MADISON – Legislation authored by Sen. Rob Hutton (R–Brookfield) to ensure employers have the tools they need to continue offering quality, affordable health insurance benefits for their employees was approved by a Senate committee on Friday.
The legislation, Senate Bill 703, addresses the explosion in the cost of employer-sponsored health coverage. With more than two-thirds of Wisconsin workers getting coverage through their employer, the alarming pace of premium increases with no relief in sight threatens healthcare access for a large majority of citizens across the state.
The average annual premium for employer-sponsored family coverage has now surpassed $25,000 per year, with employers reporting premium increases in the double digits year after year. A growing number of employers are being forced to pass some of the increases along to employees and many have even been priced out of offering health benefits altogether. Wisconsin employers consistently say the cost of healthcare is their most significant challenge.
“Like the overall cost of healthcare, the soaring cost of insurance coverage to both employers and employees is simply unsustainable. Every dollar an employer spends on these unsustainable increases is a dollar that could otherwise go to raises or new hires, so this has a direct impact on the quality of life for people throughout the state,” Hutton said.
One of the biggest challenges employers face in controlling costs is a lack of transparency when it comes to their own health plan data—information that’s critical to plan management. Some insurers and administrators of self-funded plans have begun withholding claims data and utilization information from the sponsoring employer, making it impossible for them to switch to more cost-effective self-funded plans or shop around for a different insurance company.
SB 703 will establish in Wisconsin law that employers who sponsor group health insurance plans are the rightful owners of data relating to the individuals covered under those plans and will require those that maintain that data to make it available to the sponsoring employer. This includes claims data, utilization reports, and any other information necessary to understand and manage healthcare costs.
The bill works in tandem with federal laws that protect employees and their health information. To ensure data privacy continues to be respected, the bill requires a HIPAA-compliant privacy officer to act as a fiduciary for sensitive data, responsible for safeguarding the privacy and security of personal health information. This is the same standard in place now that guides how plan sponsors can access data their data when it’s maintained by third parties such as insurers or plan administrators.
“Employers consistently tell me about the urgency of addressing healthcare costs and that timely access to data is critical to managing those costs. They want to shop around or design their own self-funded model, but the information they need is often delayed or withheld altogether,” Hutton said.
“Without this data, employers are left guessing about what is causing double-digit premium increases year after year and they lose opportunities to design a plan that better fits the needs of their employees. This bill helps ensure transparency, which is fundamental to any functioning market,” Hutton said.
SB 703 cleared the Senate Committee on Licensing, Regulatory Reform, State and Federal Affairs on Friday and will now be considered by the full Senate.
