It feels as though open enrollments ended yesterday and we are already starting medical renewals. As budget challenges and competition for attracting and retaining quality staff continues, the need to forecast next year’s medical costs and begin the process of reviewing medical and pharmacy options is on our doorstep.

Many public entity medical renewals run on the fiscal year, which means August through December is a critical time. Below are a few tips to help you manage the process:

1. Plan Utilization Review: Review the current health of your population, medical and pharmacy utilization and any gaps in coverage. Your carrier, TPA, and consultant should be working in tandem to provide detailed information, so those considerations are addressed while strategizing for next year.
2. An Eye on Claims: Now is the time to dive deep into claims to help project how your employees will utilize their medical benefits for the following plan year. Knowing how your employees consume medical and pharmacy coverage, and how your carrier and TPA are paying for claims, is essential!
3. Forecasting: Once you have the data and an idea of future costs, budgets, and necessities (disease management needs, employee assistance programs, wellness, etc.) you can make an informed decision on the three most significant choices: do you make changes to your consultant, carrier or pharmacy? Will changing any of the three options save you $$$ and is there a genuine need—financial, structural and or service related—to make the change?  
4. Innovative Solutions: Your broker/consultant should always be looking out for your best interest financially while meeting yours and your employees’ well-being needs. It’s a delicate balance that requires precise expertise and an understanding of the unique culture and needs of your population.

There are various approaches to meet the challenge of mitigating a high-cost population while setting up a school district, municipality, county or other public entity for long-term stability and success. Valley Schools and HPACT employs innovative strategies based on our members’ data, expectations, and needs. As the only nonprofit benefits consultant working with public entities in the state, Valley Schools and HPACT has a proven track record of delivering a direct savings of 30% or more over for-profit consultants, while successfully realizing a 3.54% five-year average medical premium increase for all members. Contact Valley Schools today to join at no cost and see how we can help you save!