It’s the modern-day benefits broker paradox: Employers clamor for more wellness, but they really just need better existing plan design

In order to remain profitable and competitive, benefits brokers must deliver more services – often for no additional compensation.

Since the passage of the Affordable Care Act, which gave employers an incentive to offer worksite wellness programs that encourage better health outcomes and slow utilization rates, the benefits broker has been “thrust” into the role of wellness consultant, according to Dr. Steven Aldana, CEO of WellSteps, a national provider of worksite wellness programs.

“In addition to providing guidance on health insurance products, brokers are now being asked for advice on how to set up and administer an effective workplace wellness program,” writes Aldana.

More and more employers are offering a wellness program, but WellSteps research shows that most brokers are reluctant to act as wellness consultant.

In a recent Department of Labor-commissioned study, RAND Corp. data shows that 51 percent of employers offer some kind of wellness program. Adoption is much greater among larger employers: 85 percent of employers with 1,000 to 10,000 employees have a program in place, compared with 39 percent of those with 50 to 100 workers, and 62 percent of employers with 100 to 1,000 workers.

Clearly, employers are investing more cash in these programs. Fidelity Investments data show that, last year, employers spent a record $693 per employee for wellness initiatives, up from $430 the previous year.

According to Aldana and WellSteps, though, brokers are not riding the trend. While the DOL’s data suggest that smaller and midsized employers are adopting wellness initiatives, Aldana says brokers often tell him that only about 10 percent of their books of business show employers are doing a “decent job” of wellness programing.

“That suggests that here, in the real world, around 90 percent of small and midsized companies are doing little or nothing regarding workplace wellness,” writes Aldana.

For several years, Aldana says, WellSteps has surveyed brokers on how exactly they advise employers on wellness programs.

The most popular approach by far is no approach at all: Fifty-four percent of brokers say they “do nothing” to help employers implement workplace wellness solutions.

Aldana published several responses from broker respondents underscoring their frustration with the wellness movement: “I’m a broker, I sell insurance, I don’t do wellness.”; “I get paid to close deals, there is no money in wellness so why should I spend any time working on it.”; “I don’t have the expertise, time, or interest to advice my clients about workplace wellness programming.”
‘Gut-wrenching feeling’

T.J. Morrison, vice president of Benefit Design Specialists, a Harrisburg, Pennsylvania-based brokerage that specializes in designing self-funded benefit solutions, says it’s common for prospective employer-clients to begin with a question about wellness management.

“I cannot begin to tell you the gut-wrenching feeling I get when starting to talk to a prospect, and the very first question they ask is, ‘Can you help support our wellness plan?’ ” writes Morrison in a recent blog post.

Morrison tells BenefitsPro that this sentiment is particularly common among veteran brokerages.

“Wellness plans have been marketed as the next new big thing, even before passage of the Affordable Care Act,” he says. “They offered an easy opportunity for brokers to bring something new to employers.”

He thinks that has distracted employers from addressing core plan design issues that can deliver better return. Companies can do this by channeling education and consumption options that drive employee engagement and ultimately push plan costs down while delivering tailored options that show an employer’s appreciation of its workers.

“Wellness kind of became the silver bullet solution to the issue of rising premiums,” says Morrison. “But that’s not reality.”

Use conversation on wellness to introduce ideas on better plan design

As a specialist in self-funded plan design, BDS has focused on consumer-driven options since the early 2000s. Back then, Morrison says, BDS struggled to break out by offering voluntary policies outside of core benefits. “Honestly, we felt we were selling something employees didn’t need,” he said.

That’s all changed in the past five years, he said. Today, more employers are trying to control core medical costs, and insurers are delivering higher-quality voluntary products that offer better benefits at lower premiums.

BDS partners with a voluntary and enrollment specialist, Philadelphia’s TriBen Insurance Solutions. This partnership allows BDS to focus on its specialty — designing highly customized self-insured programs —without having to also become a specialist in voluntary products or enrollment.

It’s an effective marriage, says Morrison, with each brokerage serving as a specialized firewall that ensures that each plan has the best benefit and voluntary options, custom-tailored to the client’s specific demographics and needs.

Focus on best solutions

Gut-wrenching as their over-imperative may be to brokers, Morrison says, wellness programs have a place in plan design. It’s up to brokers to help employers understand what that place is.

“Brokers’ focus needs to be on creating real solutions that have a direct return for employers and deliver the best results for workers, and that means having honest conversations about traditional wellness plans,” says Morrison.

Some of those wellness options are more effective than others; some are backed by what Morrison qualifies as questionable data.

Regardless, employers are more curious about wellness than ever before; RAND’s research shows strong employer confidence in wellness programs, in spite of the fact that fewer than half of employers have a formal evaluation process in place for existing wellness programs.

In one portion of its wellness program effectiveness analysis, RAND found that participants in wellness weight control programs lost, on average, one pound over three years.

Brokers who are leery of the overall efficiency of wellness programs -- and employers’ infatuation with them -- should still be equipped to address employers’ wellness needs. Partnering with a well-vetted wellness vendor that can deliver results-driven programs is one way to do that, says Morrison.

And by addressing employers’ wellness questions, you can turn the focus to better plan design, and drive “real results” through “real solutions.”