Practical insights for employers and HR leaders who want to manage healthcare proactively — not just react to the next renewal.
A group medical captive and your own captive insurance company are two different things, and the word gets used for both. Here is the difference, what Utah actually requires of a licensed captive, and the one protection you give up that nobody volunteers.
Read articleYour broker says a $100,000 specific attachment point and a 125% aggregate are standard. Utah publishes the actual distribution every year, so you can check. Here is what the state's own 2024 stop-loss data shows, and what it says about your next renewal.
Read articleCrossing 50 full-time employees changes your legal obligations, not just your headcount. Here is what the ACA employer mandate requires, what the IRS actually publishes about the penalty amounts, and the reporting duty that catches self-funded employers of every size.
Read articlePharmacy is the fastest-moving line in most employer health plans and the hardest one to see inside. Here is how PBM economics work, what a carve-out actually changes, and the Utah reporting law that puts some of it on the record.
Read articleMost employers never check whether their health plan paid the right amount on the right people. Here is what a claims audit looks at, the federal rule that gives you access to the data, and how the answer changes depending on how your plan is funded.
Read articleA renewal increase arrives as one percentage, which is the least useful way to look at it. Here is how to take that number apart, benchmark it honestly, and work out which of your options are still open this year.
Read articleStop-loss is the part of a self-funded proposal most employers skim, and it is the part that decides whether the arrangement is actually safe. Here is how attachment points work, what lasering does to a renewal, and the Utah rules that stop applying once you pass 50 employees.
Read articleReference-based pricing gets pitched as a way to cut hospital costs without cutting benefits. Sometimes that is true. Here is an honest look at the mechanics, the employers it fits, and the failure modes worth understanding before you commit.
Read articleAlmost every benefits firm now calls itself a consultant. The title tells you nothing. Here are the questions that separate a firm that places coverage from one that manages your healthcare spend — and how to ask them.
Read articleHealthcare is now your second or third largest operating expense. Most employers accept rising costs as inevitable. They are not. Here is what is actually driving the increases — and the approach that changes the trajectory.
Read articleThe plan-funding choice is no longer two-way. Here is how fully insured, level-funded and self-funded actually compare for a Utah employer between 50 and 500 employees — with the KFF numbers and the regulatory change nobody mentions.
Read articleThese articles are a start. A real conversation about your specific situation is where the work begins.
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