How Employers are Poised to Help Heal our Nation’s Health Benefits Crisis

At a glance, our nation’s current healthcare landscape seems bleak at best, as nearly every stakeholder within the health benefits ecosystem is up against a growing number of challenges when it comes to providing, orchestrating or accessing care.

One of the most overlooked stakeholders is also one or the most critical: employers. In 2021, it was estimated that 155 million Americans received their health benefits through their employers, putting employers at the very center of our complex healthcare equation. Yet even with such purchasing power, employers are often not included in conversations about how to improve employer-sponsored health benefits. Moreover, they are frequently left to their own devices to figure out how to provide competitive health benefits that help their workforces maintain good health.

Navigating the complex world of benefits is no easy task, and it’s especially challenging for small and midsize businesses who have less purchasing power than their large employer counterparts.

First, there’s the administrative burden of overseeing benefits. Most entrepreneurs don’t start their business to become an expert in the complexities of health benefits, yet they’re forced to be the intermediary between carriers and employees — creating burnout, inefficiencies, and acceptance of the status quo.

Second, as costs have skyrocketed, employers have been forced to offer higher–and–higher-deductible health plans to counter premium increases or find other ways to shift costs to employees. The result? Despite being such a major expense, these health benefits often don’t offer true value to employees and their health. Too often, they merely serve as a safety net for when employees are sick enough to generate significant costs.

So what can be done? For one thing, bringing funding mechanisms like self–funding and level-funding to small and midsize businesses is helping to even the playing field among different size employers. This means that employers with fewer than 700 employees are no longer forced to choose between their own financial risk and the health of their employees. With level funding — offered along with novel plan designs — they can have it both ways.

That’s exactly what we had in mind when we developed Comfort®, a radically different health plan that allows employers to prioritize and promote long-term health for their workforce by offering zero-cost coverage on the 85% most common healthcare services from day one, all at a cost comparable to traditional group plans.

Employers no longer need to accept the status quo. Benefits professionals are increasingly researching new plans like Comfort, and they stand ready to advise their small and midsize business clients on a new path forward. This may just be a tipping point for employers who, by embracing novel funding mechanisms and plan designs, are poised to elevate their voices in the national conversation on improving employer-sponsored health benefits.