• Sarah Devine

Why employers are using self-funded over traditional insurance

Annual premiums for employer-sponsored family health coverage rose to $18,764 in 2017 — employees paid an average $5,714 out of pocket in premiums alone. Seems like a pretty outrageous cost for the mere security of everyday livelihood, doesn’t it? Well, guess what? The cost for employers and employees alike is projected to keep growing, with no end in sight.


Shifting trends within the politically fraught health insurance business have led to rising costs, not only in the form of high premiums for individuals, but for employers too. Factors such as being overcharged by providers, hidden fees, exploitive processes, and many more, prey on the checkbooks of uninformed individuals and have driven up the bottom line of employer benefit packages.

It’s no secret that the health insurance model is broken. Once well-intentioned, health insurance service has degraded into a fragmented, confusing labyrinth of bureaucracy. And who fronts the bill to fund this high-level consumer exploitation? Well, the consumer of course! Much to the detriment of bank accounts around the country, health insurance providers deliver subpar coverage and at an outrageous rate — unfettered by overwhelming public outcry.

Simply put: this is price gouging. This level of corporate profiteering would be utterly reprehensible for any other consumer-end product or service, but due to legal mandate, misinformation, and, to be frank, appeasement on the part of the consumer, health insurance costs continue to rise at unprecedented rate.

Enough is enough. Resistance to the cold, exploitative full-coverage health insurance machine begins with employers. The federal health insurance mandate requires employers to provide health coverage to employees, but why default to mediocre coverage at an outlandish cost? Without the resources of a Fortune 500 company, but equally held to the same standard, mid-market employers are misled into overpaying for full-coverage health insurance.


Luckily, there is an alternative: self-funded health insurance. Self-funding is a break from the traditional, exploitive health insurance model and gives spending power back to employers. For an investment as important as health insurance, employers need more autonomy in how money is spent in order to offer employees better benefits — and save a lot of money along the way.

Self-funding means employers pick benefits that are important to their member group, skip anything unnecessary, and come out with a streamlined plan catered to employer and employee needs. Employers who self-fund handpick employee group benefits rather than adopting a “one-size-fits-all” program.


A broken system calls for an innovative solution


When you’re in need of medical services, who do you turn to? Maybe you defaulted to a cursory online search of symptoms, which offered results ranging from common cold to the plague. So... that isn’t very helpful.

Maybe you go straight to the doctor’s office — which of course comes with the cost of a premium — who may or may not be able to help. What is for certain is this option will almost certainly require subsequent visits, maybe even to an assortment of specialists, with no guarantee anyone can pinpoint your affliction. In the traditional health insurance model, there is no central point of contact to help individuals navigate the disjointed, confusing world of medicine.


That’s the problem: traditional health insurance does not offer policyholders any level of individualized care, and this lack of personalization often leads to employer overspending on coverage. Individuals in need of care ultimately bounce from doctor to doctor, essentially playing telephone, and rarely arrive at a solution in a quick or cost-efficient manner.


This prevalent conflict was the impetus for the formation of Novo Connection. Novo Connection was created in an effort to improve engagement between individuals and health insurance carriers, and deliver better care and savings.


Novo Connection is the first fully integrated, mid-market Guided Healthcare model. It stands as a resisting force and innovative alternative, to the exploitive full-coverage system by offering the Fortune 500 guided healthcare solutions to mid-market employers.


Over a decade of research has gone into developing a healthcare model that is customized for the mid-sized market, and all indications show a need for greater personalization when it comes to healthcare. Think about it: when was the last time you called your health insurance provider and left the conversation with a better understanding then when you first called? Probably never, since traditional insurance providers don’t offer a central service center to field policyholder questions. At best, a call with a traditional health insurance provider might be to resolve claims discrepancies or ask about billing.


For this reason, member engagement for full-coverage options is at a embarrassingly low 2-7%. Policyholders are left to fend for themselves in the confusing world of healthcare, and leave individuals no choice but to throw money at doctor visits until a solution is (hopefully) uncovered. Research shows that 50% of patients are confused by their own healthcare plans.

Novo Connection has designed a better way to approach healthcare. This is where Guided Healthcare comes in.


What is guided healthcare and why is it so important?

So what is Guided Healthcare, and how is it changing the paradigm of health insurance? In a nutshell, Guided Healthcare is the first line of defense in overspending on health coverage.

As a part of Novo Connection's self-funding offering, Guided Healthcare is a more compassionate approach to healthcare. Guided Healthcare proactively manages member needs with industry-leading customer service, delivers a straightforward and engaging plan design, and offers patient advocacy in real time.

Guided Healthcare offers a better way. By employing a more compassionate and proactive approach to healthcare, individuals eliminate unnecessary medical costs and save time and money for themselves and their employers. All phone calls are routed to expertly trained Guided Healthcare professionals who work alongside a team of nurses, case managers, utilization management experts, health coaches, and disease management specialists. Anything related to health coverage is subject to Guided Healthcare including:

  • Claims

  • Referrals

  • Prescriptions

  • Treatment decisions based on estimated costs

  • Quote benefits

  • Claims resolution advocacy

  • Confirmation members are using in-network or top-tier providers

  • Information on wellness incentives

  • Learning about lifestyle programs

Guided Healthcare leverages the power of empathetic support and humanity to uncover savings at every step of the healthcare process. Guided Healthcare professionals are meant to simplify navigating the healthcare process and save you money.

How guided healthcare prevents healthcare costs from mounting before they occur


Not only is Guided Healthcare designed to reduce spending, but this streamlined approach to healthcare can eliminate employee healthcare costs altogether, thanks to industry-leading member engagement.


Saving on healthcare costs begins at the individual level. With the aid of Guided Healthcare professionals, Novo Connection members have access to the resources necessary to practice daily healthy choices, which helps drive down an employer’s bottom line on health insurance. Through health education, wellness programs, and patient advocacy offered by Guided Healthcare, members are able to make lifestyle changes and avoid healthcare costs before it’s too late.


Wellness programs such as smoking cessation or weight-loss plans greatly improve members’ health through the elimination of poor habits and lifestyle choices that are at the root of as much as 70% of healthcare costs. Guided Healthcare professionals also discover and prevent redundant, delayed, and questionable treatment in real time.Astudy from the Institute of Medicinefound that one-third of all healthcare spending — $750 billion — went to unnecessary services that did nothing to help patients. Real-Time Intercept® is Novo Connection's way of fighting against unnecessary healthcare spending through immediate and relevant patient advocacy. Guided Healthcare professionals work with patients and their families, on a case-by-case basis, to help them receive the best customized care available and reduce employer healthcare spending.


Novo Connection pays for itself in long-term savings


Employers have been deceived to believe they have no choice when it comes to employee benefit packages. But, if you’re reading this, you already know the secret full-coverage insurance providers don’t want you to know: Novo Connection is flipping the insurance market on its head.


By leveraging the proven cost-savings potential of Guided Healthcare, along with other cutting-edge strategies, employers see long-term savings at only a marginal, initial increase in cost compared to full-coverage options. Novo Connection is committed to playing the long game when it comes to employer savings, which are achievable by bending the trend of employer healthcare spending.


Improved transparency is a fundamental cost-savings measure implemented by Novo Connection. Employers can access a predictive modeling engine to uncover recurring employee healthcare costs, and implement data-driven cost trend solutions to meet financial objectives and prepare for the possibility of

large claims.


What are you waiting for?


Why are you still reading this? Every minute beholden to the exploitation of traditional health insurance is costing you money. Employers have been tricked into overpaying for health coverage, and guess what — the buck stops here.

Novo Connection offers an alternative to the dogmatic, underwhelming health coverage that has unfortunately taken hold of mid-market employers. As a mighty warrior in the battle against wasteful spending, Novo Connection is proud to yield a single slingshot against the healthcare Goliath, and forge ahead as the leader in the rebellion against the immutable health insurance business. Self-funded insurance isn’t just the smart thing to do, it’s the right thing to do.


Contact Novo Connection to learn more about the cost savings potential of self-funding and guided healthcare. Get out from under the thumb of big health insurance companies, and take charge of company spending with Novo Connection’s revolutionary approach to healthcare.


Posted by: Melissa Saturnino

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