Moving From One Status Quo Plan To Another Makes No Sense

By Bill Rusteberg

Imagine a group health plan option costing around $400 per month for single coverage and about $1,000 for full family coverage with no financial barriers to healthcare. No deductibles, no co-pays, no co-insurance and no balance billing.

That’s been the experience of many of the plans we help manage in Texas.

On the other hand imagine a health plan with high deductibles, co-pays, co-insurance and surprise medical billing costing about the same or more in terms of premiums charged and costing a lot more to use.

Which plan would you choose? The answer should be obvious.

Yet we continue to see marketers selling the same old crappy status quo plans with high deductibles, co-pays, high out-of-pocket co-insurance along with the usual balance billing problems leaving patients to fight it out all alone.

Moving from one status quo health plan to another makes no sense. The El Paso Independent School District found out the hard way. Better benefits with lower rates seemed the right choice at the time but in less than 24 months the district lost $18,000,000. Ouch!

Plan sponsors would be wise to employ an experienced independent expert to guide them through the complicated maze of the American health care system. Reliance upon insurance agents paid by vendors they recommend is not good business practice.

It takes little time for an independent expert to unravel a plan’s financial structure and identify cost drivers, waste and abuse. The return on investment can be huge.

The El Paso Independent School District obviously received poor advice and has likely learned the bitterness of poor quality remains long after the sweetness of low price is forgotten.