Why Healthcare Transparency and Competition Matter for Employers

At Sympl Benefits, we're challenging the traditional approach to employer health insurance.

The healthcare benefits industry has long operated on a simple premise - employers can either accept higher costs or shift more financial responsibility to their employees. But there's a third option: actually addressing the underlying cost of healthcare itself.

The Problem with Traditional Benefits Consulting

For decades, benefits consulting has been trapped in a cycle of limited solutions. Carrier relationships restrict consultants to specific underwriters and predetermined rates, with little room for meaningful recommendations. Independent agencies initially seem better, offering multiple carrier options, but agency bonuses and carrier relationships heavily influence which solutions get recommended.

This creates a fundamental conflict. Consultants want to do right by their clients, but the system incentivizes decisions that may not align with the client's best interests.

While the industry debates broker/carrier relationships, the more fundamental problem persists: the actual cost of healthcare services. The traditional approach has become predictable: expect cost increases, or shift more financial responsibility to employees through higher deductibles and copays. But what we need to be discussing is whether the underlying healthcare costs are appropriate for the services rendered.

Unlike every other market, healthcare operates without meaningful price transparency or competition.

Our Approach: Competition at the Case Level

At Sympl Benefits, we focus exclusively on health insurance for private employers seeking sustainable employee benefit programs. Rather than accepting the traditional cost-shifting model, we address healthcare costs at the individual case level.

When an employee needs surgery or diagnostic imaging, our team helps them understand their options and creates competition among healthcare providers. This isn't about interfering with quality of care. It's about transparency in pricing and ensuring employees can make informed decisions.

Consider MRI imaging. With 40 million MRIs performed annually nationwide, this is routine. Yet even in Michigan, a state with relatively competitive healthcare pricing, an MRI can cost $2,000-$3,000 at a hospital system or under $500 at an independent imaging facility for the identical diagnostic image.

The typical patient journey reinforces expensive options: Primary care refers to specialist > Specialist orders MRI at the hospital's facility.

The result is costs 3-5 times higher for the same service.

The Michigan Market Challenge

One carrier controls approximately 60% of the employer market, while hospital consolidation has eliminated about 40% of provider options since 2019.

This consolidation creates significant leverage for remaining hospital systems, and leverage in healthcare typically means higher pricing. When fewer providers control more market share and one insurer dominates the employer market, basic economics suggests trouble ahead.

Yet most CFOs and HR directors making plan decisions remain unaware of these market dynamics and their cost implications.

The Solution

We believe the answer lies in transparency and competition at the point of service. When employees understand their options and true cost differences, they make informed decisions that benefit both themselves and their employers.

Every healthcare dollar saved through informed decision-making has dual impact. For employees and their families, it reduces out-of-pocket costs. For employers, it helps control underlying claim costs that drive future premium increases, even in fully insured arrangements.

Our Mission

At Sympl Benefits, we solve the healthcare cost problem one case at a time. We believe that if there are willing providers offering quality services at lower costs, employers and employees should have access to that information and those options.

The solution isn't just finding a different insurance carrier. It's fundamentally changing how we approach healthcare purchasing decisions. In a market where consolidation is reducing options, creating transparency and fostering competition becomes critical.

We help employers create sustainable, employee-focused benefit programs that address the real cost drivers in healthcare. When employees have better information and more options, everyone benefits.