People Processes

People Processes


New Trump Order means Insurance has to tell you how much things cost?

January 03, 2020

Good morning, Ladies and Gentlemen.

Welcome to the people processes podcast where we dive deep into the tools, laws and processes that you need to scale and grow your people processes. I'm your host, Rhamy Alejeal and I'm the CEO of people processes. My company helps organizations all across the United States streamline, optimize, implement, and revolutionize their HR operations. We've helped hundreds of companies, thousands of HR leaders across the world get their people processes right. Today, I'm excited to dive in a little bit into a new Trump department of labor health and human services regulation that talks about insurance regulation, how fun, how sexy, how crazy, but this insurance regulations a little different. It says that insurance companies are going to have to disclose how much you will pay for a service before you get it. Whoa. Before we dive too deep, I just want to ask you to please subscribe to our podcast. You can find us on iTunes, Google podcasts, Spotify, Stitcher, pretty much any pod catcher you like. We're there. You can also subscribe to peopleprocesses.com which is what I love because we give you exclusive subscriber only content in there, like our new on-boarding checklist for 2020 with updated information about the four pretty cool setup. Check it out at peopleprocesses.com.

All right, let's dive right into this thing. So what is Trump doing? Okay. On November 27th, 2019 the U S department of labor, health and human services and the treasury jointly issued a proposed rule. That rule is actually linked on the peopleprocesses.com website if you want to read it in depth yourself. That rule is going to require group health plans and health insurance issuers in the individual and group markets to disclose price and call sharing information upon request to participants, beneficiaries and enrollees or their authorized representatives.

So that means your actual plan participants, your employees, their spouses and their kids, if they ask the proposal would give consumers real time personalized access to call sharing information including an estimate of their call sharing liability for all covered healthcare items and services through an online tool that most group health plans and health insurance issuers would be required to make available to all of their members and even in paper form at the consumer's request. Good Lord, I can't even imagine. Maybe that'd be a two week process to get a letter in the mail or something. This is going to help consumers compare costs between specific providers before receiving care. So imagine you know you need a knee surgery rather than knowing your deductible and your out-of-pocket and assuming, all right, well this is gonna max it out or maybe it will be less or Hey, my doc said it'd probably be around three grand and then trying to figure out what that would mean.

You could use the online tool, look up specific pre-negotiated rates with specific carriers or with your insurance carrier, with specific providers and get an actual estimate of what you would pay given your deductible spend so far, your max deductible, your max out of pocket, your co-insurance rate and their negotiated rate with that provider. It would allow you to shop providers. This could be huge. Together the agencies concluded that the additional price transparency efforts are necessary to empower a more price conscious and responsible healthcare consumer, promote competition in the healthcare industry and lower the overall rate of growth in healthcare spending. Look, I don't care what your politics are. Healthcare spending has gone crazy for a long time. Really since the mid 2000's before Obamacare. Though Obamacare really added some costs in there too. It's been a roughing and one of the reasons is that employees and just consumers in general can't shop you.

It's like you went to best buy and you had to just trust the best. And he's like, I want a TV. And then he goes and picks it...