That “40% Off” Sign Isn’t Fooling Anyone. So Why Does the Same Trick Work in Your Health Plan?
We all know that store. “40% OFF – THIS WEEK ONLY!” Painted across the window. Every week. All year. Since 2019.
Nobody walks in thinking they scored a deal anymore. We know the game. They marked everything up so they could mark it back down. The “sale price” is the real price. The “original price” never existed outside of a tag.
So why does your health plan get away with the exact same play?
The Markup You Never See
In retail, the inflated price is right there on the tag. You can do the math. You can roll your eyes and walk out. In healthcare, the markup happens before anyone shows you a number.
Every insurance company and (almost) every PBM wants to say they get the highest discount. So what do manufacturers do? They raise the price to give a bigger discount. The “discount” gets bigger, the press release looks great, and the actual cost to your plan goes… nowhere useful.
Premiums get built with the same padding so the renewal “discount” feels like a win. The carrier gets to play hero – negotiating you down from a price they inflated in the first place.
Same trick. Raise the price, then take some off so everyone feels good about the transaction.
The difference? At the store, you lose $40 on a sweater you did not need. In your health plan, employees skip medications, delay care, or stare at a bill they cannot make sense of.
What Your Employees Actually Experience
When a retailer runs a permanent sale, consumers shrug. When a health plan runs the same game, employees make decisions about their health based on prices that were designed to be confusing.
They choose the cheaper drug that does not work as well. They avoid the specialist because the cost estimate looks terrifying. They stop trusting the plan entirely. (Can you blame them?)
And the people fielding those confused, frustrated calls? That is you.
The Annoying Part
You already suspect something is off. The renewal math never quite adds up. The rebate reports read like they were written to be unreadable. The “savings” keep going up while employee complaints do the same.
The retailer with the permanent 40% off sign at least puts the game right in the window.
Your health plan puts it in a 47-page contract addendum.
Want to know what your medications actually cost – before the markup-and-markdown game?
