Navigating Healthcare Changes in 2024

As you know, our team has recently joined HUB International. HUB is globally recognized as one of the top five insurance brokers, and their Retirement & Private Wealth team, operating across the United States has over 150 offices and is truly an industry leader. By aligning ourselves with HUB, we’ve opened doors to a variety of employee benefits and risk management services our experts can provide, extending beyond retirement plans and financial wellness programs.

While healthcare is constantly changing employers have a key role in supporting your employees' health. The Consolidated Appropriations Act (CAA) has brought about significant changes that require attention. The CAA was enacted in late 2020 and has ushered in critical shifts that directly affect how we manage healthcare benefits today. Let's discuss why it's important to take a proactive approach and how we can effectively manage these changes for 2024. Here are the highlighted changes:

  1. Elimination of Gag Clauses:
    • Historically, gag clauses prevented health plans—both fully insured and self-funded—from sharing essential information with plan members and sponsors.
    • The CAA now prohibits these restrictive clauses, promoting transparency.
    • Employers can access claims data, cost breakdowns, and quality metrics, enabling informed decision-making.
  2. Reviewing Medical and Pharmacy Spend:
    • The CAA provides an opportunity for organizations to assess their medical and pharmacy expenditures.
    • By understanding where healthcare dollars are allocated, employers can identify cost drivers and explore potential efficiencies.
  3. Quality Assessment and Efficiency Metrics:
    • Beyond cost, evaluating the quality of care within health plans is crucial.
    • Efficiency metrics help ensure optimal resource utilization.
    • Employers can fine-tune their offerings based on these insights.
  4. Plan Functionality and Claims Adjudication:
    • Employers hold a fiduciary responsibility to ensure their health plans function as intended.
    • Claims adjudication—processing claims in accordance with summary plan descriptions (SPDs)—is paramount.
    • Proper administration mitigates legal and financial risks.

The CAA empowers organizations to access data, evaluate quality, and fulfill their fiduciary duties. By embracing these changes, we can create a better, more transparent healthcare experience for our employees. 

When you're ready to take the next step in your employee benefits program, consider taking our HUB Workforce Persona Analysis. This tool goes beyond anecdotal information to deeply understand the segments within your employee population. By providing insights into your employees' unique characteristics and motivations, it helps you deliver employee benefits that truly resonate with your workforce.

Using advanced data analytics, the HUB Workforce Persona Analysis helps you identify key segments within your employee population based on factors such as age, job role, and work style. This understanding enables you to tailor engagement strategies to meet the specific needs and desires of each segment, ultimately helping you retain and develop your employees.

By leveraging this tool, you can ensure that your employee benefits program is customized to meet the needs of your workforce. Whether it's offering flexible work arrangements, providing targeted training opportunities, or implementing relevant health and wellness programs, you can create an environment that supports and nurtures your employees, helping you attract and retain top talent. Reach out to our team to get the process started.