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Medications known as GLP-1s (glucagon-like peptide-1 receptor agonists) have gained attention for helping people manage weight and related health conditions. Many health plans, including BCBS, Priority Health and UHC in Michigan, do not cover GLP-1 drugs when prescribed specifically for weight loss, which can leave employees wondering what, if any, alternatives exist. 

The good news is that insurance coverage isn’t the only path. There are legitimate, medically supervised ways to access these medications on a self-pay basis. This overview explains what GLP-1s are commonly prescribed for and outlines options employees may consider if insurance coverage is limited or unavailable. 

When Can GLP-1 Medications Be Prescribed?

GLP-1 medications are FDA-approved for certain medical conditions, and providers may also prescribe some of them off-label based on clinical judgment.

Common diagnoses include:

• Type 2 diabetes 

• Obesity (generally a BMI of 30 or higher) 

• Overweight (BMI of 27 or higher) when combined with a related health condition such as high blood pressure, high cholesterol, sleep apnea, or insulin resistance

Some GLP-1 medications approved for diabetes are often prescribed off-label for weight loss. This is a common and legal practice when a provider believes it is appropriate for a patient’s health needs.

GLP-1 Medications You May Hear About

You may recognize some of these brand names: 

  • • Wegovy® (semaglutide) – approved for weight management 
  • • Saxenda® (liraglutide) – approved for weight management 
  • • Zepbound® (tirzepatide) – approved for weight management 
  • • Ozempic® (semaglutide) – approved for Type 2 diabetes; commonly used off-label for weight loss 
  • • Mounjaro® (tirzepatide) – approved for Type 2 diabetes; commonly used off-label for weight loss 
  • • Trulicity® and Victoza® – primarily prescribed for diabetes, with potential weight-related effects 

These medications generally work by helping regulate appetite, slowing digestion, and increasing feelings of fullness. Results and side effects vary from person to person. Many users report reduced appetite and weight loss, while others experience nausea or gastrointestinal discomfort, especially during early dose increases.  Most people experience only mild side effects with GLP-1 medications, but in rare cases, more serious side effects can occur. 

What to Do If Your Health Plan Doesn’t Cover GLP-1s for Weight Loss

If your plan excludes weight-loss medications, you still have several legitimate self-pay options that involve licensed clinicians and regulated pharmacies. 

Telehealth and Virtual Care Programs

Several telehealth companies offer medical evaluations for weight management and GLP-1 prescriptions without involving your insurance. 

Examples include (but are not limited to): 

• National telehealth providers such as Hims & Hers, CareVolidate/CareGLP, Ro, Sprout, MEDVi, SkinnyRx, MyStart, Noom, etc. or retail-based programs affiliated with major pharmacies. 

• TrumpRx is a federal prescription drug pricing initiative designed to help individuals access lower-cost medications by reducing supply-chain markups. It does not provide medical care or prescriptions, but it may help locate more affordable pricing once a valid prescription is obtained.  This program is expected to rollout in spring 2026. 

Reported pricing projections suggest: 

• Injectable GLP-1 medications may be available at significantly reduced monthly cash costs compared to typical retail pricing. 

• Oral GLP-1 options, as they become available, may be priced even lower. 

• Patents expire starting in 2026 in countries like India, China, Brazil and Canada.  Patents in the US remain in place until the late 2020’s at the earliest.  When a medication comes off patent, cheaper generics/biosimilars tend to come to market. 

A Note About Compounded GLP-1 Medications

Some pharmacies offer compounded versions of GLP-1 medications. These are not FDA-approved and can vary in strength, formulation, and quality. If you are considering compounded medications, it’s important to discuss the risks and benefits with a licensed healthcare provider and use a reputable pharmacy. 

Avoid online sellers that do not require a prescription. Counterfeit and unsafe products remain a concern in this space. 

Helpful Tips for Employees

• Ask your provider to document your diagnosis clearly; this can help with eligibility across programs. 

• Compare self-pay pricing between telehealth services, retail pharmacies, and discount programs. 

• HSA and FSA funds may be used for eligible prescription expenses. 

• Medication works best when paired with nutrition, physical activity, and lifestyle support. 

Bottom Line

While insurance coverage for GLP-1 weight-loss medications remains inconsistent, employees are not without options. Telehealth platforms and cash-pricing programs can help bridge the gap—often with more predictable costs and ongoing clinical support. 

We know that as HR professionals, you’re probably receiving a lot of questions about GLP-1s.  Please feel free to share this blog with your employees. As always, if you have any questions, please reach out to your Rose Street Advisors’ Relationship Manager. 

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Employers No Longer Need to Automatically Distribute ACA Reporting 1095 to Employees

Summary of Key Changes to ACA Reporting Requirements

On December 23, 2024, the Employer Reporting Improvement Act and the Paperwork Burden Reduction Act were signed into law, significantly altering the requirements for distributing IRS Forms 1095-B and 1095-C to employees and covered individuals. 

ACA Reporting

As a reminder, the Affordable Care Act (ACA) required that Applicable Large Employers (ALEs) and health insurers report health coverage information to employees and covered individuals using Forms 1095-B or 1095-C. These forms were filed with the IRS alongside Forms 1094-B or 1094-C to determine if employers owed Employer Shared Responsibility Payments ("penalties"). 

Key Changes Introduced by the Acts

1. Distribution of Forms 1095-B and 1095-C

•  Employers and insurers are no longer required to provide these forms to all eligible employees and/or covered individuals. 

•  A form must be provided only upon request, and it must be delivered by the later of: 

•  January 31 of the year following the coverage year, or 

•  30 days after the request date.

•  Employers must notify employees of their right to request these forms. However, a model notice hasn’t been created yet.  Employers are expected to make a good-faith effort in drafting this communication.  Contact your Relationship Manager if you would like assistance with this communication.   

•  If employees have consented (or haven’t actively requested to NOT receive electronically), the communications and forms can be delivered electronically.  Contact your Relationship Manager for more information on Electronic Safe Harbor communications.

2. Extended Response Time for IRS Penalty Letters and Statute of Limitations for Penalties

• Employers previously had a 30-day window to respond to IRS letters, often leading to rushed investigations and responses. Additionally, there was no statute of limitations for assessing penalties, leaving employers exposed to potential liabilities indefinitely. 

• Employers now have 90 days, instead of 30, to respond to IRS Letter 226J before any further action is taken.  This extension provides employers more time to investigate and address errors or missing information that often result in proposed penalties. 

• A six-year limit now applies to the IRS’s ability to assess penalties, starting from the later of: 

•  The due date of the 1095 Forms, or 

• The actual filing date.

Effective Dates

•  The Paperwork Burden Reduction Act applies to calendar years after 2023. 

•  The Employer Reporting Improvement Act applies to returns due after December 31, 2024. 

•  The distribution requirements for Forms 1095-B and 1095-C will no longer apply for returns due January 31, 2025, covering the 2024 calendar year. 

ACA Reporting is Still Required!

•  Employers must still prepare and file Forms 1095-B and 1095-C with the IRS, along with the associated Form 1094. 

•  These Acts only modify the distribution requirements for employees and covered individuals in group health plans. 

As always, if you have any questions, please reach out to your Rose Street Advisors’ Relationship Manager. 

Ben Cohen

CEBS | Employee Benefits Relationship Manager

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As employers continue to field questions about rising ACA Marketplace premiums, there is a new development worth watching closely. On January 8, 2026, a bill was introduced in Congress aimed at addressing the expiration of enhanced ACA subsidies. If the House and Senate agree and pass this legislation, it could significantly change the landscape for individuals enrolled in Marketplace coverage.

While details are still emerging, here’s what employers should know—and why this remains an evolving situation.

A Brief Look Back: ACA Subsidies Before and After 2021

Prior to 2021, ACA premium subsidies were available only to individuals with household incomes between 100% and 400% of the federal poverty level (FPL). Many individuals above that threshold paid the full cost of Marketplace coverage, which often made premiums feel unaffordable.

The American Rescue Plan Act (ARPA), passed in 2021, temporarily expanded these subsidies by:

• Increasing subsidy amounts for those already eligible

• Extended eligibility beyond the 400% FPL cap

• Capping the percentage of income individuals would pay toward Marketplace premiums

When those enhanced subsidies expired, many individuals saw significant premium increases or lost eligibility for assistance altogether. 

What the Newly Introduced Bill Could Change

If Congress passes the bill introduced on January 8, 2026, enhanced ACA subsidies could be reinstated or modified in a way that reduces premium costs for individuals enrolled in Marketplace plans.

While the intent of the bill is to improve affordability, the final impact will depend on how the legislation is passed and implemented. Until the law is finalized and guidance is issued, many key questions remain unanswered.

Key Unknowns Employers Should Be Aware Of

Even if the bill passes, there are several areas of uncertainty that employers and employees should keep in mind, including:

• Timing: When would subsidy changes take effect, and would they approve retroactively?

• Eligibility Rules: Will subsidy income thresholds mirror prior ARPA rules, or will new limits be introduced?

• Duration: Are the subsidies temporary again, or intended to be extended longer-term?

• Employee Action Required: Will current Marketplace enrollees need to reapply or update their information to access enhanced subsidies?

• Interaction With Employer Coverage: Will any guidance be issued affecting affordability determinations or employer reporting obligations?

Until regulatory agencies release formal guidance, these questions remain open. 

What This Means for Employers Right Now

Until regulatory agencies release formal guidance, these questions remain open. 

At this stage, employers are not requires to take any immediate action. However, proactive communication can help manage employee expectations:

• Reinforce that Marketplace premium increases alone are not a qualifying life event for employer plan enrollment 

• Acknowledge that legislative changes may be forthcoming, but details are still evolving

• Encourage employees enrolled in individual coverage to stay informed and monitor official Marketplace communications 

Employers should avoid making assumptions or promises until legislation is finalized and guidance is issued. 

Our Team Is Monitoring Developments Closely

We understand that uncertainty around ACA subsidies can create confusion for both employers and employees. Our team is actively tracking this legislation and related regulatory guidance. As more information becomes available, we will provide timely updates and practical insights to help employers navigate the changes.

If you have questions or would like to discuss how potential ACA subsidy changes could impact your workforce, please reach out to our team. We're here to help you stay informed and prepared.  

Justine Dickens

EMPLOYEE BENEFITS ADVISOR

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1. Protect your family

2. Protect your business partners

3. Protect your employees

It doesn’t have to be anymore complicated or complex than the fundamental reasons listed above. A person's income and their ability to continue to earn an income in the future is their most valuable asset. Disability/Income Replacement Insurance protects a person’s ability to earn income if they become physically or mentally unable to work.  This type of coverage allows a person to continue to provide for their family by still receiving an income, it allows business partners to protect each other’s interests in the case a partner’s disability disrupts business and it may prevent an employer from hastily selling his/her business in case of a disabling event.    

As a valued executive benefit for your high-income earners, additional Disability/Income Replacement Insurance can be an easy add-on to complement your existing group long-term disability plans. If you have any questions or would like to connect with a Rose Street Advisor, please contact us today.

Rob Hunt II

LIC & CLU® | Principal & Chief Executive Officer

As Principal and CEO, Rob spearheads the vision, drive for growth, and pursuit of excellence at Rose Street Advisors. Rob loves being outdoors with his wife Erin and kids. He has slalom skied for the past 35 years, never missing a season. He also enjoys spending time at the lake and on the golf course.

This material and the opinions voiced are for general information only and are not intended to provide specific advice or recommendations for any individual or entity. To determine what is appropriate for you, please contact your Rose Street Financial Professional. Information obtained from third-party sources are believed to be reliable but not guaranteed.

 

Securities and Investment Advisory: Services offered through M Holdings Securities, Inc., A Registered Broker/Dealer and Investment Advisor, member FINRA/SIPC. Rose Street Advisors is independently owned and operated. Rose Street Advisors is a member firm of M Financial Group. #4491815

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Understanding Non-FMLA Leave and Health Coverage: Employer Responsibilities

When an employee takes leave that is not covered under the Family and Medical Leave Act (FMLA), employers often have questions about how to handle health insurance coverage. Unlike FMLA leave, which mandates continued health benefits, non-FMLA leave operates under different rules. Employers must navigate federal and state laws, company policies, and benefit plan provisions to ensure compliance. Here's what you need to know. 

Can an Employer Terminate Health Coverage During Non-FMLA Leave?  

Yes, in some cases an employer may terminate health coverage during non-FLMA leave, but this depends on several factors:

    • Employer Policies: If company policies specify that health coverage continues during leave, the employer must follow its own           policies. 

    • Insurance Plan Rules: Some group health insurance policies have specific provisions about continued coverage during                    unpaid leave. Employers should review their plan documents to determine eligibility requirements. 

    • Americans with Disabilities Act (ADA) and Other Regulations: If the leave qualifies as a reasonable accommodations under          the ADA, the employer may be required to maintain health coverage 

Employers should be consistent in applying their policies to avoid discrimination claims. 

 

What Notices Need to Be Provided?  

If an employer decides to terminate or modify health coverage during non-FMLA leave, proper notice must be given to the employee. Notices may include: 

    • Plan Documents & SPD (Summary Plan Description): Employees should already have received details about health coverage        continuation in their SPD. 

    • COBRA Notification: If coverage is terminated and the employer has 20 or more employees, COBRA (Consolidated Omnibus           Budget Reconciliation Act) requires that the employee be notified of their right to continue health coverage at their own expense. 

    • State-Specific Notices: Some states have mini-COBRA laws that apply to smaller employers or provide additional protections. 

    • Internal Communication: Employers should send a written notification outlining the impact of the leave on benefits, deadlines        for premium payments, and any available options for continuation. 

How Can Employers Collect Premiums During Non-FMLA Leave?  

If an employer chooses to continue health benefits while an employee is on non-FMLA leave, they need a clear process for collecting premiums. Options Include: 

    1.  Prepayment Before Leave: Employees can pay their portion of premiums in advance before going on leave.

    2.  Payroll Deductions Upon Return: Employers may allow employees to catch up on missed premium payments through payroll          deductions once they return 

    3.  Direct Billing During Leave: Employers can set up a system where employees pay premiums directly to the company or the            insurer during their leave.  

    4. COBRA Enrollment: If an employee loses coverage due to non-payment or termination of benefits, they may elect                              COBRA to continue coverage.  

 

Should Employers Address This in Their Employee Handbook? 

Absolutely. A well-drafted employee handbook should include: 

    • Eligibility for Leave and Benefits: Clearly outline which types of leave are covered and how they impact benefits. 

    • Premium Payment Policies: specify how employees are expected to pay for their health coverage during unpaid leave.

    • COBRA and Continuation Coverage: Explain what happens if health coverage is terminated and how employees can                         maintain benefits. 

    •State-Specific Regulations: If applicable, include any state-mandated provisions for health benefits continuation. 

By having a clear and consistently applied policy, employers can ensure compliance and help employees understand their rights and responsibilities. 

Conclusion

Navigating health coverage during non-FMLA leave requires careful attention to company policies, insurance plan provisions, and legal requirements. Employers should provide clear notices, establish a fair premium collection process, and document policies in their handbook to prevent misunderstandings. By proactively addressing theses issues, employers can maintain compliance while supporting employees during their time away from work. If you have questions about your responsibilities or need assistance with non-FLMA leave, consult your Rose Street Advisors team for assistance. If you are not a current client of Rose Street Advisors, please feel free to contact us at 269-552-3200 or contact@rosestreetadvisors.com to speak to someone. 

Justine Dickens

EMPLOYEE BENEFITS ADVISOR

Justine is a devoted and meticulous team member with a passion to educate and support business partners and their employees. Since 2013, Justine’s commitment to her clients has allowed her to instill confidence and stability in the benefits packages offered to their employees. Her strengths allow her to communicate efficiently, focus on customization and understand the complexities of an ever changing industry. She is a Dale Carnegie Graduate and has her NAHU Self-Funded Certification.

When she is not working, Justine is busy running her son and daughter to their practices and games and volunteering in the community. She enjoys playing golf, hiking and spending time with her family and friends.

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If you’ve been waiting to hear the status of the Earned Sick Time Act (ESTA) before updating your leave policy, you’re in good company.

We had hoped that there would be some movement on this during the end of the year lame duck legislative session but weren’t that lucky. Fortunately, the new legislature seems to be making this a priority. The House has already passed legislation that would change several key elements. Some of those items are listed below:

•  Excludes employers with 50 or fewer employees. 

•  Excludes employeees who work less than 25 weeks per year.

•  Excludes employees who regularly work less than 25 hours a week. 

•  Allows employers to limit the carrryover of ESTA time to 72 hours. 

•  Allows employers to provide paid earned sick time at the beginning of a benefit year and avoid the carryover requirement. 

There are more details in the House bill, but these are the ones that we found addressed the most problematic aspects of the original bill when discussing the changes with our customers.

Now it’s up to the Senate to act before the current law goes into effect on February 21st.

If you haven’t nudged your state Senator, now is the time.

We’ll keep you posted on additional changes as they come along. In the meantime, here’s a link to a matrix produced by the Chamber of Commerce detailing the components of the two bills:

https://www.michamber.com/wp-content/uploads/2025/01/HB-4002-vs-SB-15-Comparison-Doc_updated-1-17-25.pdf

Kevin Brozovich

SPHR | CHIEF PEOPLE ADVISOR

Meet Kevin Brozovich, energetic entrepreneur, people-focused team-builder and HR practitioner-turned consultant. For almost 10 years, Kevin was Founder and Chief People Officer of HRM Innovations, a Kalamazoo-based Human Resources consulting firm many would consider the top in the region. After pulling his hair out making daily decisions about running the business (does it matter where the coffee comes from?), Kevin joined forces with the Rose Street Advisors team so he could solely focus on what he loves most: working with clients.

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When HR Goes Wrong

I recently facilitated an HR session for Humanergy’s High Impact Leadership Training (HILT) program. During it, a leader described a situation that was occurring at their organization. While I’m usually careful never to say this, there was no way of denying what it was - bad HR.  As soon as I said it, people started to chime in with times when they had experienced bad HR. Frankly, I was shocked and embarrassed by the examples they shared. 

That led me to ask some of my other networks what their HR experiences have been like. The responses have been humbling. As an HR professional, I think people are hesitant to vent to me about my profession, but when I asked, the flood gates opened.  

Some of the more noteworthy examples: 

•  An employee who suffered hearing loss due to an injury asked HR about accommodations under the ADA. HR suggested that the employee learn sign language even though none of her co-workers knew how to sign. 

•  A company told their existing employees that they were paying new hires more money than them so they could recruit people. 

•  An employee told HR they felt misled about the position HR had described when they started. HR said they wouldn’t conduct an exit interview when they left because they didn’t want the feedback. 

•  An HR professional who made offensive comments about an employee who was perceived to be gay. 

•  An HR professional who refused to act on a sexual harassment complaint because “that’s just what he does…” 

•  An HR professional who would openly talk about the personal and medical situations of her employees without any regard for confidentiality. 

What do we do to reduce the incidents of bad HR?

•  If you are working as an HR person, invest the time to learn the basic employment regulations. SHRM has good information, and many firms provide courses, webinars, or podcasts. Attend them. 

•  Get certified. Hit the books and take the exam. You’ll be glad you did. 

•  Consider your employees when making a decision. Ask “How would I feel if I were in their shoes?”  

•  Keep a balance. Yes, the company signs your paycheck, but if you can’t be objective when looking at an issue, you’re doing everyone a disservice. 

•  Ask for professional help when you are working on a sticky issue. 

There will always be times when HR folks will have to make difficult and unpopular decisions, but if we’re up to date on the regulations, treat people with respect, and are cognizant of the impacts our decisions make, hopefully we can limit adding any more fuel to the “bad HR” fire. 

Got a bad HR story you’d like to share? Let us know.  

Dealing with a situation that has the potential of ending up as a bad HR story on Reddit? Call us. We can help. 

Kevin Brozovich

SPHR | CHIEF PEOPLE ADVISOR

Meet Kevin Brozovich, energetic entrepreneur, people-focused team-builder and HR practitioner-turned consultant. For almost 10 years, Kevin was Founder and Chief People Officer of HRM Innovations, a Kalamazoo-based Human Resources consulting firm many would consider the top in the region. After pulling his hair out making daily decisions about running the business (does it matter where the coffee comes from?), Kevin joined forces with the Rose Street Advisors team so he could solely focus on what he loves most: working with clients.

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How Not to Terminate an Employee

Hate having to terminate employees? When you work in HR, or leadership, it comes with the territory. That doesn’t make it easy. Still, it can be necessary. Let’s start with what not to do. Recently a friend found out that his hybrid job was eliminated when he could not login to his computer from home. When he called the IT department, he was redirected to HR. Don’t be that employer. What should you do? Being a good human is a nice start. From there, you should: Include HR. If you are a leader doing this, engage your HR resource early. HR is your friend in this situation. They’ve done this before and know how to do it safely and legally. Do terminations face to face. Remote employees are the only ones you should meet online. Terminations via text, email, or worse, social media, are never acceptable. Do explain the reason. Employees deserve to know why they are being fired. It’s much easier for them to process if they understand why. Leaving them to fill in the gaps opens the door for them to speculate about reasons that are not only inaccurate, but potentially unlawful. Treat them with respect. Losing your job is hard. Kicking the person when they are down is only going to exacerbate the situation and open the door to workplace violence. Be kind, be compassionate. Provide Assistance. Especially if you recognize an employee is in a vulnerable place, make certain to connect them with a support option. Connect them to your EAP or an outplacement service.  Have a plan. No one should be fired without a well-coordinated plan to collect their things, continue their benefits, and collect their last check. Keep it calm.  Terminations in the heat of the moment are never a good idea. If things are hot, suspend the employee until cooler heads can prevail. Have a difficult situation that you need to address? Give us a call, we’re happy to help.

Kevin Brozovich

SPHR | CHIEF PEOPLE ADVISOR

Meet Kevin Brozovich, energetic entrepreneur, people-focused team-builder and HR practitioner-turned consultant. For almost 10 years, Kevin was Founder and Chief People Officer of HRM Innovations, a Kalamazoo-based Human Resources consulting firm many would consider the top in the region. After pulling his hair out making daily decisions about running the business (does it matter where the coffee comes from?), Kevin joined forces with the Rose Street Advisors team so he could solely focus on what he loves most: working with clients.

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Michigan's Minimum Wage &
Paid Medical Leave Laws -
Here We Go Again!

If you’re feeling a bit of whiplash regarding the minimum wage and paid medical leave news in Michigan, you’re in good company. Frankly, I’ve lost track of the number of times this has been the topic of the Fun Socks blog.

As a quick refresher, here’s the history:

In 2018, a petition drive was successfully headed to get both a minimum wage proposal and a provision for earned sick time on the ballot for the fall election.  The legislature at that time decided to adopt the ballot proposals, making the ballot initiatives unnecessary.  The initiatives were dropped, and the Michigan Earned Sick Time Act and the minimum wage standard were adopted.  Then, during the lame duck session after the election, the legislature significantly changed the acts by passing the Paid Medical Leave Act and Michigan’s Improved Workforce Opportunity Wage Act of 2018.  Several groups filed a lawsuit challenging the constitutionality of those Acts arguing that the legislature usurped the rights of the people to implement a ballot initiative. 

The initial court ruled that the adopt and amend process was unconstitutional, that decision was overturned by the court of appeals, which was just overturned by Michigan’s Supreme Court.

What does this mean to employers?

The Improved Workforce Opportunity Act and the Paid Medical Leave Act have been eliminated. Both will be replaced by the original ballot initiatives that voters were to consider in 2018 and will take effect February 21, 2025.

What will be the new minimum wage?

We’re not certain yet. The Michigan Supreme Court has tasked the State Treasurer with calculating the inflationary impacts that have occurred since the original 2019 effective date of the ballot initiative.

How much paid time off will we need to offer?

Employers with 10 or more employees will need to offer 72 hours of paid time off per year. It will be accrued at a rate of one hour for every 30 hours worked.

Employers with less than 10 employees still need to offer 72 hours of leave time, but only 40 of those hours need to be paid.

Does this apply to all employees?

Yes. It applies to full time, part time, and temporary employees.

What else?

Employers need to allow employees to take their paid sick time in the smallest increment of time tracked by their timekeeping system.

How should we prepare?

Theres’ some discussion that the legislature will step in with new legislation this fall. I think that is unlikely to happen during the height of a presidential election. For now, HR leaders should use the time before February to review their current policies and compare them to the Michigan Time to Care initial ballot initiative to see what changes they will need to make.

Here's the link: https://legislature.mi.gov/documents/2017-2018/initiative/pdf/MITimeToCareFINAL.pdf

The original ballot initiative for the Improved Workforce Opportunity Wage Act link is: 

https://www.michigan.gov/-/media/Project/Websites/sos/04holland/R3792_Wage.pdf?rev=f9ec92df8ffe443d85d63ee32cd82056

Questions? The HR Consultants at Rose Street Advisors are happy to help! 

Kevin Brozovich

SPHR | CHIEF PEOPLE ADVISOR

Meet Kevin Brozovich, energetic entrepreneur, people-focused team-builder and HR practitioner-turned consultant. For almost 10 years, Kevin was Founder and Chief People Officer of HRM Innovations, a Kalamazoo-based Human Resources consulting firm many would consider the top in the region. After pulling his hair out making daily decisions about running the business (does it matter where the coffee comes from?), Kevin joined forces with the Rose Street Advisors team so he could solely focus on what he loves most: working with clients.

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Top 4 Reasons Healthcare
Costs are Rising for 2025

We all know healthcare costs increase annually. Medical trend increases are based on higher costs for prescription drugs, advancement in medical technologies, reinsurance costs and regulatory changes. So, what are the reasons for the higher than normal premium rates as we approach 2025? The aftereffects of COVID are creeping into the system. 

Following is a few of the consequences of the pandemic:

1. Many of the experienced nurses who shouldered the responsibility of caring for COVID patients were burned out. 

These brave medical personnel, who normally would have continued to work in the industry longer; left the field of nursing, which created a shortage. Higher wages, bonuses and hiring traveling nurses were the only way to keep facilities staffed to take care of patients. This increased expenses at all hospitals.

2. Beginning in 2021 through 2023, inflation has more than doubled compared to the previous 20 years. 

 This has not only impacted interest rates but also the cost of goods and services provided by health care organizations.

3. Health insurance companies were previously locked into 3-5 year reimbursement contracts with hospitals that would not let the hospitals receive more money for their services.

As the contracts come to term, hospitals are looking to recoup their losses and want insurance carriers to pay more for services.

4. We are still seeing an increased use of healthcare post-pandemic by those who delayed treatment and are either catching up on their treatments or have a chronic condition that has progressed which has placed them in a worse state. 

The list above highlights some of the key reasons why we anticipate you will see higher than normal rate increases than in the past. If you have any questions or would like to have a conversation, please reach out to us at Rose Street Advisors.

Chris Werme

LIC | Employee Benefits Advisor

As an advisor, Chris partners with clients to develop benefit strategies that meet organizational goals, budgets and company culture. From his background in accounting, he has a talent in picking out trends arising from claims data, reviewing analytics and negotiating renewal pricing with underwriters that serve his client’s well. He is an advocate in the healthcare world for his clients and their employees. On a personal note, Chris enjoys family and friends, especially while traveling, playing golf or boating. He is also a ‘Proud Papa’ to three grandsons!.

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