EBLF Health+Benefits

Limiting Your Losses

Q&A with Jennifer Collier, SVP, Stop-Loss and Health, Sun Life
By Katie King Posted on June 26, 2020
What is one trend you’ve seen among clients since the onset of COVID-19 that has surprised you?
Actually, it was the outpouring of requests we got from our clients who wanted to keep their employees covered under their medical plan despite having to make staffing changes based on financial challenges their businesses were facing. They were coming to us to make sure these changes wouldn’t impact their stop-loss coverage or rates, and we reassured them we were totally supportive of these decisions. They did not want their people facing a pandemic without their benefits. It was really encouraging to see how much genuine care and concern they had for their employees and their families during such a difficult time.
What are some ways Sun Life increased flexibility for self-insured employers during this time?
We got so many calls those first few weeks. Honestly, we listened to the new challenges and needs and spent a lot of time talking about how flexible we could be to help our employers. We worked to increase the flexibility for self-funded employers to make changes to their underlying medical plans without impacting their stop-loss coverage or rates. This was related to helping our clients keep their employees covered under the medical plan, but it was also related to allowing changes in cost-sharing for COVID-19 testing and treatment, so no member would possibly avoid care due to the cost. We also provided an extended grace period for premium payments and added coverage for COVID-19 to our critical illness policies. Another thing we focused on was staying in touch with clients and partners even though we were in this new virtual environment. We provided a series of webinars with the latest insights and analysis and made it easier for clients and partners to interact with us virtually with enhanced digital capabilities.
Do you think employers are feeling any differently at this point about the amount of risk they are taking on regarding their medical benefits?
The reality is that the financial impact of claims directly related to COVID-19 continues to evolve. Certain industries and geographies are likely to be impacted more heavily than others, but what I do think we will see is a different level of investment from employers in keeping [their employees] healthy. Considering the expansion of wellness programs and initiatives in the market, many were already evolving this way, but I don’t think we’ve ever seen a time before now where employers had been so focused on the health and wellbeing of their employees. For many, it was a matter of their business continuing to function. Related to that, I think we could see a continued greater interest in use of telemedicine and other new options around site of care. We are definitely likely to see a focus on balancing risk when we begin the return to work (literally returning to their place of work), with employers very focused on safety measures to keep employees healthy.
What do you expect the long-term implications of COVID-19 to be on employers’ views on self-funding?
It’s a great question because I do think there are likely to be different short-term versus long-term implications here. In the short term, it is possible we may see smaller employers staying in fully insured arrangements more often. We could even see some smaller self-funded employers consider moving back to fully insured. But, in the long run, self-funding is still a really effective way to manage costs associated with employee medical benefits. That need isn’t going to go away. And you have to remember that we could see fully insured rates increase as a result of everything happening this year, which would certainly have an impact on employer’s decisions. Overall, I anticipate that self-funding growth will continue, though it would not be surprising if we see growth slow down for this year.
The affordability gap in healthcare has created opportunities for disruption. What is one opportunity for the stop-loss sector in particular?
Stop-loss has the opportunity to support employers who are working to deliver great benefits for their employees at the best possible cost. On one hand, we have a role to play in keeping self-funding attractive for employers so they can use that additional flexibility to construct a plan that works for them. There are also opportunities to continue to develop solutions that provide increased predictability through data and insights. Giving employers insight into their claims and what to watch out for can lead to more effective programs and better plan design. Remember that employees are paying a percent of the overall cost of the health plan and that means they are impacted by the overall cost of the plan, not just their own use of it. Ultimately, if we can control the rising costs associated with healthcare, it helps everyone.
Katie King Vice President, Health Policy & Strategy, The Council Read More

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