Jeremy Bentham (1748–1832)
A 450 life self-funded health plan spends more than $1.5 million GLP-1 drugs, or about $300 pepm benefiting 20% of plan members. A majority of plan members don’t benefit at all.
In lieu of spending $300 pepm for the benefit of the minority at the expense of the majority would it make more sense to gift every full-time employee a $3,600 pay raise instead?
Those taking GLP-1 drugs could then source their drugs for about $450 per month, a hell of a lot cheaper than through their group’s PBM. Their pay raise would cover the majority of the cost. Whereas formerly their copay was $100 per month their net cost increase would be about $50 per month. So instead of paying $100 per month in copays they would be paying $150. Their pay raise would cover the difference.
The philosophy behind employing these strategies is based on utilitarianism, the moral system founded by English philosopher Jeremy Bentham (1748–1832) and encapsulated in the principle of “the greatest good for the greatest number.”
Why not gift every employee $300 per month through an ICHRA instead? Wouldn’t that make more sense. Then everyone could pick and choose the coverage they need. Need GLP-1 covered? Pick Insurance Company “A.” Need to have a plan that includes your doctor? Pick Insurance Company “C” and “G.” Need a transplant? Pick Insurance Company “D.” Need all of the above, pick Insurance Company “A”, “B”, “D” and “Z.”
An ICHRA gets the employer out of the insurance business, a business they have no business being in.
Here’s a unsolicited testimonial we received from the owner of 500 life company that we helped switch from a self-funded plan to ICHRA;
“So far, the ICHRA is great. For the first time in 40 years, I don’t have to worry about plan renewals, costs, outliers, stop loss, PBM’s and all the other crap (government regulation) that comes with this line item. And let’s not forget risk. I lived in fear each week those pay apps came through, not knowing what they were going to be.”
“Businesses should NOT be in the health insurance business. It’s a complete misallocation of resources and risk. Employees need to be weaned from the employer tit. I don’t like single payer either. Employees need choices that fit their particular needs. ICHRA seems to fulfill that requirement.”
“And that’s the truth!!”
