As the close of 2017 approaches, now is an ideal time for small-group brokers and benefit advisers to reach out to clients and ask this very important question: Were there any network disruptions or problems they or their employees encountered with their health plan coverage this year?

If the answer is no, that’s great. But if the answer is yes, then there is opportunity now to pre-emptively address and explore remedies before you clients enroll in an option that doesn’t necessarily meet their needs.

It is no secret that people want and expect to be able to see their doctors. As advisers well know, when that access is limited, interrupted or unavailable due to network snags, the cost can be significant. Frustrated employees and upset clients are among the biggest threats to an agent’s business.

The fourth quarter is a fitting time for brokers to convert a potential negative into a positive. Here are three ways to help resolve or fix network disruption problems:

1) Provide a wider range of plans. Offering a full array of benefit types — HMO, PPO, EPO and HSA, for instance — is a smart move. Good exchanges and carriers can help provide these in plan designs that are still manageable for agents.

 

 

In today’s competitive marketplace, having a solid range of coverage choices is imperative. Whether an organization has two workers or 100, each will likely have employees who want different types of healthcare plans depending on age, lifestyle, pre-existing conditions and so forth. One worker may have unique personal and family needs that are best served by a PPO. Another may want a low co-pay plan option a good HMO can offer. Someone else may be better served by an HSA because of cost and tax considerations.

The upshot is that access to multiple plan types provides more opportunities to meet a more diverse assortment of coverage needs and better assures participants have the ability to see the care providers and get the services they want.

2) Offer carrier diversity. Providing options from multiple insurance carriers and through multiple benefit tiers is also a good way to connect employees to the coverage that is right for them.

Offering more than one group health insurance plan design clearly provides more options. This enables workers to decide for themselves which is the best plan choice and which connects them to their preferred physicians, pharmacies, labs and more.

For agents, managing multiple carrier plans does not need to be difficult, either. For example, a well-structured exchange can provide a variety of health insurance plans but offered in a single, seamless package with one point of contact and one monthly itemized bill.

3) Empower employee choice. Offering multiple benefit options, carriers and plan designs not only provides access to a larger network of doctors and hospitals, but it also gives clients and their employees something else — the power of choice.

Coupled with guidance from professional advisers, workers are able to be more actively involved in identifying and selecting the coverage they need, all with an eye on ensuring they can access preferred care providers. This upfront collaboration can help identify and resolve potential provider access issues early so that any network issues can be averted.

Remember, now is the time to check in with clients. Actively connecting with clients to pre-emptively discuss network or plan disruption issues now is an astute approach to provide fixes that clients and their employees will appreciate and value.

Ron Goldstein
Goldstein, CLU, is president and CEO of CHOICE Administrators, which provides health and ancillary insurance options and provider access to small businesses and their employees.

Leave a Reply

Your email address will not be published. Required fields are marked *