Reducing Healthcare Costs: How TEG Health Employers and Employees with Zero Out-of-Pocket Services

Mae Cornes, November 14, 2024 - https://www.laweekly.com/reducing-healthcare-costs-how-teg-health-employers-and-employees-with-zero-out-of-pocket-services/

Healthcare costs in the United States have become a growing challenge for companies and their employees. Employees frequently face high deductibles and co-pays, forcing them to delay or even avoid necessary medical care. For companies, rising premiums, and complex administrative costs only add to the financial strain. Balancing these costs with offering comprehensive healthcare benefits has become increasingly difficult.

A survey by the Kaiser Family Foundation showed that the average annual premium for employer-sponsored family health coverage exceeded $22,000, a figure that continues to climb. Many businesses pass some of these costs on to employees already dealing with high living expenses. This situation leaves many people feeling stuck, unsure whether they can afford to visit a doctor.

Traditional Barriers to Affordable Care

In typical healthcare insurance systems, financial and logistical barriers are common. Even with employer-sponsored insurance, employees still have to pay out-of-pocket costs for doctor visits, mental health support, and urgent care services.

On the employer side, managing healthcare plans is not easy. They must handle complicated administrative fees, process healthcare claims, and deal with constant changes in healthcare laws. These hurdles add even more costs to running a business.

A report from the National Business Group on Health in 2022 predicted that healthcare costs for employers would rise by about 6.5% every year. Issues like chronic diseases and needing more specialized care drive these rising costs. Sadly, traditional insurance models, which often involve high premiums and employee co-pays, do not do enough to control these costs or improve the quality of care employees receive.

The TEG Health’s Approach: No Out-of-Pocket Costs

TEG Health has developed a new way to handle healthcare for self-insured companies. Removing deductibles and co-pays makes it easier for employees to access healthcare without worrying about costs.

“Our approach is simple: eliminate financial barriers to healthcare, so employees get the care they need, and employers reduce their overall costs,” says Bill Koehler, CEO of TEG Health.

TEG Health’s plan includes access to services like primary care, urgent care, weight management programs, and mental health care. TEG Health encourages employees to take care of their health early by offering these without co-pays or deductibles. This can prevent small health issues from becoming major, costly problems.

Michael Neal, CFO of TEG Health, points out that this system is especially helpful for businesses with many low-wage workers. “For many employees, even a $20 co-pay can be prohibitive. By removing these costs, we’re helping them access healthcare and improving overall employee satisfaction and retention,” he says.

Benefits for Employers: Lower Premiums and Fewer Admin Costs

TEG Health’s solution also saves employers money by reducing premiums and cutting down on administrative fees. Traditional insurance models come with many hidden costs, including high administrative fees that drive up premiums. TEG Health uses a more efficient system by partnering with high-performance healthcare providers and using electronic medical records (EMRs). This reduces the paperwork, makes claims processing faster, and lowers the overall cost of managing healthcare.

“We wanted to create a system where everyone wins—employees get care without financial stress, and employers save on premiums,” says Lenny Cagno, Director of Strategic Partnerships. “Our focus on administrative efficiency and transparency means that companies can cut costs without compromising the quality of healthcare their employees receive.”

By streamlining these processes, TEG Health allows employers to focus on providing good healthcare to their employees while controlling costs. This setup also makes healthcare providers’ jobs easier by reducing non-clinical work so they can focus more on patient care.

Ensuring Compliance with Healthcare Laws

Another major challenge for self-insured companies is keeping up with healthcare regulations like the Employee Retirement Income Security Act (ERISA) and the No Surprises Act. Failing to follow these rules can lead to heavy fines and legal issues. TEG Health helps companies navigate these complicated regulations and ensures that they stay compliant. TEG Health offers price transparency and comparison tools, allowing employees to make smart decisions about their healthcare and protecting businesses from surprise medical bills.

“Regulatory compliance is a complex field, and it’s easy for companies to make costly mistakes,” says Neal. “We help businesses manage healthcare effectively while staying on the right side of the law.”

Extensive Pharmacy and Dental Coverage

Beyond the standard healthcare services, TEG Health’s model also includes a broad pharmacy network. Through partnerships with Costco Health Solutions and other providers, employees can access prescription drugs without extra costs. This network covers more than 19,500 pharmacies across the country, ensuring that employees can get the medications they need without financial stress.

TEG Health also offers comprehensive dental coverage, which includes regular check-ups, cleanings, X-rays, and even orthodontic services for dependents up to age 26. Offering these dental services at no or low cost ensures that employees’ overall health is addressed, not just their medical needs.

An Advanced Healthcare Solution

As healthcare costs continue to rise, TEG Health’s approach could become a key option for companies looking to manage costs while improving care for their employees. This model provides a smarter, more efficient way to handle healthcare by eliminating out-of-pocket expenses for employees and cutting premiums for employers.

With its focus on technology, simple administration, and preventive care, TEG Health offers a healthcare solution that benefits everyone involved. Cagno sums it up, “We believe this model is the future of healthcare for self-insured companies—it’s a smarter, more efficient way to manage costs while improving employee health and satisfaction.”