What do insurers say about health insurance premiums?

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To find out what insurers are saying about health care premiums, NJBIZ conducted an email interview with Michael Considine, vice president of consumer, small group and middle market markets at Horizon Blue Cross Blue Shield of New Jersey.

NJBIZ: Why do you think so many people, even those with employer-sponsored insurance, find the cost of health insurance premiums a burden?

Michael Considine: Nearly 90 cents of every Horizon rewards dollar goes directly to hospitals, doctors, pharmacies and others to pay for health care services or products for our members. There is no question that healthcare costs, which ultimately determine premiums, are rising and are due to a variety of factors, from breakthrough drugs and technologies that are priced high to higher prices charged to those who provide healthcare services or offer products. Taken together, these factors have caused the cost of premiums for private insurance, including employer-sponsored plans, to rise faster than wages for years.

Anyone who pays for their health care – through insurance premiums or out of pocket – is feeling the impact of higher costs. New Jersey’s Healthcare Affordability, Accountability and Transparency Program, launched by Governor Phil Murphy in 2021, recognizes that New Jerseyans are facing a healthcare affordability crisis.

Their most recent reports acknowledge the complexity of the challenge but cite provider price increases, rather than higher utilization or an increase in illness cases, as the primary cause of rising costs.

Q: What can companies do to reduce their premiums and therefore the premiums they pass on to their employees?

A: Horizon works closely with its customers to help them find the right insurance solutions. We are constantly developing new products and options to help you provide your employees with higher quality, more affordable insurance. At the same time, we partner with physicians and hospitals who share our commitment to reducing costs through improving quality and more closely tying the way we pay for our care to the quality of outcomes that care produces for our members. These pay-for-performance models are effective partnerships that deliver better outcomes and reduce the overall cost of care. Beyond working with their wireless carrier to take steps to reduce costs, New Jersey employers should use their voice to support the goals of New Jersey’s HART program. Reducing costs is the responsibility of everyone involved in healthcare.

Q: Can we talk about what you as an insurer are doing to curb or reduce premiums?