How one nonprofit has made employee health care benefits affordable for 20+ years

October 04, 2021

Written by Jim Molis

Mid Florida Community Services has paid 100% of the health care premiums for its employees for as long as the organization’s current Chief Financial Officer Kris Bates can remember. That’s a long time considering he’s been with the nonprofit for 35 years.

“Our CEO, who was here for 44 years said, ‘If you work here, you shouldn’t have to worry about your health insurance,’” said Bates.

Controlling benefits budgets has become harder for employers as health care costs have risen steadily. The average premium for single coverage increased 20% from 2015 to 2020 while the average family premium rose by 22%, according to the Kaiser Family Foundation’s 2020 Employer Health Benefits Survey.

“The biggest challenge is keeping rates as low as possible, so we can still pay 100% of an employee’s premium,” Bates said, noting the nonprofit covers only the full premium for employees and not their dependents.

But Mid Florida Community Services has kept its premium increases minimal as it has continued to address the causes of poverty through a comprehensive service delivery approach, like through education programs for children. “Probably the biggest increase over the last 10 years might be 7% in one year. It’s pretty stable,” Bates said.

Managing its benefits proactively and supporting employee health have been key.

Managing employee benefits

As a nonprofit that depends mostly on government funding, Mid Florida Community Services has little room for budget increases of any kind and must ensure health care benefits remain affordable when it comes time to renew. So, when that time comes each year, Mid Florida Community Services first compares its claims from the prior year to its premiums to confirm it has not paid for more coverage than employees have used.

The organization then projects what its needs may be for the coming year. Once it has an estimate, it looks at ways to avoid or minimize any premium increases.

The nonprofit has avoided large increases in premiums in part by adjusting copays and out-of-pocket shares for employees. But it is working to control those costs as well so employees can afford care relative to their incomes, Bates said.

Mid Florida Community Services also participates in a shared savings program that its insurer, Florida Blue, Florida’s local Blue Cross and Blue Shield health plan, offers for fully insured organizations. In years that it has paid for more coverage than it has used, the nonprofit has received surplus checks from Florida Blue and has used the funds to defray costs for the coming year.

Supporting employee health

Helping employees stay healthy has also helped Mid Florida Community Services control its health care costs. For example, the nonprofit has worked with Florida Blue to maintain consistency in its provider networks so employees can continue to get the care they want.

Employees also have taken advantage of the telemedicine benefits Florida Blue provides as well as apps for mobile devices and other tools offered by the insurer to make it easier to get care, Bates said. “All of our employees have cell phone access so that helps big time,” Bates said.

While many employees navigate care and appointments online, like by finding a doctor or checking the status of claims, they can get in-person and virtual help through one of the insurer’s Florida Blue Centers as well. They can also get preferred pricing at GuideWell Emergency Doctors high-acuity urgent care clinics or Sanitas Medical Centers through Florida Blue.

“If people are sick, they don’t want to wait a week or 10 days to see their doctor. They can go to a clinic and get what they need to fend off any sickness,” Bates said.

Working with Florida Blue for 20 years

Though Mid Florida Community Services has not invested in any wellness programs, its employees have availed themselves of wellness opportunities, including chances to learn about nutrition or participate in exercise programs offered through Florida Blue. The insurer has offered to bring services to Mid Florida Community Services locations as well.

Whether it has been connecting employees to health resources or assisting the organization with premiums and coverage options, Florida Blue has been integral in keeping health care affordable for Mid Florida Community Services employees, Bates said. After 20 years of working together, the insurer and the nonprofit know each other well.

“We like having the longevity because we know that in a bad year, our rates may go up but they’re willing to adjust those rates because they know we’re not shopping around for a lower rate,” Bates said. If large premium increases are imminent, Florida Blue will work with Mid Florida Community Services to lessen the impact, he said.

As a nonprofit organization with a strict budget, Mid Florida Community Services is doing what it can to keep health care affordable for its employees, just as its long-time CEO desired.

Learn more about Florida Blue Employer Plans

Florida Blue, an independent licensee of the Blue Cross and Blue Shield Association, has been providing health insurance to Florida residents for 75+ years. Driven by its mission of helping people and communities achieve better health, the company serves more than 5 million health care members across the state.

Jim Molis is a freelance writer with The Business Journals Content Studio.

This article was originally published by Orlando Business Journal.