The $25,000 Elephant in the Room

The cost of group healthcare plans is the elephant in the room for businesses, municipalities, and schools across the country. The average cost of an employer-sponsored family plan has climbed to $25,572 per year, with workers paying about $6,296 of that. Since 2020, costs have jumped more than 30%, while wages have grown far more slowly. For many organizations, that gap is breaking budgets. For a family, that is like paying for a brand new car every year.

Families also face growing out-of-pocket maximums. On the ACA marketplace, the cap can reach $18,400 for a family. Employer plans are somewhat lower, but limits of $7,500 to $10,000 are common. For a teacher or city worker earning $45,000 to $70,000, that is a heavy financial strain. These costs affect not just wallets, but workplace morale, productivity, and even whether an employer can keep its doors open.

In my book Total Benefit Control I lay out innovative strategies that are helping organizations take back control of their healthcare spending. By embracing self-funding, transparent pricing, and direct primary care, employers can lower costs while giving employees better access to care. Often that care is available with little or no out-of-pocket expense. And in many cases, total spending on benefits can actually decline year over year.

The $25,000 elephant is real, but it is not immovable. Tackling healthcare costs requires the courage to face the problem directly and the willingness to explore new approaches. The good news is that solutions already exist and they are working. Waiting until the next renewal almost certainly guarantees that the elephant of cost may step on you.

Like eating an elephant, the way forward is one bite at a time. For businesses, schools, and municipalities, that first bite is deciding not to ignore the problem.

For more information, give me a call today.

Glen Riensche, CLU, RHU, REBC 402-202-2550 [email protected]