Creative plan design: from traditional to possible

At the recent Q4Live memeber conference in Nashville, Wendy Keneipp, Q4i partner, moderated a panel of benefits advisors, who discussed their challenges, successes and opportunities when it comes to creative plan design.

While the panelists found common ground on many topics, they emphasized that there are many different ways to achieve similar goals — and it can happen at different speeds. Josh Butler, president of Butler Benefits & Consulting in Amarillo, Texas, noted that when he thinks of the term “creative plan design,” he thinks of how all solutions — including non-insurance solutions like direct primary care and concierge pharmacy — can be bundled together in an innovative way to address a client's issues. Rachel Miner, founder and owner of Charlotte, North Carolina-based Thrive Benefits agreed, adding that the ultimate goal is to “give more control back to the employer.” Bret Brummitt, managing partner at A.G. Insurance Agencies in Fort Worth, Texas, compared finding creative plan design solutions to plugging a hole, noting that it's often about fixing the biggest problems immediately and then working backwards to address other issues over time.

It quickly became clear that like many benefits advisors, the panelists take health care personally. Traditional models don't reduce costs, Butler said, they shift cost “onto the employees, who are the most vulnerable people in the organization. That isn't a long-term solution … If you don't innovate in our part of the world, you're going to lose clients pretty quickly.” He added that clients and prospects don't necessarily want cheaper insurance, they want access to affordable and transparent care. “Even though some of our solutions might not help the employer, they're helping the employees,” he said. “When the employer sees that, they're very appreciative. In our market, unemployment is 2 percent, so it's very competitive for top talent. The status quo health plans are no longer a great incentive or retention tool; that's what helps fuel our creativity.”

Brummitt emphasized the need to use simplicity and humor while educating employees. “If you can't make it simple, memorable and maybe even ridiculous, then it's not going to stick at the employee level. If they can't execute and understand the plan design, then anything else we do won't work. We won't get to the end goal.”

Miner agreed, noting that the employee experience is often lost in the drive for cost savings. “I've been guilty of that myself; we focus on saving the plan money but forget about the employees.” She added that she focuses heavily on employee education, sometimes traveling thousands of miles in a few days. “I tell employees, I've been a consumer of health care, my son has been a consumer of health care. We've had a $14,000 out of pocket spend, so I can tell employees, “I know how it feels and I want to help you.”

Keneipp asked the panel, how do you start the conversation and make sure clients are ready to jump to self-funding and some of these innovative solutions?

“I'll tell you one thing, they're not just going to take your word for it,” Butler said. “I wouldn't recommend most companies go from 0 to 60 in a year. Typically, it's a progression, and we start with data. That serves as a foundation to start the conversation about how there are better ways to finance risk, even if you're a smaller company.” He also noted that they encourage employers to share the savings with the employees, many of whom are one medical procedure away from a “financial catastrophe,” which is not what employers want.

Miner added that it's far easier to have a conversation with someone who's open to the idea. “In the past, I've tried to drag people who weren't willing towards self-funding,” she said. “I've learned to meet people where they are while also opening up their horizons to something different.”

But what if a prospect is fully-insured and happy? Keneipp asked the panelists, “Will you work with prospects who aren't ready to make the jump?” The range of answers was telling, and offers a snapshot of the various ways advisors are helping employers in this rapidly changing environment.

Brummitt said that he will work with companies all along the spectrum between fully insured and self-funded. “At the companies we work with, HR changes out, the C-Suite changes out, so there's often an ongoing conversation and opportunities open up over time. It's about how to be a good steward of these relationships and best serve them as you go.”

Butler agreed, noting “You need to find where they and work from there. It may take four years to get them where I believe they need to go, but I think we have a duty to work with those clients.” And even if they never get to “run” and are stuck on “crawl” for the next 20 years, that's OK, he added. “You chip away and get opportunities to educate them and their employees. We can make a big impact on their lives.”

Miner offered a different perspective, noting that the often divisive legislative environment in North Carolina has led her to a more targeted approach. “I have made the decision for my own business that I won't do business with carriers, only with independent TPAs. So I'll work with fully-insured companies on a consulting basis, but just as they're interviewing me, I'm interviewing them, too. If they tell me their goal is to have more control, long-term sustainability of benefits and they want their employees to feel well taken care of, I know in my heart that I won't be able to do that if they stay fully insured. So I'm not going to set both of us up for failure.”

Taking a leading role as a pioneer in creative plan design can be daunting, but it can also be truly rewarding, the panelists said. Butler noted that focusing on new ways to help employers and their employees has “invigorated my career and our agency,” adding that he's been inspired by learning from others in the industry who are innovating and trying new things.

“Change can be painful, change can be beautiful, but most of the time, it's both,” Miner said. “There are going to be certain things that won't feel great at the time, but it's often a short-term loss for a long-term gain.”

Stay tuned for more coverage from Q4live. In the meantime, be sure to check out these 4 takeaways from Heidi Rasmussen of freshbenies.

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Paul Wilson is the editor-in-chief of BenefitsPRO Magazine and BenefitsPRO.com. He has covered the insurance industry for more than a decade, including stints at Retirement Advisor Magazine and ProducersWeb.