Traditional Group Insurance
Sometimes this is best. Situations include:
- ICHRA can be more expensive. ICHRA relies on the individual market, and sometimes the individual market is more expensive than small or large group.
- If all employees love the same carrier, it can be administratively easier to stick with that insurer.
- If your company culture is resistant to change, staying with familiar group can be best.
Shift is licensed to sell and service group health insurance in Oregon and Washington.
Large Group
Being classified in large group brings opportunities.
Your premium not only has age and location as factors, but also claims experience. The more you can do to create a healthy workplace and offer alternatives (like AI-driven care and telehealth) to avoid large claims (ER visits), the more this should play into your premium rate.
Large group brings increased risk of waste in your spend. Traditional brokers are paid a percent of the premium, so they benefit when your costs go up. Insurers have bonus and rewards programs for brokers that retain business. And margins for middlemen are the largest in large group.
If this is you, you have one of the greatest opportunities to save money by conducting audits and exploring alternatives.
Works best for 51-100 employees
Small Group
Small group is the default for employers with 50 or under employees.
It's difficult to control premium rates since this market segment is "community rated" which means your rates are only determined by employee age and location.
Employers seeking to reduce costs have three options:
1. Shop between different carriers (each carrier has different rate increases each year).
2. Explore different benefit designs, such as HSA-compatible plans.
3. Consider switching to an ICHRA.
Works for 3-50 employees
