In the U.S., there are a multitude of national-level and regional-level health insurers – the majority of which offer multiple product lines. This typically translates to hundreds of benefit design options for employers. Determining the right option for an employer’s unique and specific needs takes time, experience, expertise and a solid understanding of the insurance industry and world of employee benefits.
That’s where a health insurance broker can help.
As an employer, when you utilize a broker you are engaging a health insurance professional who can work objectively on your behalf to find the right solutions for your business. It’s the broker’s job to help you better understand your benefits options and make the best choices. This means understanding industry trends, being familiar with carriers in the market and staying informed and current on reform legislation and regulatory requirements. Choosing a broker to serve your business is an important decision and one that should be made with due diligence.
The Selection Process
A full-service, committed health insurance broker can offer your business a great value – especially if you’re a small or medium-sized employer – through consultative analysis and plan evaluation services during the selection process, open communication and firm support during the implementation process, and continued on-going service as it relates to maintenance and renewals.
In order to be a licensed broker, an individual must complete a comprehensive classroom training program and successfully pass a proficiency exam. The individual must also participate in required licensing and continuing education established to ensure sustained professional levels of service. Beyond these professional requirements, there are numerous other criteria to consider. Recommendations from fellow trusted employers, setting standards for years of experience and scope of service, and many other intangibles deemed important can all help you narrow the field of candidates.
It’s also important to conduct personal interviews and obtain professional references. The final decision should be a personal one based on your level of comfort with the individual. Ensuring a good fit in terms of style and personality is always a smart idea.
The Affordable Care Act – The Broker and You
In the coming years, the Affordable Care Act (ACA) will add a whole new dimension to the relationship between the broker and the employer. Specifically, as the requirements for employers to comply with new regulations and a myriad of new products and services emerge and evolve, there is a whole new level of value to what a broker can offer.
The role of the broker will expand to encompass an understanding of the complexities of health care reform, compliance requirements and consequences, as well as the need to help employers navigate to appropriate solutions.
Searching for a Health Insurance Plan for your Company? Consider the following:
- Provider Network. Who are the doctors, hospitals and other providers that are participating with the plan you are considering?
- Benefits of the Plan – Does the plan meet your objectives in terms of a focus on prevention, wellness programs and healthy lifestyle promotion?
- Service Levels – How does the plan perform in terms of customer satisfaction and claims payments? What do their service scores look like?
- Quality Indicators – What accreditation and quality measurement scores has the plan achieved? (Consider a number of organizations evaluating health plan performance from a quality perspective on a national basis.)
- Cost – What services are included? What are the future costs likely to be? This is always an important consideration. However, consider not just the “price,” but the “value” as well.