador in [their] neighborhood – no strings attached. Request a call!”
HAUSER THB: Expanding Hauser Insurance Group Solutions
This is the most recent news announced by Hauser Insurance Group and expands on the company’s current range of offerings. In addition, they offer specialized insurance services, merger, and acquisition (M & A) transaction solutions, as well as supplementary employee benefits and retirement services.
About Hauser Insurance Group
Hauser Insurance specializes in insurance solutions for private equity portfolios so that fund managers understand and are protected from the complex risks of today and tomorrow. The firm focuses on unique insurance solutions for organizations of all sizes, from multinational enterprises to founder-led businesses.
The Hauser Insurance leadership team offers unparalleled knowledge and experience. The company has assembled dedicated, highly experienced teams of risk management, employee benefits, insurance, and retirement planning professionals who understand the unique complexities and specific demands that can arise during a transaction. They serve as subject matter experts providing consultative resources throughout every stage of an investment, from due diligence through exit.
Headquartered in Cincinnati, Hauser Insurance also has associates and offices in Atlanta, Chicago, New York City, St. Louis, Kansas City, and Los Angeles, ensuring they can provide personalized service to all clients across the U.S.