Like many employers today, one Arkansas County was struggling to provide an attractive health insurance benefit plan to its current and prospective employees.  The cost of insurance and their experience with

a self-funded plan created a dilemma that would have hindered their ability to provide even catastrophic coverage to the members of their plan.

The anticipated increase in premiums, in addition to the reduction in benefits, would have adversely affected the take home pay of every single employee, regardless of whether or not they were on the plan. In order to have funded their claims, they would have had to take from other discretionary lines, specifically payroll.

Simultaneously, they realized that the typical strategy of paying for increasing health insurance premiums would only work temporarily. In order to ensure a better future for their plan they would have to identify and deal with cost drivers, which ultimately was the size, number, and frequency of claims.

Overall Claim Spend Increased Dramatically

A two year claim review revealed some eye-opening facts. Additionally, their claim spend was increasing by over 1 million dollars a year.

  • Total claim lines had increased from 6,424 to 11,682 in oneyear
  • The average claim amount per participant was $6,574.55, a 50% increase in oneyear
  • The percentage of total claims that were considered catastrophic jumped from 13% to37%
  • In two years, they were spending 50% more just on pharmacycosts

total claims history

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BeniComp chosen as employee health and wellness programs presenter for 2016 HR Florida conference in Orlando, FL August 29th through 31st.

TAMPA, FL - JUNE 14, 2016

BeniComp Insurance Company, a supplemental group health insurance company that offers national employee wellness solutions, today announced it was chosen as a presenter for the 2016 HR Florida Conference and Exposition, an affiliate of the Society for Human Resource Management (SHRM).

This year's presentation examines why wellness in the workplace doesn't work, why we need it to work, and what to do about it. In an industry that makes up over one-sixth of the GDP, it's important that our country's companies know there are solutions to managing healthcare costs.

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Studies show that by coupling a high deductible health plan with outcome-based deductible incentives, employers will see a jump in employee participation and, thus, a sustainable financial future.

FORT WAYNE, IN -- BeniComp Health Solutions, a leading national provider of supplemental group health insurance, has seen a significant spike in their clients’ employee participation for their wellness initiatives. BeniComp clients experience nearly 100% participation in their annual biometric health screening by implementing a high-deductible health plan (HDHP) with outcome-based deductible incentives. As a result, BeniComp clients have been able to cut their healthcare spending and offer lower premiums in exchange.

“Companies need to identify, realign, and manage their risk in order to truly control the cost of health insurance premiums,” says Doug Short, President and CEO of BeniComp Insurance Company. “When a company invests in the health of their employees they are not only saving dollars, they are investing in their most valuable asset. The results are a win-win for everyone.”

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While most employee wellness programs get 30% employee participation, BeniComp Advantage engages nearly 100% of the employee population through supplemental health insurance and deductible wellness incentives.

Tampa, FL April 12, 2016 - It’s no secret that America has a health insurance problem. Rising health care costs and declining health has left companies struggling to provide the kind of health insurance employees had 10 years ago. Affordable Care Act customers turned out to be much sicker than anticipated, and now health insurance companies are seeking rate increases of 20-40% or more.

dark secret of wellness 24 percent participation

The industry’s answer was to offer wellness programs designed to promote awareness, education, and lifestyle change. The programs have evolved into an overly saturated market of wearables, apps, and fun programs without accomplishing the original goals. A recent study by MetLife claims that nearly 75% of employers offer a wellness program1 but only 24% of employees actually participate.2 Worse yet, those who participate are primarily employees who have already adopted healthy lifestyles. The remaining participants are those with greater health risks. When cash incentives are used, the employer pays low-risk employees resulting in an expensive program with little to no improvement in employee health or reduction in health care claims.

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A part of Baylor’s commitment to employee wellness is its partnership with BeniComp Advantage, which rewards healthy lifestyles by allowing employees to earn credits toward base health plan costs, and Baylor affords employees many opportunities to make positive and healthy lifestyle choices. According to Brenda Waddell, Director of Human Resources for Baylor School, healthy lunch menus in Guerry Dining Hall, free on-campus exercise and yoga classes, access to Baylor’s exercise facilities, a monthly health newsletter written by Baylor coach and fitness expert Julian Kaufman, and the BeniComp biometric screenings have all stimulated the commitment to improving personal wellness. Baylor employees and families also have access to the nurse practitioner and registered nurses at the school’s Health Center, including free or discounted flu shots each year. 

“Physical activity and employee wellness are important priorities at Baylor, and our long partnership with BeniComp has been significant,” said Mr. Joseph. “There is no greater benefit we can offer our employees than helping them live healthier, happier lives. Through this venture, we’ve seen a great improvement in our employees’ health and well-being, and Baylor is honored to be recognized..." Click here to read the full press release.

When you are trying to navigate the compliance web, being exempt is a good thing-but what is Exempt?

Webster’s Dictionary defines EXEMPT as:


Released from, or not subject to, an obligation, liability, etc.

Synonyms: free from, not liable to, not subject to, exempted from, excepted from, excused of/from, absolved of

navigating the compliance web 400

In todays complicated- regulated world of health care, the above definition makes it easy to see why being “exempt” is desirable. Let’s take a closer look at what that means.

The Department of Labor (DOL) has affirmed to us that “to the extent benefits qualify as excepted benefits, they are exempt from the provisions of Part 7 of ERISA, chapter 100 of the Code, and Title XXVII of the PHS Act, including the relevant provisions added by the ACA.”

As stated above, excepted benefits are exempt. Excepted benefits, as defined by Federal Law, are benefits that are supplemental to a group health plan if provided under a separate policy, certificate, or contract of insurance. These regulations clarify that, for coverage supplemental to a group health plan to qualify as excepted benefits, the coverage must be specifically designed to fill gaps in primary coverage, such as coinsurance and deductible.

To further connect the dots, our A rated carriers have attested that the products we sell through them are excepted benefits and therefore exempt.

What does this mean for you?

By issuing policies, insurance risk and compliance risk are transferred. Our carriers have accepted that risk and the DOL has validated our position. In other words you are protected.

In 2010, BeniComp Advantage launched their Predictive Health Management (PHM) division, which offers the analysis and coaching of participants biometric screening results by Registered Nurses, Dietitians, Nurse Practitioners and MD’s to further the awareness and prevention of future claim spend. In this recent case, an employee of a client in Indiana whose data BeniComp has acquired for almost 4 years completed the annual blood screening, yet this one was different. Upon receiving the results, BeniComp’s medical professionals were able to detect an elevated serum GGT level which is an enzyme found primarily in the liver. In high risk circumstances, this is an indicator of liver or bile duct disorder and/or heart disease. In this specific case, it meant a hepatitis C diagnosis. 

An estimated 3.2 million people in the United States have chronic hepatitis C, a blood-borne virus that can cause liver failure, liver cancer, or even lead to death if left untreated. In February of 2014, BeniComp was able to pinpoint hepatitis C in one individual, and provide access to immediate intervention and treatment. While the 12 week treatment is almost completed, the prognosis is excellent and the participant’s new lease on life is priceless. 

Hepatitis C is becoming more and more of a known diagnosis, and there have been many advances made in the search for a cure. One well known drug is called Sovaldi, and is actually the drug prescribed to our client’s employee. For people in a clinical trial for the new drugs daclatasvir and sofosbuvir (Sovaldi), hepatitis C cure rates were astonishingly high at 98 percent, even for the hardest to treat patients. Additionally, Sovaldi can treat patients in 12 weeks, while previous drug combinations took 24 or 48 weeks.

The key is prevention and early detection. Many potentially life threatening diagnoses (and pocketbook threatening too) have been thwarted by routine wellness screenings and predictive outreach. This is BeniComp’s modus operandi. And this method is what keeps claims controlled, trend suppressed and employees healthy.

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