Speak with an adviser 1-800-861-9364

Start Here
Employee Benefits

New Transparency Laws Are Here and Employers Are Ultimately Responsible

We recently had a major health insurance provider offer us a $15,000 bonus to bring back a pharmacy program that we took outside of their company. And although we don’t have the exact numbers, you can imagine how many brokers would be tempted to take the deal. 

After all, that is a significant amount of money to get paid for a client’s signature, who may never know the deal wasn’t in their best interest. For us, the move to the new program was in the best interest of our client and therefore was non-negotiable for movement back to the original provider, and we hope that most professionals would make the same decision.

Incentives like this are not uncommon in the health insurance industry. This example shows just how easy it is to offer a program, plan or policy that is not ideal for clients and how unfair these hidden commissions can be. 

Transparency in the health insurance industry

Under the new legislation, brokers, agents and advisors are required to disclose this information to their existing and potential clients. This allows employers to make better decisions about the health insurance they provide. The legislation also comes with new reporting requirements for your business, making transparency between providers and clients essential.

The Consolidated Appropriations Act requires brokers and agents to inform their clients of direct and indirect commissions, including any bonuses and incentives they may receive. These benefits, that are paid to brokers by insurance companies, have been around for a long time and can come in the form of luxury vacations, six figure bonuses, and yearly commission percentages. 

The earnings are legal and considered, by some, to be a cost of doing business. However, with the transparency act, employers will now have the opportunity to see information about what they are paying for and most importantly, if there are any conflicts of interest.

Employers are the ones who pay

Knowing this information is important for employers, because they, and their employees, are the ones that will pay for these incentives in the end. Sometimes the costs become wrapped up in the ever increasing yearly premiums. 

Not only are employers potentially paying more, they’re also at risk of being penalized for unreported information. Employers can be held responsible for any unclaimed taxes, costs and data that is not reported to the IRS or related institutions, which may lead to fines and charges for non-compliance. To avoid these circumstances, the necessary data and information must be provided by the broker and done so in a timely manner.

Know the questions to ask your broker

There are several questions that will help you get the answers you need from your broker such as:

  • Are they receiving any outcome that is not commission based?
  • Are they receiving a bonus for selling a certain kind of product?
  • Are there hidden revenue streams and if so, are any of them contingent on selling a particular product?
  • Are they able to give the data required to you in a timely manner?
  • What is their process so you can complete any IRS forms that may be required?

Ultimately, if your broker isn’t truthful or responsive, you could end up being penalized. Our job as insurance advisors is to help you get the information you need, while also providing complete transparency about your health insurance recommendations and plans. If you have questions regarding your health insurance plan, how the new The Consolidated Appropriations Act affects you, or what questions to ask your broker, don’t hesitate to reach out. 

The legislation that went into effect in December of 2020 is important to brokers, agents, advisors as well as employers and their employees. Transparency in the health insurance industry like this allows employers to get one step closer to getting important data they need to make the right choices.

Employee Benefits

The Delta Variant — Leading Your People Over the Wave

The benefits of listening to your people is evident when we look at Coca-Cola’s decision to rebrand. Back in 1985, Coca-Cola decided to release a reformulated coke which became known as New Coke. However, the public rejected this formula. Coca-Cola listened to the people and within months, they rebranded to the popular Coca-Cola Classic and were rewarded by surpassing their competitor, Pepsi. 

With new COVID variants emerging, the workplace is changing again and as leaders, we need to listen to our employees. Coca-Cola came out on top because they listened to the people who mattered, and right now, our people matter. Our employees are adapting and coping to the new variants and repeated waves of the Coronavirus in their own way, which means a one-size fits all approach of leadership won’t work.

I have an employee who is very concerned about new variants of the virus. She is most comfortable wearing her mask at all times in the office and uses the protection of plastic shields around her desk. She designed and placed the shields on her own accord, doing what she feels is necessary to protect herself.

These extra precautions are important to this employee because they allow her to feel safe while at the office so she can continue to be a valuable member of the team. As leaders, we need to assess our workplace and determine what we need to do to protect the safety of our people and if there are employees that require more, we need to adapt to those requests.

Not all employees share the same concerns, however, and we need to make sure we are addressing everyone equally.

Understand your people

With the politics, media and our own logic and beliefs surrounding the pandemic we are going to see a natural division between those that are concerned about COVID and those who may not believe in it at all. As leaders we need to balance these opinions and navigate those beliefs. If we can lead with respect, our people will interact with respect too.

By listening to concerns and supporting our employees’ individual concerns we can begin to move forward and create a safe and comfortable environment that works with everyone’s beliefs. Allowing some employees to use extra protective measures certainly doesn’t affect the functionality, safety or productivity of the business and allowing others to be physically distanced in a collaborative environment doesn’t either.

In fact, by allowing our people to feel safe we emphasize our culture. 

We are the first employers to lead companies through this global pandemic and perhaps now more than ever, we need to lead by listening. By having conversations and listening to our employees we open the doors to a happier, more loyal workforce, which paves the way to increased productivity and better retention. If our culture is about our people, we open doors to more employees, eager to be a part of the team.

Ask the right questions

The very nature of leadership involves guiding and motivating your team and should include appreciation, empathy and flexibility. As leaders, there are several questions you can ask yourself to ensure you are meeting these requirements, such as:

  1. Who are you listening to? 
  2. What have I done to show I am listening?
  3. In what way am I leading? Do I lead with a dictatorial style, a democratic style, an affiliate style?
  4. What effects do the decisions I make have on the team?
  5. Am I listening to everyone?

Make the needed changes

As leaders, knowing what our employees need and want is unlikely unless we ask them directly, obtain feedback and take their opinions into consideration. This doesn’t necessarily mean making big changes to your benefits program, it could be something as simple as providing free COVID-19 testing within the company.

Or even allowing an employee to surround her desk with plastic shower curtains.

Coca-Cola’s leaders didn’t hesitate to listen to the public and quickly brought back their original recipe, even though they had spent a considerable amount of time and money formulating New Coke. Sometimes as leaders our decisions are not always right for the company and we need to be flexible and prepared to make necessary changes. 

Employee Benefits

Leadership is about your people.

One of our most important responsibilities as a leader is maintaining an environment where all employees feel valued. Leadership is about encouraging our people to grow and excel while ensuring the organization’s values and visions are met. 

In other words, leadership is about inspiring and motivating people to reach a common goal. 

In the last decade, while the definition of leadership has stayed the same, our perception of leadership has changed. Now, leadership is considered a skill, one that can be actively refined and improved. Learning how to adapt your leadership skills to fit a diverse workforce in ways of age, ethnicity, gender, background, and motivational style is important for you and your company’s long term success. 

This gradual transition in the way we view leadership could be fueled by the addition of a younger generation entering the workforce, adding to the already diverse nature of companies today. As a leader, our job is to understand how each employee works, how they feel and how we can provide the tools they need to succeed.

People, Culture and Vision

One style of leadership cannot fit every employee. Following a strict protocol for all employees could lead to failing a large portion of the team, especially the younger members who are known to have a greater desire for self-direction and dexterity within the workplace. Where millennials may thrive on feedback and mentorship opportunities, a baby boomer may prefer to converse only when there is a clear problem.

Uniting your employees’ perspectives and listening to their individual opinions will help communicate that they are important to the company’s success, no matter what the hierarchy order is. After all, teamwork is a collaborative effort, each group member contributing ideas and knowledge.

We can relate this concept to a bakery. A customer places an order for a cake, as a leader you show your employees the recipe and the team is responsible for baking the cake. The customer only cares about the taste, not how many steps or ideas were generated while baking the cake. In fact, if team members feel able to contribute equally, deciding who is responsible for each ingredient and each piece of equipment, the cake could be baked more efficiently.

Learn, Adapt and Change

For leaders of large companies, reaching all employees personally can be challenging. In these cases, your leadership needs to empower your direct reports to maintain consistency across the organization, ensuring that all employees are heard and treated equally. As the company’s values are passed down the line, trust in the company’s culture is built up, which can improve employee morale and overall job satisfaction.

Good leadership should allow for adaptability to ensure everyone on the team receives the same opportunities.

As the team grows and develops, so should your leadership. Leadership is about continual improvement and growth, the ability of balancing technical enthusiasm from one employee to business experience from another. Learning from our experiences as well as our employees’ experiences, both in life and business. 

Being successful now doesn’t make you successful tomorrow. Tomorrow is a new day and a new environment. Embrace the change life provides and thrive as a successful leader.

Employee Benefits

Hidden Revenue Within Your Health Insurance Plan – A Case of $100,000.

Chances are you know how much you spend on your current health insurance plan, but do you know how much is actually being spent on care? Imagine discovering over $100,000 of unused revenue within the cost of your health insurance plan.

Most business owners know the importance of monitoring their investments and calculating their risks carefully throughout the year. However, the same attention is not always given to health insurance plans. Rises in healthcare costs, increased annual premiums, and general changes to the company such as growth and expansion are all reasons the cost of your health insurance plan can change.

Adjustments like these are why digging into your plan’s data is essential. You may be missing opportunities to make your plan more effective, both in terms of the impact of dollars spent for your people as well as reducing overall costs. Using the help of an experienced health insurance advisor can be beneficial in accessing the information you need. 

You never know when a significant change can be made. 

For example, we recently had a discussion with an employer who felt their health insurance plan was too expensive. The employees weren’t happy and although the employer thought he was overpaying, he couldn’t be sure. 

The answers are in the data

He provided insurance for about thirty employees with a traditional ACA pricing plan and spent $403,000 annually. After obtaining 100% of the company’s claims data, we discovered that their total claims were $226,000. 

Yes, he was definitely overpaying. 

Unfortunately, with a traditional plan and the way this insurance market works, our client was sure to see this rate continue to rise, regardless of their claim history, because there are no credits for good claims.

By digging deeper into the data, we noticed that two medications were driving $138,000 of the historical claim costs. That worked out to be 7% of the employee membership, which is less than half the expected 20% of membership, contributing to a significant portion of the plan costs.

Further analysis showed that of the $138,000, each employee was paying $350 a month for medication. That’s $4000 a year. These costs were on top of what our client was spending in health insurance for their employees. 

After evaluating the data, we developed a plan in which the employer now pays a total medication plan of $34,000, saving the company $104,000 and the employees their monthly costs as well. 

Open the doors to possibilities 

By accessing data within your health insurance plan you could reverse the trend of rising costs and put the extra revenue towards sustainable growth and investments such as:

  • Business improvements. Reinvest the money into the business by strengthening company infrastructure, improving equipment, investing in new machinery or improving client/customer experience.
  • Give back to your people. Consider building a benefits plan developed with your people in mind, invest in training programs or create a new company culture.
  • Update current marketing campaigns. The digital world is always changing. Streamline social media accounts or ad campaigns. Invest in performance metrics. 
  • Save for hardships. Cash flow is fundamental for any business, making sure there is money set aside for unexpected expenses can help protect your business. 
  • Hire more help. Keep operations running smoothly by hiring new leaders or expanding in technical, marketing, insurance and Human Resource departments. Consider outsourcing tasks to specialized companies, such as advisors, advertising agencies and accountants.

When it comes to health insurance plans, getting the most for each dollar spent is a realistic expectation and one that is often overlooked. Unlocking potential revenue from your current health insurance plan can not only increase employee retention, recruitment, health and happiness but expand company growth. 

If you have any questions about how your money is being spent within your health insurance plan, let’s schedule a meeting today.

Employee Benefits

Crawl, Walk, Run to Unlocking Revenue in Your Benefits Plan

A self-funded benefits plan means a business runs their own plan instead of purchasing a traditional fully-insured plan. Though many business owners and leaders have heard of this option, the perceived complexity of the process coupled with a fear of change deters them from fully exploring what’s possible with this approach.

With increased flexibility and greater control of their benefits plans a business can create true cost-saving opportunities as well as improved employee experience and retention. Historically, self-funding has been viewed as something that only large companies can do but with the advancements in predictive tools, this option is available for medium and even small companies. 

The key to implementing self-funding into your business is to understand your business goals, estimate your timeline, and to consider the needs of your employees. The process doesn’t have to happen overnight, either. Each step can be done gradually over time. 

Step 1: Understand Your Goals

Cost-savings is one of the biggest advantages to self-funding benefits plans. However, being self-funded means your company will assume the responsibility of paying for employee claim costs out of pocket. While this can sound intimidating, most businesses engage an advocate or third party administrator to help with analyzing plan data to create a cost-saving plan without sacrificing benefits or quality care for your employees. Additionally, your advisor should put mechanisms in place that safeguard your business if a radical increase in your benefits costs occurs.

In other words, self-funding can be de-risked to maximize your upside.

With risk addressed, self-funding allows freedom of choosing the benefits you offer to your employees, which presents the opportunity to increase employee retention and overall job satisfaction. For example, an industrial company with a large labor force will likely have different needs than a technology company where most employees work remotely. By offering wellness programs and benefits tailored to the needs of your employee population you reduce the number of health insurance claims made each year as well as eliminate the cost of under-utilized programs.

To reach these goals, you need to invest the time, gather and analyze your data (so that you understand your people and how your benefits have been used today). With that data and insight, you can create an appropriate timeline to transition from traditional benefits to a self-funded plan.

Step 2: Explore Employee Data and Engagement

Analyzing your employee’s data is a crucial part of structuring any health insurance plan. By analyzing the data within your plan you gain transparency by having complete access to employee claims (in a HIPPA compliant way, of course). This gives you the historical view of what your plan actually costs, enabling you to see the real value of your current plan.

You may find that you spend far more on premiums than is actually needed for care, but you may also discover that your plan has absorbed significant costs for the businesses and is actually delivering a great value for the business.

Using this data along with predictive and analytic tools can help identify potential areas of concern within your employee population. For example, a combination of health factors could create claims challenges down the road, but by tracking and analyzing the data produced by claims, you can plan for these challenges. For example, analyzing data to detect risks of diabetes amongst a population of employees can help an employer offer solutions to better manage the condition. 

Having the ability to choose your healthcare benefits plans also means you determine which doctors, facilities and hospitals will be included in your plan. Employees may feel intimidated about this aspect of the new plan, but by providing a plan to educate and engage your employees you can ease this worry while actually improving the care they receive. Including information sessions and training courses to your employees is part of making self-funding successful.

Step 3: Identify Your Timeline

Different businesses will begin and complete the transition from fully insured to self-insured at different speeds. Knowing your business’s financial situation can help develop your unique timeline for self-funding. For example, by calculating your expected premium increases over the next several years, you can determine if the amount is feasible to pay. If not, you may need to consider a more aggressive plan, which will implement the self-funding model quickly, but may take more resources early on. 

If done correctly, despite the speed of execution, the move towards self-funding insurance can generate long-term financial gains and overall employee satisfaction for your business. Mapping that timeline will enable you to match the process to your unique needs while eliminating potential obstacles.

Knowing Your Options

The ideal self-funded plan is one that minimizes risk and maximizes your return, one that provides cost savings without giving up the benefits your employees value. To achieve the advantages of self-funding, you need to be willing to break away from traditional insurance providers, to take back the profit they are making from you, and return it to your employees by offering benefits plans that are unique to them. 

You won’t know if you’re making the right choice until you look at all of the options.

Employee Benefits

How the Renewal Process Handcuffs Your Business

Employee benefits can be a complicated endeavor to navigate, especially during the renewal period–a time when employers are faced with a staggering amount of decisions to be made in a very brief decision-making window. The ability to negotiate or even explore alternative options feels rushed because most brokers initiate the renewal process a few weeks before the renewal is due, leaving little time to make adjustments and changes. This can be even more troublesome if you are facing a steep increase in costs.

The reality is that the renewal process should begin months before your renewal date. If left unaddressed for too long, you run the risk of renewing a plan that can leave you overpaying or underinsured.

Update, Quote, Review

When your company’s insurance policy is up for renewal, there are a few steps that need to be completed to ensure you have the best, most cost-effective plan in place for your business. First, your plan needs to be updated to reflect the current needs of your employee population. Perhaps your business has grown and you’ve hired more team members, or there’s been a change in key personnel. In either case, you should be looking at benefits that suit the business today because premiums are sure to increase, and last year’s plan may not provide enough value for the cost.

Next, you should evaluate your plans data to understand how your benefits budget was actually spent. Your broker may resist or defer the request for your data because they say there isn’t enough time or assure you the current policy is ideal. But advisors (like us), have tools to make this information accessible to business owners. This data will help you to understand the real value of your plan and if any major difference in cost—either in your favor or against—are present and worth addressing.

Understanding the Data

To design a benefits plan that meets the needs of your employees in a cost-effective way, you need to understand your data and ask the right questions. Several points to consider when designing your plan are: 

  • Enhance your employee benefits. Part of understanding the information your plan has is knowing which benefits are important to your employees and which benefits could be wasted.
  • Explore opportunities for cost-savings and experience improvements. For example, prescriptions are a major source of overspending in benefits plans. Alternative sourcing could lower your costs and your employees’ out of pocket expenses for the same prescriptions.
  • Look at your trajectory. If you’re seeing consistent annual increases in your premiums, how long can you absorb those costs before it threatens the business? Knowing that timeline can help you gauge how aggressive or conservative you can be in your planning.
  • Know your state laws as well as federal laws. Meeting your unique business needs should also mean avoiding being out of compliance for minimums or transparency requirements (which are changing and evolving each year).

As you have probably started to realize, these suggestions come with several follow-up questions and potential considerations, which is why starting this process is so critical. Renewing your business benefits plan is a lengthy process that should begin in a timely manner. Having an advocate available from the beginning can help save time and even unlock doors to potential savings, illuminating blindspots and giving you access to new options.

We’re here when you’re ready.

Employee Benefits

What You Don’t Know Can Cost You

In Blackjack, if you know the dealer’s hole card, you can make smart and logical bets to ensure a beneficial outcome. But that’s not how the game works. You don’t get to find out if you made the right bets until the game is done. Health insurance is the same way. Imagine the dealer is your insurance provider and the hole card is the data on your plan. The dealer has information you need, they make the rules and the house has the advantage. But what if you could get access to that hole card? 

As a business owner you are expected to make decisions about your group benefits plan without knowing key details, like if there is any compensation for agents, what percentage of your premium was used for care in a given year, or the amount of money expensed towards the cost of care for employees. In other areas of business, making decisions without knowing all of the facts is considered unacceptable. 

For example, if you provide a cellular data plan for your employees, you have constant access to how much the plan costs as well as how much of the plan is being used by employees. If the cost of the plan suddenly goes up or if you see a big spike in usage in a singular week, you would investigate the change to make an informed decision about what comes next.

Maybe the phone provider made a mistake. Maybe an employee misused the cell phone plan. Maybe a feature was added that your business doesn’t actually need. Understanding the cause allows you to pick the right solution moving forward.

In a health insurance setting, these details are rarely shared. If the rate of your benefits plan changes, you deserve to know why, and you deserve to know how the money is being spent because changes in your insurance plan not only affect you, they affect your employees too.

From budgets to employee morale

Group benefits are offered to ensure the well-being of your employees and their families. The lack of transparency in costs to your business can also impact the costs for your employees, which means they could be getting surprise bills for procedures they thought were fully covered. This can lead to employees who are frustrated by a plan put there to support them, and that frustration is often directed at the employer. 

With data transparency, you could reverse this narrative. If you learned that, year over year, most of your healthcare spend went unused (pure profit for the insurance company), you could unlock that wasted capital and use it to improve the business and the lives of your people. You could invest in 401ks for employees, hire new staff, update equipment, or implement employee appreciation days, all of which can improve the quality of life for your employees.

But you can’t make those strategic changes when you don’t know what’s really happening in your plan.

Unlocking your data

When asked to disclose your data, providers may dodge the question and hide behind the complexity of benefits plans or blame HIPAA regulations. To put this into context, let’s say you spend X amount of dollars for your plan, you have no way of knowing if the insurance company paid double to cover care or if they paid less. 

An experienced advisor has the means to get access to your plans data. This information gives you the ability to see what your plan actually spends, allowing you to make informed decisions on the value it provides. You may discover that based on your plans actual costs, you are getting a good deal and an increase in your bill is justified. You may also discover that you are setting aside far more budget for your plan than necessary, which can be a potential gain of revenue for the business if you can unlock that unused budget and invest it elsewhere. 

Once you have that data, you know exactly what’s on the table, and you can make easier, smarter decisions. You get to see the dealer’s hole card and this clarity tips the odds back in your favor. 

Employee Benefits

The Absurdity of Healthcare: How Medical Facilities Get Away with Extra Bills

Imagine the team goes to a restaurant for lunch. Everyone takes a seat and orders lunch. Conversations fly, food and drinks are enjoyed, and team morale is high. The bill arrives, appears accurate, and your business pays the tab. Then two weeks later, the restaurant sends an invoice with a charge for premiere seating. The waiter never mentioned the charge, the restaurant never advertised it, and you definitely didn’t ask for it. You try to dispute the restaurant, but they point to some fine print and shrug their shoulders, saying that you’re stuck paying for the charge whether you like it or not.

As absurd as this sounds, this scenario happens every day in healthcare. 

Before COVID, one of our clients reached out with concerns following an employee’s telemedicine appointment. The call was scheduled through her health plan. She was pleased to complete the consultation in the comfort of her own home, speaking to her doctor remotely. The paperwork appeared to be finished and the doctor was paid according to the contract between her insurance company and the national network of physicians in which the doctor worked. Ten months later, the employee received a bill for a facility fee, for the telemedicine appointment. 

But this employee never stepped foot in the building, but the hospital argued that since the doctor could have used the officer for the appointment, the facility fee was still justified.

In our client’s case, the concerns were clear: 

  • Their employee never stepped foot into a facility
  • The appointment was completely virtual
  • She was unaware and not informed there would be an additional fee on top of the covered telemedicine appointment
  • After speaking to the provider, who was part of the integrated health system, the response was simply “we are allowed to do it.”

Facility Fees are Unethical 

Our client is not alone. Healthcare providers hide behind the complexity of healthcare billing and hidden disclaimers to charge facility fees on top of covered procedures or services. We believe this practice is unethical and quite possibly illegal. In fact, the state of Connecticut requires hospitals and medical providers to better disclose facility fees. While this is a step in the right direction, the disclaimer can be easily overlooked or hidden in confusing billing language. Many employees are still left surprised when they receive a secondary bill for hundreds and in some cases thousands of dollars. 

Facility fees are not limited to the walls of the hospital. Outpatient services and physicians practicing outside of the hospital are subject to fees, making them difficult to avoid. For example, a facility fee can be charged when an employee has routine blood work performed at an outpatient facility. The lab work gets covered, but the employee is left to pay significant balances after the fact. A report by Orlando Sentinel, citing information from the Medical Payment Advisory Committee, states that facility fees “can increase the total cost of a service by three to five times,” putting recipients in a difficult position. 

Surprise expenses of any kind can put enormous strain on a working family, and that stress can impact the employer. Not only will general morale suffer, but the employee may also blame the benefits plan, which can mean problems with retention and performance even if the employer did their best to provide the best benefits possible.

This is unfair for everyone involved.

The Game Changer

An advisor can help. Having someone in your corner who understands the complexity of the healthcare system can protect your employees from unexpected and costly medical bills and allows you to stay focused on your business. An advisor dedicated to your business can help employees navigate their options, avoid unexpected charges, and advocate on their behalf if they are overcharged is the individualized attention your business deserves.

We hope that legislation will eventually address this problem in healthcare, but for now, you should take steps to protect your business and your employees from unfair charges.

Employee Benefits

When Doing the “Right Thing” Hurts Your Business and Employees

I meet a lot of business owners in my work, and very rarely do I meet someone who genuinely wants anything less but the best for their employees. These are the leaders who, even in the face of an opaque and unwieldy healthcare system, invest significant portions of their revenue to give their people better benefits.

But in our healthcare system, even the “right thing” can backfire to the point that no one wins– not the business owner, not the employees, and not the families of the employees.

Higher Costs, Less Coverage

This is a true story:

I spoke with the owner of a lumberyard who covers 94% of premium costs for employees, which is well above the average and fairly generous. To achieve this, he spent an additional $7 on their hourly rates, yet the deductible was still $7500, and his broker had recently informed him that he should expect a 43 percent cost increase in the coming year.

Yes, 43 percent.

With a $7500 deductible, this employer’s generous approach to benefits was already not manageable for his employees, many of whom are unskilled blue collar workers. For those families, a medical emergency with that kind of price tag would be devastating financially, which hardly feels generous from the employee perspective.

And then the plan is due to get worse next year, forcing everyone involved to spend more to get less. That’s simply unsustainable. And the worst part is that this employer was actively trying to do right by his employees, using all of the resources he had available to him to do so.

When the “Right” Choice is Hidden

In a situation like this one, the most affordable path for the employer and his employees might be an aggressive self-funded strategy, or at least a partially self-funded strategy. In the worst cases, he might be better off dropping what he contributes to employee healthcare so that his people qualify for a subsidy on the healthcare exchange.

That approach, on the surface, can sound like the employer wanting to cut costs, but the “penalty” he faces could half his total expenses while at the same time giving his people access to better care. At that point, his challenges would be around educating employees on how best to take advantage of the healthcare exchange to get the plans that best suit them and their families.

Unfortunately, businesses across the country face challenges like this every year, and the best solutions are not always the intuitive “right” answer. You need an advisor who can see the big picture of both your business and your potential options to help you find a path that is sustainable for the business without sacrificing the employee experience.

See the Full Picture of Your Benefits Options

Solutions aren’t always easy, of course, but as soon as you see that your healthcare costs are trending in an unsustainable direction–which is the case for nearly all businesses, eventually–you should dig deep for every possible switch to flip and button to press to put you on the path to sustainability.

Otherwise, everyone loses. But it is possible to win.

Employee Benefits

How to Transform Your Benefits Without Losing Your Broker

Few aspects of your business may feel as unwieldy as your benefits plan. We often talk with business owners who are frustrated by the year-over-year increases in benefits costs, but the challenge of making substantial changes to a plan deters many leaders from actually addressing the problem.

Most business owners are not benefits experts. They don’t want to upset their employees by making the wrong change. And decades of benefits frustration can make any attempt to alter the trajectory of this situation feel like a pointless exercise.

So when we reach the point of a leader being willing to make a change, this question sometimes comes next: “Can I keep working with my current broker?”

Impactful Change Without Leaving Your Broker

For how scary a benefits change can seem, keeping your existing broker can feel like a security blanket. You likely have rapport with the broker, have worked with them for years, and may even have come to trust their advice and insights. Though many leaders may not admit to this part directly, keeping the broker relationship intact could make it easier to reverse course if the experiments with the new advisor don’t work out.

Is it possible to make meaningful changes in the cost and quality of your benefits plan with your current broker in the mix? Yes.

Is it practical? Maybe.

Is it easy? Absolutely not.

If a broker is fully willing to collaborate with an advisor like myself, the process of unlocking new revenue with your benefits plan can go smoothly, but the reality is that brokers often represent the status quo, creating natural friction between them and anyone who challenges the business to think differently.

Sources of Broker Friction

In a traditional benefits cycle–the one that increases your annual costs by 10 to 20 percent each year–most broker activity happens annually around plan renewals with some light administrative work peppered throughout the rest of the year.

Self-funded benefits plans and partially self-funded benefits plans require much more activity. These approaches are designed to be agile and responsive to improve efficiency and to reduce overall costs, which means that your broker now has to manage their normal day-to-day work , such as:

  • Additions to the plan
  • Deletions from the plan

But also assist in the management of:

  • Directly address claims and claims-related issues
  • Field benefits questions from you and your employees
  • Managing ongoing education for your employees revolving around a changing employee and employer mindset of how they are accessing the healthcare system

While the broker takes on these tasks, our team is implementing cost-savings strategies, addressing your pharmaceutical spend (which could mean doing the legwork to source drugs at a lower costs), analyzing your historical benefits data and your ongoing data, and negotiating with providers to lower your expenses while increasing the quality of care.

That’s everyday at the office for our team, but for a broker, this is a very different model and can be much more demanding than the status quo alternative.

On top of the logistics, each suggestion our team makes hints at an unspoken but troublesome question: “If this new solution has merit, why didn’t your broker recommend it in the first place?”

The potential answers to that question can be uncomfortable for the broker and deter them from fully collaborating.

What’s Possible vs. What’s Practical

Our team is always willing to work with a broker, but the broker has to be willing to work with us. They need to put your interests first and lean into new ideas so that we can do our jobs as the advisor or consultant in this dynamic. 

1 2 3 4 5 6 7
Start Here