TxProl @ 72, your company’s HR department should have at least one person who is a specialist in understanding the insurance companies’ offers and negotiating the best plan the company can get. Those offers are determined by many factors, of course. Here are a few. The insurance companies hold internal meetings where the actuarial department says, “For what they want and their mix of employees, we’ll have to charge this much in premiums to make any money,” while the marketing department says, “We can’t make the sale at that price, so we’ll have to charge less.” The marketing department usually wins while the actuarial department is generally right, and this is one reason health insurance premiums go up every plan year to make up for last year’s miscalculation. Many state insurance regulators require that all policies offered within the state must include specified coverages that your fellow employees may neither need nor want, but must pay for. In general, the bluer the state, the more such coverages. There are many other non-transparent factors that go into setting premiums. For example, if your company employs a large number of young people your premiums will be significantly higher to cover all the babies young families produce. It only takes a preemie a couple weeks in the NICU to make everyone in the group’s rates soar.

You’re not delusional in thinking your company should have some patient advocates. They’re called the HR department. That’s another hat the insurance specialist would wear. I’m surprised they don’t already do this for you.

I will say this: an additional $5K per employee per year is a whale of a lot of money, half a million dollars for a company of 100. I suspect that unless your company is in a very lucrative business, it will have to take that $5K from the employees’ compensation, or have a layoff, or indefinitely postpone its expansion plans….maybe that’s what happened to your patient advocate(s). If not and they want to hire one, let me know!