How small employers are balancing cost, choice and simplicity

Health care costs, evolving employee expectations and increasing administrative demands continue to challenge small employers as they build competitive benefits programs. We sat down with Kate Skouteris, vice president of individual and small group markets at Point32Health, to discuss what she’s hearing from small businesses and how employer priorities are shaping the future of health benefits.

What are the biggest challenges small employers are facing when it comes to offering health benefits today?

Kate Skouteris: The biggest challenges tend to come down to three things: cost, choice and simplicity. Small employers are balancing several competing priorities. They're considering both the cost of coverage for their business and the out-of-pocket costs their employees will face when they access care. At the same time, they want to offer meaningful choice in a way that's relatively simple to understand, administer and navigate. Every organization has a different perspective on how those costs should be balanced and what kinds of options they want to make available to employees, so finding the right fit isn't always straightforward but we are confident that our 2027 small group plan offerings are designed to serve the needs of all small employers.

How have small employers' priorities changed in recent years?

KS: Affordability has become an even greater focus. While employers have always been mindful of health care costs, we're seeing many organizations take a much closer look at both premiums and employee out-of-pocket expenses as they evaluate their options. Employers generally don't want to move their employees between plans year after year, but we've seen more organizations actively shopping for coverage as they look for ways to manage costs.

At the same time, access to care has become a larger part of the conversation. We hear regularly from brokers and employers about the challenges employees face in finding a primary care provider, particularly when they're new to an organization or changing coverage. That's one of the reasons we've introduced virtual primary care for 2027, providing employees with another pathway to access ongoing care and support. It's a reflection of how the conversation has evolved from simply offering coverage to helping employees connect with the care and resources available to them.

How can small employers balance providing employees with meaningful choice while keeping benefits simple to navigate?

KS: Small employers don't necessarily want to sort through dozens of plan combinations on their own — nor should they have to — but they do want options that can meet the needs of different employees. The challenge is creating enough choice to accommodate different preferences around provider access, deductibles and out-of-pocket costs without making the decision-making process overwhelming.

That thinking helped shape our new small group health plan bundles for 2027. The bundles are designed to simplify decision-making for employers while still giving employees meaningful choices. In Massachusetts, for example, the bundles include three plan options, which is a departure from the two-plan pairing approach commonly seen in the small group market.

In addition to offering a range of coverage options, the bundles include value-added resources that have traditionally been available only to larger employers, such as a no-fee Health Savings Account (HSA) and expanded decision-support tools. It's a different approach that helps employers balance affordability, choice and simplicity while giving employees greater flexibility in how they access and use their benefits.

What other factors should small employers consider when evaluating health coverage for their workforce?

KS: It's important to think about more than just the plan itself. Employers should consider the experience their employees will have when they need care, have a question about their benefits or are trying to navigate the health care system. Access to quality care and strong support can have a significant impact on how employees view and use their coverage.

Network design is another necessary consideration. Different workforces have different needs, which is why employers should evaluate the types of providers and care options that are most important to their employees. For 2027, we've expanded our offerings to provide additional flexibility, including new EPO options for small employers in Maine and New Hampshire and expanded ChoiceNet offerings now available to small employers in Massachusetts. The EPO offerings provide access to Harvard Pilgrim's broad nationwide network without requiring referrals, giving employers additional options to consider as they balance access, affordability and employee preferences.

What sets Harvard Pilgrim Health Care apart when it comes to supporting small employers?

KS: Small employers want a health plan that understands their needs and the communities where their employees live and work. As a local, nonprofit health plan, we have deep roots across New England and a longstanding commitment to helping employers and members access quality, affordable care. We have never wavered in our commitment to driving affordability, and we are building meaningful momentum in that area, reflected in our highly competitive premium rates across the region.

We also place a strong emphasis on listening. We regularly hear from brokers, employers and members about what's working well and where improvements can be made, and those insights help inform how we evolve our products, benefits and services. Health care needs and expectations change over time, and it's important for health plans to be responsive to those changes.

And as an independent health plan, we're able to be more responsive and adapt to the evolving needs of our members and employer customers. That means continually looking for ways to strengthen access, improve the experience people have with their coverage and provide solutions that reflect the needs of the communities we serve.

Ultimately, our goal is to help small employers provide quality coverage that's affordable, accessible and relatively simple to manage. Whether that's through expanded plan options, new ways to access care or value-added resources, we're focused on helping employers meet the needs of their workforce today and in the future.