Health Welfare Consulting

We help our clients understand how insurance underwriting and pricing can be structured to manage risk

We specialize in managing risk by structuring benefit programs that allow a group to pay for employee and dependent health care claims as they emerge rather than in advance while transferring or insuring risk that is difficult to isolate.

If your medical, pharmacy and dental plans are fully-insured, ask yourself the following question; When is my company at the greatest risk or exposure to excessive cost and insurance carrier profit taking? The Answer: During a good year and almost always following a bad year.

Why pay in advance for healthcare that may never be needed?

The healthcare delivery system is like the delivery of electric power by a utility. When you flip on a light switch, the meter begins to run and you receive a bill at the end of the month that represents your actual usage. What if your power company said they are now going to charge you in advance for what we believe your usage will be. And, since our projections might be off and you may leave a light on or two all day long occasionally, we’ll go ahead and add that margin of usage to your monthly bill too. This would be fully-insured electric utility premium.

Since roughly two-thirds of your healthcare spend is a manageable risk, insuring it actually puts you at a greater risk of paying higher benefits costs compared to being partially self-insured. Here’s one big reason why; the year-over-year fully-insured premiums never price or adjust for the 3 out of 5 years when your healthcare costs are average or below average. We help our clients understand how insurance underwriting and pricing can be structured to manage risk, control cost and minimize insurance carrier profit-taking.