Forward Janesville - TheReport - Second Quarter 2023

Sponsored Content Paul Roelke | Manager of Member Services at The Alliance Paul Roelke joined The Alliance in 2013 and currently serves as Manager of Member Services, where he leads the team responsible for developing and implementing services and solutions for employer-sponsored health bene昀t plans. Paul has more than 15 years of experience in bene昀ts and insurance, including positions with UMR and Wellpoint. Employer Health Plans: Evolving to Meet Employee Needs By: Paul Roelke, Manager of Member Services, The Alliance The Alliance Self-Funding Smart Employer health plans have changed over the years in response to economic in昀uence and labor force demands. From basic o昀erings to robust health plans, the health bene昀ts o昀ered by employers have expanded, and rightly so. An e昀ective health plan can help businesses attract and retain talent in a competitive hiring market. Early Years of Employer Health Plans Employers began o昀ering access to company-sponsored onsite, or near-site clinics in the 1930s. In the 1940s, employers began o昀ering health bene昀ts more widely to compete in a tight labor market amid salary caps . By the 1960s, health insurance was so closely tied to employment that retirees and the unemployed lacked access. Medicare and Medicaid were established in 1965 to address this issue. Changing Tides In the 1970s, employers began to cut back on health bene昀ts to mitigate costs. This sparked the creation of HMO plans which are still widely used today. HMO plans typically require patients to seek care from healthcare providers in the plan’s network, except in emergency situations. PPOs were created in the 1980s to o昀er more 昀exibility in where people could seek care . This health plan allows employees to pay less for healthcare when they seek care from providers in their plan’s network. The A昀ordable Care Act, passed in 2010, requires preventative care to be covered fully by health plans. The ACA was designed to manage healthcare costs by catching health issues early before they become more di cult and expensive to treat. Employer Health Plans Today and Beyond The needs and priorities of employees are changing. Today, employees expect robust bene昀t programs that include behavioral health services and virtual care options. Behavioral Health Services Employees now expect their employers to provide some kind of behavioral health services. Most respondents (81%) to an American Psychological Association (APA) survey said that mental health services coverage and support is an important consideration when looking for a new job . Virtual Care Services The demand for virtual care options has also increased exponentially. Telehealth services, including virtual primary care, can be an e cient solution for preventative services like consultations, screenings, and counseling. $0 Copays When employees seek care where the quality is good, and the cost is low, employers realize signi昀cant savings. These savings can be passed on to employees through $0 copays for high-value providers. Self-funding with The Alliance As the cost of healthcare continues to rise, employers are increasingly choosing to self-fund their health bene昀t plans to manage costs, remain competitive, and increase value for their employees. Because self-funding saves employers money, they can provide better bene昀ts and higher wages for their employees. The Alliance is a network for self-funded employers that o昀ers unparalleled coverage in the state of Wisconsin. We give self-funded employers the power to increase employee access to care, improve quality, and reduce costs. We use sophisticated data mining and analytics to develop custom Smarter Networks SM for our employer-members. Through our Smarter Health SM Analysis, we help employers understand their data, empowering them to design a health bene昀t plan that directs employees toward high-quality, low-cost care. This means the employer and their employees pay less for better healthcare. Learn how The Alliance can help you design an e昀ective self-funded bene昀t plan for your business and your employees at the-alliance.org/janesville .