Some small- and medium-sized business owners are combating rising health insurance benefit costs with the help of an online tool launched by Humana Inc.
The Louisville, Ky.-based insurance company has created the Broker Benefit Utilization Director, or Broker BUD.
Broker BUD is a Web-based program for brokers to use with employers. The tool gives smaller companies the benefit analysis brokers have historically done manually through research and recording with larger companies, said Gary Davis, regional vice president of sales for small business for Humana.
It is difficult for insurance carriers to offer robust reporting to small-group clients both because of privacy laws and because ad hoc reports take a lot of time to compile and create, Davis said.
Broker BUD compiles information quickly using records that are electronically available. The broker and employer can examine in detail how employees are utilizing the company’s health insurance plan and see how the price of the premium can affect the employees’ utilization of health care services, Davis said.
Every aspect of Broker BUD is HIPAA-compliant, Davis said. Employers do not receive information about individual employees.
The information provided to the employer is both by percentages and a range of instances. If a percentage is low – for instance if one person in a 20-employee company was hospitalized in the past year – the system will say that the company had less than five hospitalizations, so that privacy is always protected, Davis said.
“Employers and brokers can sit down and have a very unique conversation based on data, the way employees are utilizing their benefits plan to design something more effective going forward,” Davis said.
Broker BUD’s two main components include the Health Utilization Tool and the Contribution Strategy Tool. The Health Utilization Tool gives employers a view of employee usage of services, including doctor office visits, prescription drug purchases, inpatient admissions, outpatient surgery and emergency room visits.
For instance, if an employer sees that a large percentage of employees are seeing out-of-network physicians or purchasing tier-three prescriptions, the employer may want to implement an educational program for the company. The educational program would explain the benefits of utilizing the in-network physicians because of the discount or explaining the different tiers of prescription medication and providing a list of less expensive alternatives to common medications.
The Health Utilization Tool also offers a regional component, in which employers can compare their employee usage of services to other similar groups in the region, Davis said.
The Contribution Strategy Tool enables employers to test different contribution strategies and assess how the strategies can impact premiums.
“Broker BUD becomes most actionable at the renewal of a benefit plan, but we are seeing a lot of brokers use it several times throughout the course of the year to provide insurance check ups for groups,” Davis said.
Broker BUD was developed in Wisconsin but is available nationwide and is available through Humana brokers.
Humana is considering adding a hypothetical portion to the program, in which brokers can enter a higher or lower number of services utilized by employees to show an employer how the group benefit plan could be affected and where cost savings can occur, Davis said.
The ongoing development of Broker BUD is a reflection of Humana’s overall dedication to creating transparency in health insurance policies, Davis said.
“This is transparency at the small group level,” Davis said. “We are trying to help members, employer groups understand the way their benefit programs work and design effective benefit programs at the group level going forward to wisely use dollars available to them.”
