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  • Anthem, a large health insurance company, and Northside, an Atlanta hospital system, go head-to-head in a legal controversy in Georgia’s Supreme Court that could impact the state residents’ healthcare.

    In May 2021, Anthem decided to terminate Northside from its network due to the Atlanta hospital system billing overwhelming funds to Anthem. According to Insurance Newsnet, “One legal issue centers around the definition of “public health emergency.” That is because the General Assembly passed a law during the 2021 session prohibiting insurers from dropping health-care providers from their networks during and for 150 days after a “public health emergency.”

    A public health emergency, as declared by the city, the state, or the Federal Government, is an occurrence of a threatening illness or medical condition caused by an epidemic, pandemic, or an infectious agent. In the lawsuit, representatives of Anthem and Northside argue for different definitions for a public health emergency. Anthem argues for a “narrow” definition of a public health emergency meanwhile Northside argues for a “broad” definition of a public health emergency.

    What This Means For Georgia Residents

    It is possible that both parties may not be able to negotiate and reach an agreement, affecting Georgia Residents. With the extension of this case in the state Supreme Court, a decision will be made within the next six months. A public health emergency dispute that cannot be resolved affects state residents not only disrupts medical treatment but the collapse of healthcare facilities and systems, use of prescribed medications, and disrupts health surveillance and programs.

    How GMS Can Help

    Here at GMS, we have experts to assist with any healthcare inquiries you may have. Having an expert team by your side can be extremely beneficial for you and your employees. Let us assist in finding you the best healthcare plan, so you can focus on growing your business. Contact us today!

  • If you’ve noticed that your family health insurance prices are on the rise, you’re not alone. In fact, the cost of family premiums for employer-sponsored coverage has jumped 47% in the last decade – which outpaces wage growth at 31% and inflation by 23% over the same period. In the last year alone, premiums for family coverage reached an average of $22,221, a 4% increase.

    Roughly 155 million people rely on employer-sponsored coverage, with 59% of employers offering health benefits. It’s no secret that the larger the company, the more likely they are to offer a health plan. That said, the looming crisis of affordability continues to be an ongoing issue throughout the country. This proves especially true for small businesses with tighter budgets and fewer management resources at their disposal. On average, small businesses pay 8-18% more than large firms for the same insurance plans. Furthermore, location and industry type can make your organization’s premiums even (you guessed it) higher. Northeast and Midwest regions of the United States typically see more expensive premiums – as do those in the transportation, utility, and construction industries.

    Outside of the cost to implement a group health plan, many small business owners are often spread too thin – thus making the cost of time to actually administer the plan yet another hurdle to overcome. Managing a group health plan can be labor-intensive because of the ongoing regulatory changes, complicated communication processes, and the dreadful renewal process.

    Still, not offering health benefits is a recruiting and retention risk that you do not want to take. “Offering a healthcare plan is one of the most effective steps you can take as we continue to witness a workforce shortage,” shared GMS VP of Benefits, Beth Kohmann. “In today’s turbulent times, people throughout the country are looking for a solid, affordable healthcare plan to give them peace of mind. As an employer, providing that to your employees is one of the most vital things you can do.”

    Given the difficulty of offering an affordable, comprehensive plan, it’s easy to see why many business owners turn to a Professional Employer Organization like GMS. When you partner with GMS, you’ll take advantage of our consultative approach, giving you plan options and savings that will benefit your organization. In fact, last year GMS family premiums were 34% lower than the U.S. average.

    Contact us today to discuss a health plan tailored to your organization’s needs.

  • As a small business owner, you probably rely on the services of other organizations to accomplish a range of tasks, services and other duties. Your health insurance broker or policy provider is one you expect has your best interest in mind. The reality is, they may not, especially when it comes to premium and individual claim costs.

    With all your other responsibilities, you don’t have time to keep tabs on everything your health insurer does, however, there are some key questions you need to ask in order to effectively evaluate just how much they are working for you:

    What does the plan cover? 

    Many health insurance providers add in coverage for care you and your employees may never need. By providing an everything-but-the-kitchen-sink plan, insurers are able to increase the overall cost of the policy, meaning you and your employees are paying for benefits that don’t match their needs. Alternatively, using a third-party administrator (TPA) can help you secure group coverage that fits the needs of your employees, which can help you keep your healthcare-related costs down.

    How do you negotiate costs? 

    Healthcare is expensive. While some insurance companies claim to negotiate lower costs on your employees’ claims, they are not revealing the entire truth. The discounts are taken from the astronomically expensive costs doled out by the hospital or physician’s office. With a TPA and other services, there are many other ways to negotiate costs.   Multiple negotiation strategies keeps claims in line with more realistic pricing. 

    How do you audit medical bills? 

    Health insurance companies have little transparency when the final bill for medical care comes in for a claim. Generally, they do not ask for details related to costs or challenge prices. Instead, they pay their portion and turn the balance over to your employee. TPAs have the resources and knowledge to help your employee check each bill to ensure there is no double billing for equipment or health care services. They will challenge prices for services that are beyond “reasonable and customary,” substantially reducing patient bills and keeping your costs related to medical claims down.

    What type of customer service do you offer?

    With most insurance companies, you and your employees are a number in a huge system. You are at the mercy of the representative who takes your call when you have a question about your policy or have an issue with a claim. Navigating through red tape and other administrative obstacles can be frustrating and can lead to paying for unnecessary expenses. With a self-insured health plan managed by a TPA, each person’s needs can still be handled with personalized customer service to ensure issues are resolved and costs are minimized.

    Asking these questions of your health insurance carrier or broker can expose issues you may not have known existed. With a self-insured plan managed by a third-party administrator like GMS, you have more control over the type of insurance you need. Ultimately, this can cut your healthcare costs and enable you to provide better, more customized coverage for your employees and their dependents.

  • Changes in healthcare are prompting many small business owners to rethink the role of employee benefits like health insurance at their companies. According to PricewaterhouseCoopers, health insurance premiums are expected to rise by 6 percent in 2020, which can weigh heavily on your bottom line. Below, we explored some of the top health insurance trends that will impact small businesses and how you can adapt in the ever-changing benefits landscape.

     Small business health insurance is changing in 2019.

    Small Business Health Insurance Trends

    In order to stay competitive in an ever-tightening market, small business owners must develop savvy benefits strategies to attract and retain top talent. From trending workplace initiatives to increases to federal regulation changes, here’s how small business healthcare is changing in 2020.

    Increase Deductibles

    To combat rising premium costs, many small businesses are switching their insurance offerings to high deductible health plans (HDHPs). HDHPs can be paired with health savings accounts (HSAs), which allows employers to make tax-free contributions to their employees’ accounts and receive tax benefits. Additionally, the funds rollover every year, making them a great supplement for retirement savings accounts and an attractive employee benefit.  

    According to the Society of Human Resource Management (SHRM), 56 percent of employers offer HSAs as a benefit—a percentage that is expected to see rapid growth in the coming years. According to Devenir, HSAs have risen 12 percent year-over-year, with assets growing by 20 percent annually. The investment advisory and consulting firm projects that by the end of 2021, the HSA market will approach $88 billion in assets held by more than 30 million accounts.

    Prioritize Preventive Care

    With rising health care premiums, unhealthy habits can further drive up small business healthcare expenses. As a result, preventive care will become a larger priority for small business owners in the coming years.

    Already, the Centers for Disease Control and Prevention reports that almost half of U.S. businesses offer some type of wellness program. Moving beyond counting steps or logging water intake, initiatives like gym memberships, screening tests, and smoking cessation programs will be commonplace among small businesses in 2020. 

    Benefits PDF

    Offer Virtual Care

    Seeing a doctor in person can be inconvenient and costly when you factor in scheduling issues and co-pay fees. Many small businesses have found telemedicine, also referred to as telehealth or virtual care, to be a good solution. According to the National Business Group on Health, 56 percent of the companies surveyed currently offer telemedicine services to employees. NBGH projects nearly all companies offering group health care plans will also provide telemedicine by 2020.

    Telemedicine allows a patient to have a consultation with a medical provider via a computer, smart phone, or tablet. It’s an attractive benefit that allows patients to see a doctor around the clock, saving you and your employees time and money. In fact, insurance broker firm Willis Towers Watson found that employers could save up to $6 billion per year by providing telemedicine.

    Utilize Benefits Technology

    Small firms are increasingly looking to better utilize technology for help managing employee benefits. A Guardian Life Insurance study found that nearly half of all small businesses are more digital than paper-based—a percentage that will continue to grow as more business owners realize the low cost and high potential. 

    Migrating benefits administration to a web-based portal offers a simpler and more efficient way for employers to manage their back office in one place. In addition to managing benefits, small businesses can look to digitize payroll, employee reviews, timekeeping, PTO requests, and company communication.

    Improve Compliance

    As a small business owner, you know your employees, business, and industry like the back of your hand, yet when it comes to federal regulations, you’re likely left scratching your head. After all, it can be challenging for small businesses to stay up to speed on regulations and the changes made to them each year. 

    This past year was no exception, as we saw a few legal changes to health insurance. For businesses with at least 50 employees, business owners must offer the minimum essential health coverage that’s affordable or pay a penalty. In deciding whether to pay or play, keep in mind that penalties will increase by nearly 30 percent in 2020. 

    Outsource Benefits

    Managing healthcare is a timely chore for small business owners that takes them away from focusing on client relationships and workplace satisfaction. Perhaps that’s why so many small businesses have found that the best option is to outsource benefits management to a professional employer organization (PEO). 

    PEOs take on the responsibility of providing and managing things like health insurance, so employers can focus on growing their business. Not to mention, PEOs will also take on the regulatory liability of your employees, so small business owners can have better peace of mind. Working with a PEO also allows small business workers to gain access to big-business employee benefits like wellness programs and health, dental, life and other insurance offerings.

    Get Small Business Health Insurance

    With each passing year, healthcare will only become more complex. Small business owners will need greater support to navigate the changes and develop benefits strategies. 

    Group Management Services (GMS) provides a Master Health Plan, offering small business owners the best healthcare benefits at lower premium costs. We leverage our buying power through mass policies, so small businesses can purchase multiple policies like health, vision, dental and other types of supplemental insurance coverage. Additionally, GMS provides payroll and tax, human resources, and risk management services to further meet your small business needs. 

    Contact GMS today to talk with one of our experts about how your small business can offer quality health insurance at a lower cost.