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Hot Topics Blog

Tuesday, August 15 2023

Are group health insurance prices going up?

If you are a small business owner or an employee of a small business, you may be wondering how the recent changes in the health care industry, the pandemic and inflation will affect your group health insurance costs. We will explain some of the factors that influence group health insurance prices and what you can do to manage them.

Group health insurance is a type of insurance plan that covers a group of people who are affiliated with a common employer, organization, or association. Group health insurance plans typically offer lower premiums and more benefits than individual plans, because the risk is spread among a larger pool of members.

However, group health insurance prices are not fixed and can vary depending on several factors, such as:

- The size and demographics of the group. Larger groups tend to have lower premiums per person, because they have more bargaining power with insurers and can negotiate better rates. Smaller groups may face higher premiums, especially if they have a high proportion of older or sicker members who use more health care services.
- The type and level of coverage. Group health insurance plans can offer different types of coverage, such as HMOs, PPOs, EPOs, or POS plans, each with its own network of providers, deductibles, copayments, coinsurance, and out-of-pocket limits. The more comprehensive and flexible the coverage, the higher the premium.
- The claims history and utilization rate of the group. Group health insurance prices are based on the expected costs of providing health care services to the group members. If the group has a high rate of claims or uses more expensive services, such as hospitalizations, surgeries, or specialty care, the insurer may increase the premium to cover the higher costs.
- The location and regulations of the state. Group health insurance prices are also affected by the geographic area where the group is located and the state laws and regulations that govern the health insurance market. Some states have more competitive markets and lower prices than others. Some states also have more stringent requirements for insurers, such as minimum benefit standards, guaranteed issue, community rating, or essential health benefits, which can increase the premium.

So, are group health insurance prices going up? The answer is: it depends. According to a recent report by eHealth, the average premium for small group health insurance plans increased by 8% from 2019 to 2020, while the average deductible decreased by 3%. However, these averages may not reflect the specific situation of your group. The best way to find out how much your group health insurance will cost is to compare quotes from different insurers and see what options are available for your group.

If you are looking for ways to lower your group health insurance costs, here are some tips:

- Shop around and compare plans from different insurers. You may be able to find a better deal or a more suitable plan for your group's needs and budget.
- Consider switching to a high-deductible health plan (HDHP) with a health savings account (HSA). HDHPs have lower premiums but higher deductibles than traditional plans. HSAs are tax-advantaged accounts that allow you to save money for qualified medical expenses. By combining an HDHP with an HSA, you can reduce your premium and save money for future health care costs.
- Encourage wellness and prevention among your group members. By promoting healthy habits and preventive care, such as regular check-ups, screenings, vaccinations, and lifestyle changes, you can reduce the risk of chronic diseases and costly complications that can drive up your group health insurance costs.
- Seek professional advice from a licensed broker like PNW Insurance Solutions. A qualified broker can help you navigate the complex and changing landscape of group health insurance and find the best plan for your group. They can also assist you with enrollment, administration, compliance, and claims issues.

Group health insurance is a valuable benefit that can help you attract and retain talent, improve productivity and morale, and protect your group's health and well-being. However, it can also be a significant expense that requires careful planning and management. By understanding the factors that influence group health insurance prices and taking steps to control them, you can ensure that your group health insurance is affordable and effective.

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