What strategies have you tried to lower your company's healthcare costs?

I went to an HSA. The major med portion is 1/2, high deductible and contributions currently are tax deductible to the HSA account.

We tried a high deductible plan with no copays and the company paying 50% of the deductible with an HRA, but it was immensely unpopular with the employees - the staff felt like they 'didn't have insurance' because they were expected to pay more than $20 at a doctor visit, even tho what they paid was going to deductible.

So, the following year we kept the high deductible and HRA features, but switched to a plan with copays for doctor visits and the grumbling has subsided. Of course, for those high utilization participants, they end up spending much more in a year because copays are not going to deductible.

You may want to consider self insurance. When you self insure, you own the downside and you can control your plan design.

The HSA option definitely helped our employee based pay more attention to their costs. We also implemented several incentives including reduced costs for joining an onsite gym and watched the success of the participants. The data was slim annd perhaps non-conclusive for the first two years. At year five, we definitely observed a decline in out of the office illness days.

We usually tinker with the plan design (e.g. raise co-pays, raise annual individual/family out-of-pocket maximums, eliminate features, raise Rx co-pays) or increase the amount the employee contributes (through payroll deduction). At the same time, we encourage employees to offset any increase in their costs by utilizing the health care FSA.

James,

Whenever the premium increases, the only way to combat that is by raising the deductible or try another product. Either way, it tends to lessen the benefits and make your employees mad. I found a way around that by actually insuring the deductible, or a portion of it. It gives you first-dollar coverage and is indemnity-based, so you do not have to wait to file after major medical has paid. The 2 products work together to give the company a cheaper premium and the employee the same, or better benefit.