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.
