Community Well-Being Collaboration

Twelve school systems collaborate on a comprehensive wellness initiative with the goal of managing health care costs effectively.

Challenge

The Lake Erie Regional Council (LERC), a strategic consortium of twelve school districts in Lorain County, Ohio, collaborated on an action plan to manage health care costs with the goal of helping individuals:

  • Make sound decisions about when and how to access health care services;
  • Better manage existing chronic conditions like heart disease, hypertension, diabetes; and
  • Improve lifestyle behaviors to prevent the development of chronic conditions.

“We wanted to provide opportunities for our employees to get fit and do something about their health screening numbers.”

Franco Gallo, Former Superintendent Keystone Local School District

Solution

With Findley’s guidance on best practices, the LERC Board has embraced a strategy to enhance the focus on wellness within each district. Through Findley’s expert knowledge on medical and pharmacy plan options, coupled with thoughtful planning, LERC now provides competitive health benefits and wellness resources to create an environment where each individual can thrive, through an “all-for-one, one-for-all” approach.

Each district is given autonomy to create a wellness program that fits into its unique culture; every district must complete the same gateway items annually. Two of these gateway items include a biometric health screening and an online health risk assessment.

Every district in LERC designs their own robust annual action plan, which promotes healthy activities, individual and group wellness challenges, health fairs, and employee assistance seminars. District leaders, staff members and support from Findley, created a committee of wellness champions to ensure effective implementation of each item.

Community Well-being Collaboration

For instance, one school district connects wellness to the entire student body and community through a mapped 7.5 mile course that encourages physical activity while connecting participants to local history. Another example, a different school district wanted to provide opportunities for their employees to get fit. After reviewing year-over-year aggregate biometric health screening results, the participants wanted to better their health screening numbers. An updated weight room with new equipment has appealed to a broader group of employees. The district also offers a local personal trainer with classes and individual assistance to participants.

Results

Over the last 7 years, the annual insurance cost trend for the consortium has averaged less than 3 percent and the LERC Board has approved 6 monthly premium holidays. With Findley’s subject-matter expertise and the core team of leadership from all twelve districts that strives to provide every employee in every district with resources at their fingertips has been key to the continued success and evolution of the LERC wellness platform. As wellness evolves, the consortium’s strategy is keeping pace with trends and expectations so every member can thrive.

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Employer Sponsors of Health Benefits Part 1: Possibilities to Sustain Healthcare Costs

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It’s little comfort to an employer sponsoring employee health benefits to be told annual healthcare trend rates are moderating. Even at a 4 – 5% trend, healthcare costs continue to grow faster than wages and salaries. Although employers have passed some of this increase on to their employees via higher contributions and out-of-pocket expenses, a tight labor market makes this more difficult to do. With the Affordable Care Act (ACA) Employer Responsibility requirements still in place, and the average employer’s share of healthcare costs now more than half the cost of an entry-level employee, some employers will continue to scrutinize work schedules to avoid full-time employee thresholds.

Employers know healthcare will be at the crux of the 2020 Presidential election. With uncertainty as a foundation, employers:

  • Are now hearing about proposals to eliminate employer-sponsored health plans in favor of a “Medicare for All” program.
  • Want to know if the “Medicare for All” proposal is economically feasible; would it, indeed, “level the playing field” in terms of attracting talent.
  • Question if the increase in their taxes needed to support this program would be more or less than what they spend now on healthcare benefits.

Between now and the 2020 election, employers are striving to sustain competitive, affordable health benefits. They have tried and exhausted many tactics to contain healthcare costs, and are looking for other alternatives—beyond putting their health plan out to bid to optimize network discounts and/or reduce fixed costs, such as Administrative Services Only (ASO) fees and stop loss premiums. The following diagram shows a range of possibilities an employer can consider for 1/1/2020. It presupposes the employer has:

  • Completed a claims analysis to identify cost trends and drivers.
  • Examined demographics for health status and special needs to address well-being.
  • Considered proposed regulations liberalizing the use of Health Reimbursement Arrangements (HRAs), by employers of any size, to pay individual health insurance premiums are finalized for 2020.

This diagram does not speak to interactive modeling tools, like Findley’s BenScan® modeler, to value the impact of these potential changes on their gross and net costs.

Possibilities to Sustain Healthcare Costs

However, many employer concerns involve questions about future legislative, regulatory, and litigation activity that could affect employee health benefits. As a result, we have developed a three-part series to delve into the current situation in Washington, DC and the results of the 2020 election and how it may impact the future direction of employer-sponsored health benefits.

Your thoughts are appreciated too. Share your input here or voice your opinion on what the future hold for employer-sponsored health benefits.

Read more about the current situation in Washington, DC in our next article in this series: Employer-Sponsors of Health Benefits: Part 2: More Gridlock Ahead.

Questions? Contact the Findley consultant you normally work with, or Bruce Davis at 419.327.4133, Bruce.Davis@findley.com.

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Posted March 4, 2019