"This business used to be easy, you just had to make one sale and that was in the boardroom. If the executives selected your health plan then everyone else just went along with the decision and enrolled in the group health plan."

That was how Harry Reynolds, Director – Health Industry Transformation, IBM Global Healthcare and Life Sciences Industry began his talk at one of the networking breakfasts held this year during AHIP Institute, the annual gathering of health insurance plan executives held in San Francisco.

Reynolds went on to say that this is all quickly changing. During his presentation entitled, "Healthcare Transformation: The Movement Towards Individuals," Reynolds sketched his vision of the near future to be one where carriers and presumably brokers will need to rethink their core business processes, learn from other industries, and redefine their consumer brand in order to sustain and strengthen their business model.

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Reynolds predicted that by the year 2017, 40 percent of the non-Medicare health insurance market will be direct to consumer. Despite what you believe about the recent McKinsey study predicting the demise of employer-sponsored health insurance, this shift in the market can occur even if employers don't decide to bail on sponsoring health insurance, sending all their employees off to the state-run insurance exchanges.

Actually, most surveys seem to show that, at least for now, employers will continue to provide health benefits to their employees. It just makes sense to avoid the penalty of $2,000 per employee and to remain competitive in the labor market.

What the surveys are not saying is how these benefits will be provided. Companies like Aon Hewitt bet that even the largest employers will move to a defined contribution-type of benefit plan. Similar to the way that most retirement plans have been operating for the last 30 years, employers will simply make available to employees a fixed amount of dollars for them to spend on health insurance coverage. Employees will then access a private exchange platform like the one Aon Hewitt has built and select from a menu of carriers and plan types.

Any premium cost for the plan selected that is above the employer's fixed contribution will be paid for by the employee probably though a pre-tax premium only plan operated by the employer.

This is a way for employers to continue to offer health insurance, keep a handle on their cost increases and likely avoid the excise tax on so-called "Cadillac" plans that will kick in starting in 2018. For employees it may mean more cost sharing, but will also bring more choice – potentially an overwhelming amount of choice.

This is where the broker of the future comes in. Not your father's broker who made the boardroom sale, but the new business-to-consumer broker who will have either developed or acquired the technology and the skills needed to help employees in a one-to-one setting determine which carrier and which basic plan type will suit them the best. This is a broker who has learned from other industries about how to operate efficiently and effectively in the b-to-c environment.

Think travel industry. Airlines and travel agencies have done a great job of learning how to use technology to present consumers with a vast number of choices of routes, departure and arrival times, connecting cities, fares and so forth. The consumer can sort through this information to make choices that best accommodate their travel needs and budget. Once that is done they then are prompted to make similar choices about the ancillary services which will make their travel plans even more complete such as hotels and rental cars.

With employees expected to be attracted more and more to consumer-directed health plans for their lower premium cost and increased flexibility, there will be ample opportunity for the broker of the future to not only advise them on the core plan, but also to recommend ancillary coverages such as dental, vision, accident policies, and of course HSA administrators — all services that make the health coverage more complete and will ultimately increase overall employee satisfaction with the program.

The broker of the future will still need to make the first sale in the board room. That is where the employer will have to be convinced that you possess the expertise and the tools to guide their employees though an increasing complex enrollment process. Once over that hurdle, the broker of the future will have access to a vast new individual market willing to buy multiple products if they understand why they need them, and it is likely that employers will be willing to pay a nice fee to anyone with the skills and tools to take this task off their hands.

It seems cliché to say that the future is now, but it is. So what are you doing now to rethink your core business processes, learn from other industries, and redefine your consumer brand in order to sustain and strengthen your business model? What are you doing to become a broker for the future?

 

 

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