The individual responsible for plan design varies across organizations (Figure 8). HR/Benefits staff hold plan design responsibility for 43% of all responding employers. Just over 20% of employers rely on an insurance carrier, with 13% using a consultant for plan design. Only 5% of respondents gave their PBM responsibility for plan design. Just over 50% of fully-insured employers relied on the insurance carrier or HMO for plan design, compared to 10% among self-insured (p<.05). Similarly, 56% of self-insured used their HR/Benefits staff for plan design, compared to 27% of the fully-insured employers (p<.05).
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