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The health care plan that will help you retain, attract drivers

By decreasing the cost of benefits, fleet managers can free up money to allocate to other areas of the business to increase margins, improve recruitment and retention, and more. 

It’s hard to keep a high-grade fleet. There are driver shortages, high turnover, escalating benefits costs, low-profit margins — the list goes on. These factors might feel uncontrollable, but fleet managers have a say on many of these issues. 

Take benefits: Between 2009 and 2017, the average cost of benefits per mile increased almost 35%, growing to a hefty 10% of every mile. By decreasing the cost of benefits, fleet managers can free up money to allocate to other areas of the business to increase margins, improve recruitment and retention, and more. 

Stopping this domino effect starts with taking control of health care costs. And not by going to a limited-benefit or high deductible plan. But rather, through reference-based pricing, which can save companies upwards of 25% on health care spending.

Reference-based pricing 

Reference-based pricing is an increasingly popular health care payment model for self-insured companies that choose to pay for their own health care. Self-insurance is already a cost-saving route many mid- to large-sized businesses take, but reference-based pricing takes the savings even further.  

With reference-based pricing, a self-insured company pays for health care services based on what they cost or the Medicare reimbursement rate plus a reasonable profit — not on bloated and variable insurance prices. For example, the cost of a CT scan in the U.S. varies widely among hospitals. Medicare pays about $200. With reference-based pricing, a trucking company could pay about $240. The savings are significant compared to traditional PPO models where claims are typically paid on a percentage of charges. A 50% discount in charges can still result in a $5,000 bill. 

According to a recent report from ELAP, companies using reference-based pricing have achieved savings of 15-30% in their first year. Trucking companies that use this health care model can then reinvest savings into other areas of the business or their employees — for example lowering deductibles, raising contributions to 401k plans, or increasing bonuses — giving them a competitive edge in attracting and retaining top talent.

Reference-based pricing can also be more affordable for employees. Drivers see reduced out-of-pocket costs, but their coverage doesn’t suffer. Plan members attain broad access to physicians and medical facilities and can receive care wherever is most convenient for them. There’s no in or out-of-network.

Addressing drivers’ needs 

The rising age of the trucking workforce creates more frequent, unique, and typically more expensive demands on health care than in other industries. 

Specifically, truckers face a high volume of musculoskeletal injuries from getting in and out of their trucks, lifting items, and the other physical demands of the job. These injuries require costly treatment from orthopedic specialists. Reference-based pricing makes it more affordable to treat these injuries by paying a fair and reasonable amount based on the actual cost of the treatment rather than inflated insurance prices. 

Truckers are frequently away from home, whether they’re driving a day route or one that takes weeks or months. If a trucker is injured on the job, the chances of them being in network are relatively slim, unless the company is paying a huge amount for a large coverage area. Again, this isn’t an issue with reference-based pricing. Because there’s no in or out-of-network, truckers can seek treatment wherever they are, whenever they need to, without worrying about a health care network. Further, if a situation arises where a provider does not accept the payment, the right reference-based pricing solution will provide member advocacy for any billing issues.

This is also useful considering the high rates of obesity and diabetes among truckers. In a reference-based pricing model, drivers with these conditions pay less out of pocket for care and don’t have to delay (or skip) treatment when their routes pull them out-of-network. When truckers can take care of themselves, they’re going to be safer, smarter and happier drivers. 

Offset other costs

From gas costs to increased congestion that delays routes, trucking companies can’t control a lot of the factors impacting their business. But they can control health care costs. 

With reference-based pricing, fleet managers can lower the price per mile and improve their bottom line, all while creating a more competitive and attractive benefits package for employees.  

It’s the fleet manager’s job to look out for the drivers and maintain a dependable fleet. When drivers are healthier and happier, not only does their work improve, but so does trucker retention. Reference-based pricing is the modern health care solution whose positive impacts will reverberate across the business for years to come.


Steve Kelly is the co-founder and CEO of ELAP Services, a leading health care solution for self- funded employers across the U.S. He is a recognized expert in the insurance, employee benefits and risk management industry, bringing more than three decades of experience solving his clients’ complex health care challenges.

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