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7 Ways to Lower Employee Healthcare Costs

Steps You Can Take to Lower Employee Healthcare Costs

As a business owner, you want to know where you stand financially.

But there is one line item that seems to be stubbornly set to be out of your control – your employee healthcare claims.

Like everyone else, you are concerned about the rising healthcare costs, but you feel powerless to do anything about it. Or can you?

For most health insurance plans – the price you pay is determined by the expected claims. Premiums are thus determined to cover those expected claims. The more you can manage your employee claims – the more you can save in healthcare costs.

But where do you start?

Educate Employees on Their Health Insurance

The best thing you can do is educate your employees. The more you educate your employees on how to get the most out of their health insurance policies at the least cost – the lower the overall claims will be.

The reality is that most employees do not know the resources available to them.

One thing that I love about my job as an insurance agent is that I help business owners educate their employees about their healthcare plans. To really control costs, companies must continuously familiarize and reinforce the health benefits you offer.

Take advantage of employee meetings and company-wide emails to communicate the resources you offer.

How to Lower Employee Insurance Claims

Most business owners feel overwhelmed making decisions about healthcare. We tend to think we are stuck with whatever is available in the market.

But there are ways to customize a benefits plan to fit your needs. You might also discover items already on your plan that need to be utilized more by your employees.

As you prepare for open enrollment, here are practical tips on how a policy can be created to manage or lower claims:

1.    Take Advantage of Preventative Care

The sooner a medical condition is found – the less overall cost. Give incentives for employees to have their annual physical.

2.    Discourage the Use of the Emergency Room

Encourage employees to use Urgent Care facilities if possible. The Emergency Room is the most expensive care. The employee cost on most policies is a copay + deductible and coinsurance. A policy may say there is a copay for the ER, however, the cost of the physician and other tests generally do not fall into the ER copay.

3.    Be Strategic about MRI & CT Scans

Encourage employees to use a non-hospital facility. The cost of these tests in the hospital are at least double, if not triple, the cost of a freestanding facility. To encourage employees to use a freestanding facility rather than a hospital, the plan design can include a significant copay when a hospital facility is used.

4.    Utilize Vision Care

Going to the eye doctor is beneficial for everyone regardless of if they wear glasses or not. Why? Because an optometrist can detect high blood pressure, stroke, and many other conditions during a routine eye exam. Employees may seek expensive medications to control headaches when it could be a problem with eyesight. Remind employees that they can use their HSA / FSA for their eye care needs.

5.    Encourage Regular Dental Care

Dental care is more than having a nice smile. Did you know that many diseases start in the mouth? In fact, there is a strong link between cardiovascular disease and gum disease. Asking employees to have their teeth cleaned two times a year is a must. In fact, if I were writing a policy, if a person did not have their teeth cleaned, they would not have coverage for major dental work. Remind your employees they can utilize their FSA / HSA for dental expenses.

6.    Offer Free Telehealth

Telehealth has become the go-to for minor medical conditions. The cost is usually less than the cost of an in-person visit to your physician. Due to its popularity, the telehealth fair market value has been a trending issue among medical professionals. As a business owner, make sure your policy includes adequate coverage for telehealth as it can lower claims.

7.    Exclude High-Cost Drugs

When a person does not have the ability to obtain a medication through their commercial health insurance plan, often they can go to the manufacturer of that drug for assistance. The manufacturer’s cost is much less than they would pay on the company plan.

While this list may look intimidating, many of these items are probably already in your plan and the others are easily incorporated into any benefit package.

Of course, the hardest – and best thing – you can do is to set a good example to your employees. Your example of taking time out of your busy day to get a check-up will help create a culture in your company that values good health practices.

At your next employee benefits meeting, be sure to mention these helpful tips. As you educate your employees, they will be more empowered to make better healthcare decisions – and thus lower your overall costs.


Victoria Braden



With 30 years of experience, specializing in group health insurance for small to medium size companies in the state of Georgia who are looking for affordable and quality employee benefit solutions.