JBen

Back to some basics. Employer-Sponsored Insurance (ESI) - ESI is the primary source of health coverage in the U.S., covering about half of the population. - Employers provide health insurance to their employees as a benefit, which is often part of total compensation packages. Cost and Premiums - Both employers and employees share the cost of premiums, with employers usually covering the larger portion. - Premiums have steadily increased over time, impacting both employers and employees financially. Government Regulation - ESI is regulated by both state (in some cases) and federal laws, including the Affordable Care Act (ACA), which sets standards for coverage and mandates that large employers offer insurance or face penalties. Tax Advantages - Contributions made by employers toward health insurance premiums are tax-deductible, which provides a financial incentive for offering health benefits. Benefits of ESI - Health insurance through employers often provides more extensive coverage compared to individual plans. - Group coverage generally allows for better terms and lower premiums due to the larger risk pool. Challenges - Rising health care costs continue to challenge the sustainability of ESI. - Employees face increasing out-of-pocket expenses and deductibles, even as their share of premiums grows

Benefits Trends to Keep an Eye on *Well-being benefits are now essential, beyond just traditional perks. *Employers are focusing on improving healthcare affordability for employees and their families. *Aligning company culture with employee values is vital for retention. *Financial well-being programs are becoming crucial, addressing employees' top concern—financial health. *Employers are increasingly offering family-focused and mental health benefits to support employees' overall well-being. https://lnkd.in/eXrYfcWW

Captives can be a great solution for many small to medium sized businesses. About -Captives mitigate risk: Joining a captive helps mitigate the risks associated with self-funding on your own, often making it more accessible. - Captives pool resources: Companies in a captive pool their resources to cover self-funded costs, reducing risk on large or unexpected claims. - Ideal candidates: Smaller companies (25–250 employees), especially those transitioning from fully insured. - Choosing a captive partner: Longevity, performance and approach to claims management are important when evaluating a captive. Reasons to consider - Mitigates risk on catastrophic claims. - Provides a turn-key solution for long-term cost stability. - Allows collaboration with like-minded companies to achieve shared goals. - Balances spending fluctuations: Captives can help ease concerns about monthly spending volatility and offer a buffer for cost-effective benefits strategies. - Stop-loss protection: Captives can help in obtaining competitive stop-loss insurance that would normally be cost preventive on one’s own.

When making employee benefits decisions for your company and its employees, having access to your plan's data is crucial. If you're an employer and you're running into the same issues as Kramer & Elaine, reach out to us today. Your benefits. Your way.

Don't let this happen to your company! Reach out to our team today to discuss how to make changes to your current program, without breaking the bank.

The FTC's interim report criticizes pharmacy benefit managers (PBMs) for their significant and opaque influence over the US prescription drug market, accusing them of inflating drug costs and squeezing small pharmacies. Initially hired to manage drug benefits, PBMs now negotiate drugmaker rebates, set pharmacy reimbursements, and develop drug formularies, consolidating their power in troubling ways. The three largest PBMs—CVS Caremark, Express Scripts, and Optum Rx—processed nearly 80% of prescriptions in 2023 and are integrated into large health conglomerates. The report highlights that PBMs steer patients towards their own pharmacies, disadvantaging independents, and generate excess revenue from drug dispensing. For example, for two cancer drugs, top PBM-affiliated pharmacies made $1.8 billion from 2020-2022, significantly above the national average cost. The FTC also found that PBMs exclude cheaper drugs in deals with brand pharmaceutical companies for pricing and rebates. FTC Chair Lina Khan emphasized the need to scrutinize PBMs to ensure affordable healthcare. Despite limited data, the report passed with a 4-1 vote, with some commissioners expressing concerns about the evidence base. PBMs like Express Scripts disputed the report's findings, blaming pharmaceutical companies for high drug prices. Reach out to our team today to discuss the many alternatives! https://lnkd.in/e5NFAnpG

The team at JBen is happy to continue helping businesses all over the country put more money in their employees' hands by reducing healthcare spend. When there is a will, there is a way.

The team at JBen + Contractors Health Coalition had a great time last week at the ABC Delaware networking event in Georgetown at Revolution Brewery! It was nice to get out, enjoy the Spring weather and have a few brews with good people. Thanks to Ed Capodanno, Rebecca “Becky” Snyder and the rest of the staff for putting everything together.

Preparing for our first year anniversary, we'd like to thank all of those that supported and partnered with us! Over the next few weeks we are going to highlight a few of our clients' "wins" from last year. While we know good news like this helps keep us going, we hope it helps motivate others out there too! JBen is excited to double down on 2023 and help all we can in 2024!!! Without further ado, see below for our first ever client helped.