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“Pay or Play” Penalties. Is Your Church or School Growing?

When schools first closed their doors to in-person learning in the Fall of 2020, no one could have predicted just how the pandemic would impact the educational system. From Spring 2020 through Fall 2022, schools, teachers, students, and caregivers had to navigate masking, social distancing, and testing protocols, as well as the constant rotation of closing and reopening of schools.

By the 2020-2021 school year, many private schools began seeing dramatic growth. A recent Christian Headlines article shares that since the beginning of the pandemic, nearly 80% of private Christian schools have seen increased enrollment. With the uncertainty of the pandemic and the reality of the public school curriculum, many parents and caregivers decided to enroll their children into private and Christian schools. 

Now, as we continue into the new school year, both private and Christian schools are still seeing significant increases in enrollment. 

With an influx of new students ready to begin the year, additional staff must be hired to support them, driving these schools towards a new category of employers – an applicable large employer (ALE). This title, given by the Affordable Care Act, comes with employer-shared responsibilities that could be challenging for nonprofit Christian schools as well as smaller private schools to follow.

The provision includes nonprofit organizations.

The “Pay or Play provision,” requires certain employers to offer affordable, minimum value coverage to full-time employees. An employer is subject to the rules if they employ at least 50 full-time employees in a calendar year, including full-time equivalent employees. As seen below:

  • A full-time employee is one who works 30 or more hours each week. In a calendar month, per the Affordable Care Act, 130 hours is considered the equivalent of 30 hours a week.
  • Hours worked by part-time employees, or employees who work less than 30 hours per week, are counted and divided by 120 per month. This number will determine how many full-time equivalent employees a company has.
  • If the total of full-time employees and full-time equivalent employees are over 50, a company can be considered an applicable large employer.

Many schools will now need to determine if they qualify as an applicable large employer. Many details within the provision can make this a difficult task. For example, calculating hours worked for each employee includes non-working hours such as vacation and leave of absence.

Employers who do not offer their employees a health plan and are considered a large employer are subject to paying costly penalties. Schools need to work with their advisors to ensure they are in compliance with the Affordable Care Act as the penalties have recently increased

Tuition vs Enrollment vs Budget

Small private and nonprofit schools that have grown in size may find themselves in a difficult position. Often, these schools don’t have the ability to support a health plan due to limited budgets. Those who charge tuition could consider raising the cost to help support affordable coverage, however raising fees could affect enrollment, creating a challenging cycle. 

At City on a Hill, we work directly with private and nonprofit schools. We have unique solutions that can help. We can help schools deliver affordable health plans, designed for their unique workforce, even with zero budget. Options are available. After analyzing plan data we can develop a three to five year strategic plan.

A plan can be designed to complement your budget, from zero dollars to full coverage, allowing schools that have grown over 50 employees to avoid or minimize harsh penalties. If you have questions about Pay or Play penalties or need help to determine whether you are an applicable large employer, let’s chat.

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Support Employee’s Mental Health with Unique Benefit Solutions

Rising staff shortages and mental health concerns may have contributed to a challenging recruitment process for many organizations this summer. Now, as we begin the new school year, ensuring your employee benefit programs complement a supportive and encouraging environment is essential. 

The ongoing effects from the pandemic has left teachers and staff feeling exhausted and overwhelmed. A survey from the National Education Association (NEA) shows educators feel burnout is a top concern, with “67% reporting it as a very serious issue and 90% a very serious or somewhat serious issue.” These concerns need to be addressed by schools now in order to prevent the possibility of teachers leaving their field.

Staff shortages and the pandemic are listed as leading contributors of stress and although the worst of the pandemic appears to be behind us, educators may have to navigate long-term mental health effects, not only for themselves, but the students they teach.

To address burnout, those surveyed shared they are strongly in support of schools hiring more teachers and support staff to ease additional workload. As well as options to provide mental and behavioral health support for students. NEA members also expressed an interest in increased wages and while that request could be in the budget for some schools, finding and allocating these additional funds can be extremely difficult for smaller or private Christian schools

Providing support may be key for recruitment and retention this year

In these cases, schools can offer support to their staff by looking at their benefits program in a more strategic way. Making meaningful changes within your plan can improve employee experience and reduce stress that causes burnout. An important part of assessing your benefits program is to ensure employees can access programs easily and affordably. For example, reducing co-pays for mental health programs or spreading awareness using monthly email campaigns.

Advisors, like us, can help you make important data-based decisions and develop strategies that can support your people, financially and emotionally. Whether that means providing new programs or investing in current ones.

To address burnout and build retention and recruitment strategies this year, employers should consider:

  • Providing mental health programs such as workplace Chaplain services or Employee Assistance Programs that offer confidential support for employee concerns.
  • Focusing on financial well being by offering life insurance options, financial well being programs, disability or Flexible Spending Accounts.
  • Providing job and classroom flexibility for teachers. Creating more time for teachers to prepare lessons, grade work and organize student activities.
  • Concentrating on school culture and mission can be an effective way to help your people feel valued. 
  • Offering education programs to help employees achieve personal goals and develop skills.
  • Conducting regular surveys and speaking with employees one-on-one can help you better understand how your programs are working and where improvements need to be made. 

Any changes made to your benefits programs can be done slowly over time. Using change management strategies that allows teachers and staff to become accustomed to differences in their plans without feeling overwhelmed. This can be especially important due to the high level of stress teachers are feeling.

Help teachers focus on inspiring students by giving them the support they need.

Educators often choose their profession because they want to make a difference in the lives of others. By making a genuine effort to support them in that journey you can alleviate their stress and increase their satisfaction. Recruitment and retention are closely associated. When you focus on taking care of the people you have, you can inadvertently attract more talent by word of mouth and reputation. 

At City on a Hill, we understand how important your people are. We want to help you manage your benefit program in a way that gives you more control over costs. Allowing you to provide comprehensive, supportive programs to teachers during these difficult times.

If you’re worried about your teachers and staff experiencing burnout, let’s chat.

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Signs There May Be Lost Revenue in Your Benefits Plan

Most schools have been at a standstill over the past two years, hesitant to make huge adjustments to their benefits plan, due to the pandemic. But with rising healthcare costs, increased student enrollments, and the uncertainty of the Great Resignation, now may be the best time to make meaningful changes.

Schools have been in a state of day-to-day survival mode, switching to hybrid models and remote learning, conducting contact tracing, juggling mask mandates, and attempting social distancing in busy classrooms. 

Parents with children who were in Zoom meetings all day saw an unsustainable way of life and went looking for better in-person learning options. 

This created growth in private and charter schools, causing expansion and space concerns in conjunction with COVID constraints. We often hear that with an enrollment of an additional seven to eight students requires an additional staff member, leaving these schools trying to hire more people.

On top of that, the Great Resignation is also putting pressure on schools to hire new teachers and retain current ones. Teachers have already been burning out prior to the COVID-19 era, with little support and stagnant pay. 

By using your benefits spend more effectively, you can free up more budget to better compensate staff, helping to fight trending resignations.

There is revenue trapped in a bad benefits plan. 

Signs you may have hidden revenue lost in your plan:

  • If you haven’t looked at your benefits in a few years, you are almost certainly missing opportunities to uncover lost revenue. The pandemic has caused a dramatic shift in current benefit trends, with a focus on the well-being of individuals and their families. Your benefits plan should reflect this change.
  • If your employees are paying more than 25-30% of the total premium (especially in child and family tiers) or a deductible over $3000. There are ways to manage the cost of your plan more effectively, benefiting your school and your staff.
  • If your employees can’t afford a surprise medical need, like a surprise knee surgery that hits their deductible. With their salary and your benefits plan, could they afford it? If not, you have a problem.

The benefits you offer could be your path to competing with other schools. If your teachers are pulling together every penny they have to make things work and they’re hit with a surprise $5000 deductible, the benefits aren’t really working for them.

You can change that.

If you have a better benefits plan, you can improve employee experience and free up capital for compensation. Salary and benefits are key factors for most employees when considering job opportunities, with many looking for employers who invest not only in their work lives, but their personal lives as well. 

Now is not the time to stand still.

You can use your benefits to help solve these problems and significantly improve your school’s ability to attract and retain talented, motivated teachers and staff. The first step is to design a strategy that builds a solid benefits plan, one that can help your school thrive. 

There is room for adjustments within your plan, even if those adjustments are minimal to start. Working towards better, more competitive benefits can help your school overcome the challenges that the pandemic has caused. 

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There is a Place For Innovation in Your Benefits Program.

We often ask employees to be innovative. To develop and implement new ideas and concepts so we can promote growth in our schools and churches. We want our students and community to know that change doesn’t have to be scary but empowering.

But when it comes to healthcare insurance and employee benefits this strategic asset can be overlooked. In fact, we come across many opportunities to improve program designs but are met with employers who are hesitant to make changes, despite the cost-saving potential.

Sympathizing with the challenges of change. 

Employers can feel hesitant to make changes to their benefits programs for a variety of reasons. Some feel changes to the program will be too time-consuming or the disturbances caused by a change, big or small, may outweigh the advantages. Others may worry about how change could affect employees and company culture.

Those employers who are interested in innovative solutions to better their program may have brokers who aren’t. Brokers who are more comfortable being reactive with plans and sticking with what they know, instead of being proactive and producing a strategy that better fits the needs of the organization.

This can make even the most innovative employers reluctant to change.

Recently we were able to improve a client’s plan by coming in 20% below the broker’s current rate. We were able to strengthen their plan and reduce the costs by using a unique solution their broker was not aware of, leaving the current broker at a loss because the new strategy was better in every regard.

In these situations, brokers often engage with employers, telling them to remain skeptical while they search for answers. This can be confusing and stressful for employers and can cause them to question their decisions, delaying or even denying changes to their program that can improve employee experience and lower costs.

Helping employers feel more comfortable in these scenarios is important. Innovation comes naturally in all areas of our workplace, except when it comes to healthcare and employee benefits. This is a problem.

The proposed changes will save this organization money. And because costs aren’t getting passed onto employees, their employees will save money too. There are no holes in what we do. We were able to offer rebates, contracts, and bulk purchasing to help lower costs. With bulk purchasing you can save up to 10 to 15%, which was a big part of the savings we established for this organization.

We are confident in our strategies and we are used to discovering innovative, effective benefit solutions. We also know how important culture and mission are for employers and how difficult change can be. Managing your benefits program in a different way can be intimidating, especially if your broker isn’t familiar with the mechanisms.

Gain the confidence you need to improve your benefits program.

If you find yourself in this scenario and are worried about a new solution for your program, there are steps you can take to ensure you’re decision: 

  • Talk to your broker and/or advisor about the benefits and risks until you truly understand the strategy. 
  • Talk to your peers who are trying this kind of innovation and see what results they are getting with their plans. 
  • Ask for references. An advisor or broker who is suggesting an innovative change should have case studies, success stories, and clients who are willing to share outlooks. 

Being innovative with your benefits program can be intimidating. Talk to your peers, talk to your advisor and when you have the information, data, and references you need, take another look. Improving efficiency, lowering costs, and gaining a competitive advantage can be done with appropriate changes.

If you are looking for more information about innovation in your benefits program, let’s chat. We want you to feel comfortable with all of your benefit decisions.

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Your Mission is an Important Ingredient in Your Benefits Program

Offering healthcare insurance is an important decision for any business. Designed with your organization’s unique qualities in mind, your plan needs to protect the health and wellbeing of your people and their families. Ideally, offering the best coverage available, while aligning with your organization’s financial goals.

For many small churches and Christian schools, the importance of optimizing every benefit dollar is essential. Even small increases in costs can mean dramatic changes for these organizations. To recover from unexpected expenses churches need to rely on an increase in donations or look for alternative sources of income and schools often need to increase tuition, which directly affects the families and students who attend.

You need flexibility in your benefits program.

Some churches are being led incorrectly by advisors who feel restricted by rules and regulations that other businesses need to adhere to. These advisors may not be aware that churches have certain regulations that don’t apply to them, or if they are aware, they don’t want to put in the effort to make those changes. This is an area that is often overlooked, that flexibility needs to become a reality for these churches.

Your advisor needs to know the variables that come into play when designing an insurance plan for your church or school. For example, some schools will pay teachers throughout the summer, while others don’t. This can impact policies and payrolls. It is critical your advisor understands these intricacies ahead of time.

When expanding into full benefits your advisor should be familiar with regulations for disability policies, enhanced benefits, cost-sharing options, and more. These options are very unique to schools and churches and need to be strategically planned and implemented. 

In these types of environments where your culture or mission is what attracts your workforce, not necessarily your payroll, it is important to ensure you know your options.

We have talked with schools where their families are paying $2000 a month in insurance because the organization has tried to go the route of a traditional business. That’s $24,000, when they may only make $30,000 a year in salary. This is unsustainable, unreasonable and can impact your organization’s ability to retain and recruit top talent. 

You need long-term solutions for your people. 

You need to work with an advisor that knows your organization from the ground up, that can come in from your standpoint. You need an advisor who knows your organization’s financial status and can help ensure you are offering the most appropriate, effective, and affordable benefits to your people. 

Specialty advisors, like us, know how churches, Christian schools, and universities work. We can recommend unique solutions to provide cost-effective and sustainable solutions for you and your employees. Solutions that can: 

  • Help protect your organization from the effects of unexpected cost increases.
  • Provide transparency so you can take back control of your healthcare spend.
  • Generate cost savings that can be used for your school, teachers, church, and/or community.
  • Create competitive benefits programs that work for your unique workforce, while maintaining affordability.
  • Support you and your people in every aspect of the program, so you can focus on teaching the next generation.

Your mission is important. 

The value of working with someone that has a similar mind and framework is unmeasurable. Tactically speaking, any advisor can figure out the system. They can offer a complete health insurance program for your organization, but if they don’t truly understand the nuts and bolts of your church or school, can you trust they are doing everything they can to protect your mission? 

We understand your finances and understand what your people go through on a day-to-day basis. Your benefits should be as unique as your organization.

We can create an ecosystem that helps you at every turn, we plan for the future and take care of the present so you can focus on helping your people and leading your organization.

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The Value of Predictability

Predictability goes a long way. You need a plan that aligns with your school’s values and works when your people need it. They depend on their policy. But this can be difficult to provide when you don’t know what to expect and can’t plan ahead.

Many of our clients receive renewal increases of 10-20% with only a few weeks notice, leaving them with no time to look at alternative options or strategies to manage the cost.

That 20% increase is painful, no matter what, and you should have the time to plan accordingly. Practically speaking, you should know your renewal options four months ahead of time, if not earlier. By getting information sooner, you can create a better annual renewal with improved predictability, reducing surprises and stress.

You need that foresight.

If you are self-funded, you generate this data internally throughout the year and can see how your benefits are trending. But, if you are fully insured, you are likely to see your benefits handed to you promptly before renewal, with a high increase. You become handcuffed to the options, with no time to make an appropriate decision. 

If you request this information earlier, brokers and carriers may say they need more data, yet more often than not, that data doesn’t change significantly enough to justify a delay. There is a missed opportunity where they could give you that visibility, but they are typically focused more on efficiency and profit than your operations and budget. You need proactive guidance and support.

There are options if there is time.

If you have been surprised by your renewal you have options NOW to fix that. We have been able to add flexibility and visibility to groups. In a recent interaction, we were able to cut their rates by 31%, WHILE moving them to an 18-month contract that starts July 1st, saving them additional money. A good advisor can act on your timeline and budget.

You aren’t stuck for the entire year.

If this sounds familiar to you, possibly from Jan 1 of this year, there are steps you can take to help you plan ahead:

  1. Get your data. Having visibility into where the increase came from will help you better understand your plan and give you an idea of what to expect. 
  2. Work with an advisor to help you understand the data. They have the expertise to dig into your data and show you how your plan is running.
  3. Weigh your options. Your advisor should also help you decide what the best options are for your business and your people. 

You need to find a solution that provides you with more predictability. You don’t need predictability to fight increases, although that is important, you need to plan accordingly, to feel more confident and prepared. 

A good thing to remember is that a cost increase filters downhill. Deductibles go up for employees. Your coverage can change. That unpredictability is extremely painful for your people. A dramatic change can undermine their trust and hurt your retention efforts. 

Predictability creates a sense of control and dependability for employees.

Now is the time.

Talking to your advisor now can better prepare you to make appropriate adjustments, provide important data to stakeholders for budgeting purposes and allow you to better maintain a benefits plan that your school can be proud of.

Your organization needs to be able to plan ahead. Not just for the financial department, but for you, HR, and your people. Eliminate the uncertainty of renewal time. Know what to expect, plan ahead and achieve a jumpstart to a valuable benefits plan. We can help, let’s chat about it.

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The Kodak Lesson That All Schools Should Know

The 90s and into the 2000s were pivotal years for photography. As the costs of film and access to photography development services grew, disposable cameras began entering the market and were soon followed by the earliest versions of digital cameras. At first, these devices were big and clunky and expensive, but tech evangelists and key players in the photography industry saw them as the beginning of a new era for photography.

Kodak, however, disagreed. Kodak decided that digital photography was a passing fad and opted to not pivot the business into digital.

Today, we know how that story ends. Kodak is still around, but it is far from the behemoth it once was. Kodak had all of the resources it needed to seize and dominate the blossoming digital photography market, but the leadership chose not to act. And that inaction proved to be a costly mistake, opening the door to competitors to chip away at Kodak’s customer base and market dominance.

The Cost of Inaction

Kodak’s story is not a new one, unfortunately. Powerful businesses often miss new ideas because they fear change and believe that inaction is a safe strategy. 

Sear’s, with its national chain of department stores and thriving mail order catalog business, could have evolved to become what Amazon is today. Disney famously derided 3D animation and passed on supporting what would become Pixar only to buy the company later for $7.4 billion. And the examples go on and on.

If you apply this lens to your own organization, you will discover that inaction can hobble your business at many unexpected points. For example, our work with employee benefits means that we see, again and again, how painful inaction can be.

Sure, changing your benefits plan is a complex challenge, but what are the costs of not changing? Here are some top-level consequences:

  • You pay more than you should. If you overpay for your benefits, the total loss of revenue year over year can be substantial. It’s expensive to sit still.
  • You lose potential growth. All of the revenue you wasted on your bloated, ineffective benefits plan means fewer dollars to reinvest in your organization, slowing progress across the board.
  • Employee morale suffers. Choosing to not address your benefits plan means that the quality of your benefits will likely decline each year, which means more frustration and heartache for your people, and that adds up quickly.

Adopt a Proactive Perspective

To avoid becoming a Kodak in your own way, you need to be willing to pursue new ideas and try new things. That’s scary, yes, but inaction should scare you even more.

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7 Ways Private Schools Can De-Risk Self-Funding

Self-Funded Options are Available to Private Schools

We have found that private schools in our region, especially the Christian ones, have grown accustomed to doing more with fewer available resources. These institutions are so mission-driven that every person in the building is committed to delivering on their promises to their students, so they get creative with scheduling and staffing and with budgets.

Unfortunately, this scrappiness can sometimes lead to assumptions about what they can and cannot afford. Faced with ever-rising benefits costs, we have met with dozens of leadership teams who believe they simply have no option but to endure annual rate increases because of their size.

“We just aren’t big enough to do anything else,” they say.

This isn’t true. No matter how small the organization, you have more options available to you than you may realize.

Before we dive into what those options are, you should know that employee benefits plans are often divided into groups: Fully insured traditional plans and self-funded plans.

Fully Insured Traditional Plans

This is your classic employee benefits plan. The plan gives you coverage for a set rate, and you (as well as your employees) pay 100% of the premiums regardless of how much or how little the plan is used. At the end of each year, these plans typically increase in cost by 10 to 20% while employee deductibles and quality of coverage decline.

Self-Funded Plans

Under a self-funded model, you “pay as you go.” By directly managing your benefits plan, you pay for only what you use, giving you an opportunity to control the overall cost of your plan. Self-funded plans typically include a range of tools that enable employees to access better care but for lower prices.

Unlocking Rewards with Smaller Groups

Historically, larger groups have had the most success with self-funding because they are in a better position to absorb large claims. When smaller groups consider the possibility of self-funding care for an employee’s major illness or expensive prescription, the risk seems too high, so they go back to their broker and renew their traditional coverage.

We have clients with as few as 2 lives on self-funded plans, and that’s possible because of these tools:

  1. Stop-loss insurance – By capping your potential costs, stop-less insurance protects you from a bad year of claims so that you have stability and security at all times.
  2. Pharmaceutical programs – Prescription drug costs are one of the most common sources of high benefits costs, and we have tools that enable us to reduce (and sometimes eliminate) out-of-pocket costs to the employee while dramatically reducing the costs to the plan. For example, we have been able to provide $80,000 prescriptions for $30,000.
  3. Collective buying power – We use coalition and alliance models to bring several smaller schools together, giving everyone more negotiating power and better access to coverage,
  4. Direct medical contracts and reference-based pricing – In the benefits world, higher costs often do not equate to better care. We help your employees get the best possible care at fair prices, generating huge savings for your plan while giving them a better experience.
  5. Alternative delivery models – Benefits plans are full of waste. With telemedicine and prescriptions by mail, we can give employees more care at a lower cost.
  6. Progressive change – Your organization can gradually implement self-funded options overtime to make change more manageable for your leadership team. In other words, keep your plan but start saving at the same time.
  7. The right partner – The right advisor for your business will take your concerns seriously and collaborate with you to customize an approach that meets your needs.

Your Next Steps

You likely renewed your benefits plan recently, and that’s okay. Not only do we have options we can begin pursuing today to lower the costs of your current benefits plan, having more time between now and your policy renewal gives you more flexibility in your planning and your preparation. Next year, your benefits costs will go up. That is a certainty. But, if we start working together soon, we can unlock a new strategic advantage for your people without putting them at risk.

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Strategic Planning for Schools in 2021

Move from Reactive to Proactive with Your Benefits Plan

2020 was not an easy year for educators, big or small, public or private. In the chaos of COVID-19 and the rollercoaster of regulations, directives, and mandates that followed, many private schools spent the year in survival mode. Forget the strategic plan. How do we immediately transition our classrooms to distance-learning? How do we keep our faculty and students safe if in-person education resumes? How do we navigate planning and structure when we aren’t even sure what tomorrow holds?

Turning the calendars over to 2021 does not eliminate these challenges, and you’re probably still contending with your share of obstacles, but the dust is starting to settle. Elections are behind us. Vaccines are being administered. We can start to shift our thinking away from emergency problem-solving and toward the strategic initiatives that are important to you, your employees, and your students.

Strategic Benefits Planning for Christian Schools

Strategic planning is not a new idea for you. However, given the intensity of the crisis you have endured for the last several months, you may find it difficult to step away from the day-to-day to think broadly about your organization and what could come next.

We’re having these discussions with our own teams and also with our clients. Here’s the process we recommend:

  • Revisit your old plan. Though many variables and specifics may have changed, reviewing your most recent strategic plan can help you to reframe your broader goals and focus your perspective.
  • Run a SWOP Analysis. A SWOT analysis stands for strengths, weaknesses, opportunities, and threats. We have a more proactive mindset, so we think of threats as priorities instead. Regardless of your exact approach, this classic planning tool can help you to understand your current situation and reveal places you might go.
  • Talk to expert advisors. You can’t be expected to know everything, and your SWOP exercise may uncover questions that you aren’t in a position to answer. That’s okay. Talk to your trusted partners in your network so that you can make more informed decisions by leaning on their expertise.
  • Make a timeline. Map your plan to a timeline, setting key execution milestones that are both reasonable and practical. Without a plan for how you actually bring your strategic plan to life, many of your important ideas can get stuck on the shelf.
  • Revisit and recalibrate. 2020 showed us that everything can change, and it can change quickly. Your strategic plan should be malleable and adaptable, but that means taking the time to periodically reassess and reevaluate your progress and the realities facing your organization.

Make Every Dollar Count

With the volume of revenue funneled into employee benefits plans for the average organization, benefits should be a component of your strategic plan. It’s not the only priority, of course, but in an age where you may need to rapidly shift resources or, perhaps, build entirely new systems for delivering education, having more agency over your budget is a huge advantage. 

In any case, your strategic plan needs your attention, and soon.

You don’t have to figure out any of this alone. We’re happy to share what we’ve learned from our work and from our clients at any time. 

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The Problems With Traditional Health Care in Schools

And How to Solve Them

The traditional health care model that so many Christian schools are locked into is broken. These schools are stuck in a cycle of inefficiency: Their insurance carrier raises its prices to an unsustainable level, so the school goes back to the market and finds a more affordable alternative—even if it means they still have to pay a little more than they currently do. A year later, prices once again reach an unbearable rate, so they head back to the market once more. By breaking out of this cycle, schools can pursue reliable plan options that provide consistent rates and high-quality care for employees. 

When schools switch from plan to plan every few years, everyone suffers. Administrators spend weeks sorting through plan options, completing paperwork, and hoping for a smooth transition. For the employees, changes to the plan often mean a disruption in care as they seek out new doctors in the network. The worst part, however, is something that impacts everyone. In most cases, switching plans within the traditional health care model fails to provide a long-term cost-savings solution for the business or the employees. 

Breaking out of the traditional health care mold solves that problem. 

A Better Solution

Self-funded plans and group plans are proven alternatives to the typical health care model. By pulling together to negotiate lower rates, schools may finally experience something they haven’t felt within their health care program for years: stability. With this newfound stability, schools reap numerous benefits, including: 

1. Cost savings. With the power of self-funding or group plans, you’re never at the mercy of the insurance companies. Instead, you can leverage your buying power to access significantly lower plan prices. The savings potential here is enormous. In a traditional plan, all of the money you budget for the year goes to the insurance company. If your employees stay healthy and don’t use the plan very often, the insurance company enjoys handsome profits from your team’s health. In a self-funded plan, meanwhile, your excess budget could potentially come back to your school at the end of the year as a refund. 

2. Consistency. Maintaining the same plan each year leads to easier forecasting, planning, and budgeting for your school, and employees can remain with the same provider without worrying about a disruption in care. As an added bonus, you don’t spend weeks on open enrollment every year, sorting through potential vendors, comparing rising prices, communicating changes to employees, and distributing new health care cards. 

3. Better care and health outcomes. With a great plan, employees can visit the same doctors every year without worrying about who will write their prescriptions or help them when they’re sick. Since these employees visit the same doctors each year, their care is never interrupted—which means they could experience better health outcomes. For many employees, sticking with the same plan each year makes them feel comfortable while giving them an extra sense of confidence that they will receive the treatment they deserve.  

Improvements for Everyone

The traditional health care model that so many schools are locked into is broken. 

Every two or three years, we watch schools return to the market in search of a health plan that provides the smallest rate increase without disrupting coverage for employees. 

There’s a better way. 

By leveraging self-funded and group plan strategies, schools can access significantly lower rates that remain steady from year to year. In breaking away from the traditional health care cycle, schools can pursue new, reliable plan options that provide better rates and high-quality care for employees. With an optimal plan, school leaders avoid returning to the market every two or three years in search of the least painful plan. By switching, these leaders can find a plan that works.

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