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When was the last time your health insurance paid you back?

 
 
 
 

The New Direction

Health Insurance

 

With the rising costs of healthcare, today’s employers are revisiting how to best structure their group health plans. In 2016, the Affordable Care Act (ACA) took full effect. For many companies, health costs can consume up to 50% or more of corporate profits, which is why it’s important to find the best solution for your own particular business.

The health and wellbeing of your employees is a high priority. Think of all the indirect costs of poor health. Absences from work and decreased productivity can result in two to three times the amount of direct medical costs. 70-80% of these factors stem from modifiable lifestyle choices. For the benefit of your employees and your business, it’s time to make a change.

As fully insured carriers continue to increase premiums, more and more businesses are turning to self-funding to cost contain health spend. SimpleNext is the self-funded health insurance solution that consolidates health data, workers’ compensation data, services, technology and data science to engage your workforce for Total Workforce Health Management.

 
“We have now reached a point at which the cost of doing nothing is greater than the cost of doing something.”
— Helen Darling - President, National Group on Health
 
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Running the Numbers

How the costs of health and workers’ compensation affect you

 
 

Employer

• Premiums for employer-provided health insurance have risen 59% since 2000. (Source – National Bureau of Economic Research)
 
• 80 Million Baby Boomers with increasing healthcare use. Perfect storm with a silver tsunami. (Source – Health Affairs)
 
• Workers’ today are 13lbs heavier with 18% less shoulder strength and 23% less knee strength than 10 years ago. (Source – Dr. Thomas B. Gilliam Ph.D IPCS)
 
• At the moment less than 0.5% of all data is ever analyzed and used, just imagine the potential here. (Source – Forbes)
 
• Estimates suggest that by better integrating big data, healthcare could save as much as $300 billion a year - that’s equal to reducing costs by $1000 a year for every man, woman, and child. (Source – Forbes)

Employee

• A 10 percent increase in premium is offset by a 2.3% decrease in wages. (Source: National Bureau of Economic Research)
 
• Two-thirds of a premium increase is paid for with wages and the remaining third from  a reduction in benefits. (Source: National Bureau of Economic Research)
 
• Musculoskeletal disorders make up 50% of Workers’ Comp. claims of which 70% are preventable. (Source: Paul A. Terpeluk, DO, MPH, MA Cleveland Clinic)
 
• 47% of Americans have one or more comorbid conditions. (Source: CDC)
 
• Two leading comorbidities driving claims cost are obesity and depression. (Source: CWCS)

 
 
 

The Answer

Total Workforce Health Management

 
 

Self Insured Strategy

SimpleNext simplifies the shift to self-funded health insurance from fully-funded carriers and enables you to know and manage your risk.

Digital Health Management Platform 

SimpleNext uses data science and predictive modeling to target engagement where it will have the most impact on the health of your group.

Data-Driven Engagement

SimpleNext identifies trends, focuses engagement, and promotes preventative action through coaching and training for positive health outcomes.

 
“True cost-containment is achieved by merging health and safety into a truly sustainable culture of worker health we call Total Workforce Health Management”
— Troy Neimann, President SimpleNext
 
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Benefits

What you can expect by partnering with SimpleNext

 
 

Cost Management

Our self-funded health insurance solution, together with our digital health management platform allows us to capture data faster so that we can more effectively influence outcomes in a plan year. With reduced premium expenses and profit margins, not to mention captive dividends redistributed to members, you can expect a lower cost structure than traditional, stand alone self-funding.

 

A Healthier Workforce

Your employees will experience long-term workforce health strategies to identify and prevent modifiable risk factors resulting in improved health, increased productivity, and a more cohesive work culture. No two businesses are exactly alike and our customized solutions to promote employer/corporate wellness programs are tailored to your specific needs.

 
 

Performance Based Outcomes

By implementing the SimpleNext solution, employers may now manage the costs of its health insurance premiums better than before. Does this strategy, and the opportunity for the return of unused premiums and dividend-sharing, meet your needs for affordability? When was the last time your health insurance paid you back?

 

Captive
+Aggregate Only

Our Captive Solution uses a unique Aggregate ONLY Stop Loss method, No Spec Coverage Needed.

 

No Network Restrictions

No more networks for Hospital/Facility claims. SimpleNext uses reference-based re-pricing at 125% of Medicare with less than 1% Balanced Billing.

Health Plans

Three (3) Conventional, Benefit-Rich PPO Plans and a HSA plan. Self-Funded Dental and Vision plan options are available upon request.

 

Return of Premium

Aggregate Claims Funds belong to you. SimpleNext returns 100% of any unused premiums in this layer to the employer.

Unique Rx Benefit

Our pharmacy benefit is a transparent solution that returns a share of Rx rebate back to its members.

 

Unique 24/7 Telephonic Benefit

SimpleNext includes a 24-hour telephonic cost containment solution for both healthcare and workers’ compensation.

Smooth Transition
to Self-Funding

SimpleNext makes self-funding easy with a lower monthly cost structure.

 

Predictive Modeling
& Data Analytics

SimpleNext technology at its core aggregates and normalizes disparate data sources into near-real time actionable engagement.