As a Texas-based benefit adviser, I can speak from experience about the article Building value through health data transparency. In January 2008, Texas passed House Bill 2015, under which for groups between two and 50 lives I can get data on month-by-month covered lives, premium paid and claims paid. I can also get a listing of large claims in excess of $15,000. On groups with 50+ lives, I get all kinds of information on ER visits, office visits, prescription drugs, etc.
Insurance carriers here will accept the HB2015 reports in lieu of employees answering medical questions on small group applications, which has really sped up the underwriting process. My clients and I can also make informed decisions at renewal, but more importantly, we can help reduce claims through education. Too many ER visits? We can educate employees on urgent care centers, which are more cost effective. Large claims due to preventable disease? Voila – a wellness program!
