Key questions brokers should be asking all clients this year

As a broker, you play an essential role for your clients: leading them to the benefit solutions that help them accomplish their short- and long-term goals. As you well know, to do that successfully, you need to become a student of your client, and that starts with asking the right questions. By asking your clients the right questions and learning their current challenges or desires, you can help them navigate the growing number of options and alternatives they have when it comes to health benefits, and guide them to a solution that fits best. In doing so, you’ll help them achieve their priorities and provide a winning health benefits strategy that all parties will benefit from for years to come.

This approach has never been more important, as so many industries and workforces look drastically different than they did before the COVID-19 pandemic. As needs have changed for clients, it’s well worth revisiting their current needs and challenges. Based on my experience in the industry and in the changing landscape of the past year, here are what I’ve come to find are the key questions to ask clients right now, and some of the important considerations you can lead them through.

Question 1: What are your biggest priorities when it comes to the overall experience?

The responses from clients can vary widely on this question. For some, it might be having a very low-cost health plan; for others, a very simple plan set-up that eliminates confusion for both the employee and employer might be a bigger priority. Whatever the priority, it will likely be shaped by past experiences — both positive and negative. The bottom line: Don’t make assumptions about a client’s priorities.

What to help clients think about:

There are a few key aspects of the overall benefits experience that we can help clients consider when selecting their health benefits. Below are a few examples:

Employer support — Employers spend significant time managing employees’ health plans. Employers across the board would likely agree that they would prefer a plan that cuts down on the time they need to invest in managing it. A sure way to reduce the number of employee questions and issues HR professionals field on a daily basis is by providing them with plan options that are simple, transparent, and that make it easy for employees to discern what is covered and how much of the cost the employee is responsible for. This could be achieved by selecting a model that reduces or eliminates cost-sharing for care that is preventive or essential for the health of the member, or offers an online portal that lays out plan components in a simple, easy-to-understand format.

Member support — One way to cut down on the time employers need to invest is to present solutions to employers that prioritize exceptional customer service. It’s an aspect of benefits planning that is often overlooked, when in reality this can greatly differentiate one insurance provider from the next for members and employers alike.

Consumer-centric plans — The pandemic and the rise of digital innovation has put a spotlight on increasing convenience in health care, from telemedicine to drive-through and home-based care. In the same manner, benefits providers will need to keep up with and seek out consumer-friendly experiences that help individuals easily understand their health plans and manage cost expectations, find a doctor, and offer proactive support to help eliminate the frustration and confusion so prevalent in the health care eco-system today. Ultimately, a simplified experience for both employers and employees is in growing demand. 

Question 2: What funding mechanism is right for your company?

With so many different funding mechanism options on the market today, this is an increasingly relevent question to discuss in preliminary and ongoing conversations with employers. While in the past, the size of an organization allowed clients to quickly determine what might be an optimal plan, the increasing number of market options (i.e., level-funded, customizable stop loss options, and Individual Coverage Health Reimbursement Arrangements (ICHRAs) are making this a more complex — and strategic — question to pose to your clients. In today’s market, employers of all sizes have choices and need to consider all of them when making the best decision for their employees.

What to help clients think about:

The main considerations your clients should be thinking about here is risk and cost. When it comes to the risk spectrum, fully insured and pure self-insured plans are bookends of the spectrum, with an increasing number of options in between. Employers should be considering how much risk they are comfortable with, especially in relation to financial predictability, cash flow, fiduciary responsibility, staffing or outsourcing, and affordability.

Also: 4 ways brokers will be guiding clients in 2021

It’s important to note that these funding mechanism conversations should occur regularly, especially when major world events like COVID-19 or company changes directly affect how much risk a client is willing to take on. As clients think through how they are uniquely affected by these developments, you can take the opportunity to evaluate and share solutions across the spectrum of risk based on their goals, size and comfort level with risk.

Question 3: What cost-sharing model is right for your employees?

All employers want to provide their employees with a plan that reduces the cost burden on employees, but with the highest quality of services. However, before jumping into a plan, employers need to understand how different employee cost-sharing options impact their short- and long-term goals. In the past, there was inevitably a trade-off between higher cost-sharing to mitigate premium increases and lower premiums. Unfortunately, the crutch of continuing to increase the employees’ cost-sharing to control costs has become a barrier to many and hinders employees’ access to preventative medicine and necessary care.  A recent study estimated that 1 in 5 adults in the “worse” health category delayed or decided to without care because of cost barriers.  Ultimately, the cost barriers we are creating will lead to a surge in high-cost claims for the employer, resulting in an increasing cost burden on employees. Brokers can help alleviate this catch-22 for clients by continuing to have conversations with them about the latest innovative cost-sharing options on the market. Together, you can work with your clients to identify new plan options that optimize member health, utilization and plan cost, without burdening employees with steep cost-sharing commitments.

What to help clients think about:

One of the most important ways employers can help ensure their employees realize the full value of their plans is by helping them understand the potential benefits and tradeoffs before they figure out which options to select.

For too long, we’ve presented employers with the same proposition of controlling utilization, and therefore cost, by increasing employee cost-sharing.  However, new options are in the market now that encourage preventive and essential care for the short-term and long-term health of the employee and dependents while allowing the employer to better manage their cost and deliver a health plan that offers value to everyone by allowing access to full coverage for common health care services on day one of the plan. While traditional models are increasingly trying to limit high-cost activities like visiting the emergency room, innovative plans are trying to attack the problem at its root, while also lowering cost-sharing responsibilities across the board, especially when it comes to preventative care. As the world continues to adjust to the new realities brought on by the pandemic, and some industries struggle to attract and retain talent, clients may be interested in learning about the newer benefits options that provide a higher value to their employees.

Without a doubt, the brokers delivering the most value to their clients are those who anticipate the needs of their clients and learn about their goals, past experiences and future hopes for their health benefit solutions. And the right decisions always start with the right questions. Together, we can help our clients create winning health benefit strategies and become a true and trusted partner for years to come.

Thomas Sass is VP of Business Development at Gravie.