In a world where health plans for employers often seem set in stone, many companies are unknowingly hemmed in by what are often referred to as “paper walls.” This term, coined by Steven Bartlett, is a fitting metaphor for the illusory barriers that businesses accept without question. These so-called constraints—like fixed renewal dates or limited data access—are often more flexible than they appear. By peeling back these layers, companies can discover new ways to enhance their health plans, cut costs, and boost employee satisfaction. Let’s take a closer look at these “paper walls” and see how they might be deconstructed.
The Myth of Fixed Renewal Dates
One of the most entrenched paper walls is the belief that health plans must renew on January 1. This tradition, largely dictated by insurance carriers, has become an accepted norm. But some companies are starting to question this practice. By shifting renewal dates, they find themselves with increased negotiation power and less competition, as carriers often have more time to focus on individual cases during off-peak periods. This change not only facilitates strategic planning but also spreads the workload over the year, easing the burden on human resources.
Access to Claims Data and Managing Specialty Drugs
Another perceived barrier is the claim by carriers that sharing claims data is off-limits due to privacy or administrative hurdles. However, forward-thinking employers have successfully negotiated for access to anonymized data that respects privacy while providing essential insights for managing plan costs. Similarly, the high cost of specialty drugs is often seen as an unavoidable burden. Yet, companies willing to look creatively at this challenge have managed to control these expenses, ensuring that employees have affordable access to necessary medications.
Embracing Self-Funding and Enhancing Engagement
There’s a common misconception that self-funding is only for large corporations. However, with the right strategies, such as implementing stop-loss insurance, smaller companies can also benefit from self-funding. This approach offers greater control over health plans and can lead to significant savings with robust employer financial protections. Another paper wall is the assumption that employees won’t use services like navigation supports or Centers of Excellence. By actively promoting these services, companies have seen increased usage, which in turn improves health outcomes and employee satisfaction. This proactive approach demystifies healthcare options, empowering employees to make informed decisions about their wellness.
These examples show that what often appear to be insurmountable barriers in employer health plans are, in fact, not as solid as they seem. The key is to question the status quo, experiment with new approaches, and push against these paper walls. In doing so, businesses can find more flexible and beneficial alternatives for both themselves and their employees. In benefits, as in business, the biggest breakthroughs often happen when we realize that the obstacles in front of us aren’t concrete—they’re just paper we’ve never tried to push through.
