Small Clients Pay For The Big Box Claims
Offering healthcare benefits is not only essential to attracting and retaining top talent, but it’s also a fundamental aspect of caring for the people who keep your business running. But what if the system you’re paying into is rigged against you?
You may not realize it, but small companies like yours are often footing the bill for the healthcare of massive corporations.
The irony is that you might believe you’re protected when you sign up for a plan that’s used by big-name, country-wide corporations, thinking, “If this plan works for them, surely it’s good enough for us.”
Unfortunately, that’s where the story takes a turn.
There’s a harsh reality that few small business owners understand: you are not the favored client. For insurance companies, it’s the giants—the marquee clients with tens of thousands of employees—who get preferential treatment.
The system is designed in such a way that insurance companies are terrified of losing these massive accounts.
And to keep these top-tier clients happy, they’ll bend over backwards to retain them—even if that means shifting the costs of their healthcare down the line to smaller businesses like yours.
It’s a system that feels inherently unfair, yet it continues to persist. What happens is a cost shift from the big guys to the small guys. The Affordable Care Act (ACA) mandates that insurers in Fully Insured plans guarantee a profit margin of 15%-20% on claims. That’s been the case since 2010. This means the more money that’s spent on healthcare claims, the more profit the insurance companies rake in. There’s no real incentive to control costs because their margin is locked in.
Imagine running a business where you’re guaranteed 15%-20% profit on every dollar spent—who wouldn’t want to see more dollars flow through the system?
Large companies, like those employing 20,000 or more people, are marquee accounts for insurers. These are their crown jewels—the clients they’ll do anything to keep. From a business perspective, insurers want to flaunt these clients.
They want their logo on the insurance cards of federal employees, state employees, and the employees of Fortune 500 companies. It’s free marketing, and it reinforces their image as “the best in the business.”
What small employers don’t realize is that while these marquee accounts enjoy tailored deals that reduce their healthcare costs, smaller employers are left picking up the tab. This dynamic has been in place for decades, and unfortunately, it shows no signs of stopping. It’s a cycle where the insurance companies make more money, the big companies save on costs, and smaller businesses are left to absorb the difference.
Under the ACA, the guarantee of a 15%-20% profit on healthcare claims creates a perverse incentive for insurers. The more expensive the medical bills, the bigger the paycheck for the insurance companies.
And while the insurance giants make more money, small businesses see their premiums rise year after year. It’s a system where there’s no motivation to lower healthcare costs—because why would the insurance companies want to reduce their profits?
Small businesses, therefore, are not just paying for their own employees’ healthcare. They are, in essence, subsidizing the savings that insurance companies provide to their biggest clients. The more those marquee clients save, the more smaller employers end up paying.
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Now you know… The current system is stacked against small employers, but with the right tools and insights, there’s a way to break free from being the donor in this unfair system.
The decision to move away from fully insured plans is not just a financial one—it’s emotional. It’s about breaking away from the frustration of feeling like a small player in a big game. It’s about knowing that, by choosing self-funding, you’re creating a healthier, more secure environment for your business and your employees, while securing your financial future.
As a small or medium-sized business owner, you already wear many hats, and the weight of rising healthcare costs can feel overwhelming.
Imagine the relief of knowing that every dollar spent is going directly toward the healthcare of your team—your people—not funneled into some opaque pool that prioritizes others. The transparency of self-funded plans gives you the peace of mind that comes with knowing exactly where your hard-earned money is going.
It also allows you to tailor your plan to meet the specific needs of your workforce, fostering a sense of personal investment in their physical and mental well-being.
No longer are you at the mercy of a large insurer making decisions about what’s best for your employees—you hold the reins, and that creates a deeper connection between you and the people you care about.
Escape the system, or just continue feeding it… Your gateway is here >>