Shifting focus: Brokers set their sights on post-pandemic progress

As we slowly start to think about life post-pandemic, what is the employee benefits or health care issue that you’re most excited to focus on?

Opportunity to innovate

As we look forward and past the shutdowns, we are entering a time of unprecedented opportunity for all businesses, not just those of us in the HR and benefits space. We have huge amounts of stimulus money flooding the market, low interest rates (admittedly artificial) and a large demand for products and services from those who’ve been shuttered for the better part of a year. The smart money is going to take advantage of these factors in the market and win. But what will that mean to those of us in employee benefits?

Related: Pandemic-prompted shifts in employee benefits might stick

With the shortage of labor, organizations are going to have to keep who they have. With “you can work from anywhere” policies that seem to be pervasive, part of our charge as benefits advisors is to help companies keep talent and how to help them manage burnout from the burdens that will be placed on employees.

In a small market like Charleston, South Carolina, many candidates will be enticed by offers from more well-known brands from larger cities. The challenge for employers here will be how to compete with bigger market dollars. It’s an opportunity for us to dig in and help companies identify what they are really about and communicate the message about their culture to employees via their benefits program. It’s a real opportunity to innovate.

To manage burnout, lifestyle benefits that have typically been pushed aside, could be given another look as a way to cope with the demands that the post-pandemic economy will bring.

Tom DiLiegro, principal advisor, Benefit Advisors of Charleston, LLC

Partner to the professionals

Do you know who has the most stressful job in 2021? HR and operations professionals. Imagine being responsible for a list of tasks that include the transition to a hybrid/remote work environment, COVID and vaccine policies, and ensuring the mental health and wellbeing of employees. Imagine having to understand and implement different areas of the American Rescue Plan Act (ARPA) and the CARES Act. As the pandemic comes to a close, my focus is on making the lives of our clients easier.

Though lowering the cost of health care is always at the forefront of my role, leading with technology and HR solutions will be the way to shine post-pandemic. Employers are seeking support in consolidating and integrating technology systems that can assist with tax credits, tracking leave, COBRA, mandatory training and benefit administration. In addition, they are looking for a partner who has their back on state and federal guidelines, workplace policies and employee communication.

Jessica Du Bois, employee benefits advisor, Business Benefits Group

Show you care

There was a tremendous unmet need before COVID that just got heightened. Whether it’s anxiety about going to the office or staying at home, reactions will vary by the individual, like so many things. By destroying primary care over the last couple decades, we’ve harmed one of the few areas where people got help.

Wise employers are incorporating proper primary care that incorporates mental health (and PT, by the way). We are particularly seeing this in the claims analysis we do with employers who have a younger workforce. Fortunately, there are some sound approaches. Unfortunately, most don’t know about them or deal with them in yet another siloed manner.

Dave Chase, co-founder and CEO, Health Rosetta

Where to start?

There are SEVERAL things that excite me about the health care and employee benefits environment today:

AI in health care – I’d especially love to see some integration of MCG/evidence-based clinical pathways into EHRs. I think that would take us giant leaps forward in ensuring highest quality of care for every patient, and would serve to reduce disparities in health care delivery. It would also ease the path toward seamless integration from provider to insurer/health plan.

Automation of the precertification process – it’s a pain in the behind for practitioners to perform pre-cert, and it’s inefficient on the insurance/health plan side, so it’s ripe for fixing. It’s one battle that bots could solve for us all!

But, the most exciting thing that I am working on along with several of my nursing colleagues is helping individual patients/health plan subscribers and members to be a part of the solution. I believe that the end-user of employee health benefits is finally coming to several realizations: The system as it stands now is broken; insurance as it stands now is unsustainable; not all doctors and facilities are created equal; health care cost and quality are inversely related, so we as patients have an individual responsibility to arm ourselves with information. I’m excited to see individuals finally asking questions like “Why can’t I find good information about my health care situation and the quality and cost information for providers of that care?”

For the first time in forever the overwhelming majority of our patients are accepting information, engaging in deeper dialogue, and using the information to their advantage.

As more patients become part of the solution, and as the overall cost of care comes down as a result of their better choices, more employers are willing to shoulder 100% of the burden of the cost of care, eliminating patient financial responsibility. Most employers truly want their employees and their families to get the highest quality of health care possible. They want them to be healthier and they don’t mind paying for that, but they also want to make sure that they are getting value for that financial expenditure.

I believe that employer-sponsored health plans that are able to eliminate patient responsibility and provide complete coverage are going to have a real and significant strategic business advantage and that they will be a major contributor to solving one of the biggest “social determinants of health” issues – health care access and quality. That excites me!

Deborah Ault, ”Nurse Deb,” president, AIMM

A chronic issue

I wonder why more focus isn’t being placed on chronic conditions. Having owned and operated a PBM, I’ve seen how prevalent (and expensive) chronic conditions are for plan sponsors. Chronic conditions show no bias, impacting blue-collar and white-collar workers alike. Sixty percent of U.S. adults have a chronic condition, 40% have two or more, and costs increase with each added condition. Diabetes, heart disease, asthma, etc. are all chronic conditions that are managed with medications, yet 16% of all U.S. health expenditures are driven by non-optimized medication use. That’s a $528.4 billion problem.

When the world was “on a break,” individual’s’ chronic conditions weren’t. During quarantine, more people went without medications, preventative treatment, and standard care than ever before. To date, I don’t think we’ve realized the true cost of the pandemic… but it’s coming. Because more people failed to manage their disease states by going without meds or care, their risk for worsening conditions or adding conditions increased. The good news? This problem can be fixed by managing the whole person and all their disease states. This is accomplished through personal conversations with individuals to meet them where they are.

Larkin O’Keefe, president and principal, Tria Health

It’s personal

As a manager, I am really thinking a lot about the mental health and emotional well-being of the entire team. Being aware of how people are feeling, what their role is, what stressors are part of their jobs. But there is also the obvious off-work time we need to be aware of and the things that are happening for people that contribute to the whole person. If there is something happening personally and we can either help by simply understanding, accommodating or helping in some other way, I want to know. Suffering and trying to cope alone and pretend that everything is OK just adds accumulated stress. I care immensely about our team and want them to be able to be their best selves.

Wendy Keneipp, partner, Q4intelligence

Support system

Companies took a financial hit in 2020, employees and their families often delayed their health care due to the shutdown, and claims volume was down. This means in 2021 and beyond, people will access care. How will employers be proactive and support their employees to become better health care consumers? Better quality equals less cost. But how does the health benefits program provide support? There’s the focus!

Lester Morales, founder and CEO, Next Impact

Don’t forget

I believe that the senior and retiree population of any employer should be a lane that is not overlooked. COVID showed us how important the health of our senior population is, and why being in the right Medicare plan is essential. This won’t necessarily be a trend, but should be, especially when there are amazing programs out there available to all employers without a financial obligation from the employer side. I would love to shine a light on this!

Peter Meyer, sales associate/business development, AmWINS Group Benefits

Ongoing issues

We should be anticipating a significant mental health impact. As companies are asking more employees to work from home, there is an isolation that creates anxiety for a lot of people. In addition, many employees are having to deal with their spouses and children being there at the same time.

Rachel Miner, founder and owner, Thrive Benefits

Tough questions

I think there is going to be anxiety about going back to work. Who’s had shots/who hasn’t? Am I at risk going back to the office? Do I have to go back? Also, there is a lot of synergy created by being in the office; what if I choose to work from home and miss out on being part of that team? As offices start to open back up, it will be interesting to see how we progress in the months ahead.

Dena McVicker, employee benefits/technology specialist, BeneChoice

Science to the rescue

There are days where I have to remind myself that my excitement about fixing the problems facing employees and employers today needs to be toned down a bit. Throughout my career, I’ve had one goal: to help the employees at the companies I guide through a confusing and cutthroat industry. Over the next 12 months, we will see a large number of pharmacy claims increase on most of the clients we serve. Mental health will take over the health plans at such an alarming rate that employers will be scratching their heads to figure out what they did wrong. As always, they will throw bubblegum and duct tape on the busted head gasket. Meanwhile, the 8% to 12% of companies working with the industry’s leading consultants and advisors will take massive steps to regain control.

As we dig into the pharmacy spend, we are going to embed pharmacogenomics, the study of how genes affect a person’s response to drugs, at no cost to the employee. This relatively new field combines pharmacology (the science of drugs) and genomics (the study of genes and their functions) to develop effective, safe medications and doses that will be tailored to a person’s genetic makeup. This is the first step in reversing the trend that pharmacy plays on mental health. By ensuring that employees are on the correct medications, we can decrease the adverse drug reactions and lower both the dosage and quantity of prescriptions. Employees can lead happier, healthier lives and see an increase in work productivity by removing the additional side effects that are caused by incorrect medications that have been prescribed.

Anthony Pacheco, co-founder and president, P13:11 Partnerships

FML…A

As we return to normalcy in a post-pandemic environment, the topics which have dominated the discussions we are having with our clients and prospects involve enhanced paid leave programs and the new complexities of FMLA.

The pandemic itself created a host of new concerns and questions related to FMLA, such as the hours worked and location requirements, as employees work remotely or in hybrid scenarios. Additionally, employers also have to deal with new potential FMLA situations, such as employees who are asymptomatic or have underlying health conditions.

Whether employer-initiated or state-mandated, there has been a growing trend to introduce or expand income replacement programs, such as salary continuation, maternity and family leave, statutory disability, PTO, paid sabbaticals, etc. Employers, more than ever, are seeking guidance on how to provide these enhanced programs in a compliant and cost-effective manner. As these complexities increase, our recommendation is for employers to outsource or co-source their leave and absence management to a disability carrier or TPA. To that point, employers have better options available to them, as technological advances now provide seamless integration with existing HCM systems.

Kevin Kennedy, benefits consultant, TriBen Insurance Solutions

Voluntary no more

I’m excited to see that voluntary carriers are creating better plans that have less gaps and are easier to enroll in. As the benefits improve, restrictions become less existent, and enrollment is simplified, the ability to make VB part of the entire strategy becomes easier. VB isn’t just an afterthought anymore. It can truly help brokers offer more, businesses increase benefits, and employees protect their families.

Employee engagement strategies are also becoming more of a focus. The exciting part is it’s not the old you must meet with a counselor model anymore. A focused specialization and technology are playing a big role in making needed changes possible to educate employees so they can make decisions that are right for their families.

Jack Holder, co-founder, EBIS

Digital renaissance

At the risk of sounding like I’m stuck in 2015, I’m excited to talk to employers about going digital with their benefits (again). Conversations over the years were either with early adopters who were excited and all in, or they were met with staunch opposition. It seems we may be moving into the late majority stage now. There are so many great resources available and the previous belief that “our people could never use technology” has been obliterated. Couple that with teams working remotely for some time and now there’s a need and an urgency to find the right technology in order to keep things running smoothly.

I’m re-energized to help our clients and soon-to-be clients find the right solutions to streamline their processes and workflows while helping their people to better understand and use their benefits packages. It’s my opinion that technology is the first step in building a great and well-rounded benefits program. Not that you can’t have a great program without it, but adoption and utilization of benefits programs take longer without technology to assist.

Once the tech is in place, you can better engage employees with their plans, which will ultimately create better utilization and help with cost reduction. In benefits there’s no one key piece, as it all works together with each piece complimenting and helping the other to create a well-rounded, sound, and cost-effective benefits package.

Heather Torres, benefits team leader, EHL Insurance

The definition of insanity…

I’m really excited about continuing to focus on the end user’s experience. For too long, our industry has educated people using the same dialogue and processes that perpetuate the brokenness and dysfunction of the health care system.

As businesses make the transition to fully remote and hybrid work environments, we have to reimagine how we interact with members and start thinking about how they see and understand insurance. Annual enrollments and benefit fairs have never cut it and now, with a growing remote workforce, are going to be even less impactful. We need to design processes that meet a member where they are, in their time of need. Insurance should be an afterthought because it works the way it’s supposed to work, not because the member doesn’t understand it.

Alex Dampf, president, Oakmont Benefits

The long game

Last year, the health benefits industry was focused on the present, pressing needs: paying for medical expenses related to COVID; receiving health insurance after a layoff; and mental health benefits. Now that we’re slowly transitioning out of the pandemic, I’m most looking forward to thinking strategically and long-term about health and wealth. Our own surveys have shown us that people are thinking more about saving and investing now than they were pre-pandemic, and I’m excited about some of the solutions that can meet consumers in this moment. In particular, I think we’ll see an increase in the younger generations investing their health care dollars.

Brian Colburn, SVP of corporate development & strategy, Alegeus

Care navigation

The current boom in health care point solutions is creating complexity for benefits leaders, especially when these point solutions all claim to lower costs and increase employee satisfaction. As employers introduce new, expanded post-pandemic benefits offerings, the burden of navigating these solutions falls on employees, who must learn an evolving landscape, often with little education and understanding about what benefits are available to them and which service to use at what time. When employees don’t understand the resources available to them, they don’t take full advantage of their benefits and undervalue the investment made by their employers.

Luckily, effective care navigation can drive value for employers by increasing adoption of sponsored benefits, lowering health care costs, and supporting their most valuable asset: their employees. Providing employees with expert navigators who engage with them on an emotional level not only simplifies health care, but creates well-informed employees who can appropriately utilize their benefits. Further, a proactive, consumer-centric approach that intelligently leverages clinicians improves outcomes and drives down costs for employers. As the new landscape offers more and more point solutions, care navigation is going to be key to driving value for both employers and their employees.

Jordan Feldman, CEO, Rightway

Stewards of equity

The Pittsburgh Business Group on Health is working to help the region’s employers, as well as the general public, become aware and be better stewards of health equity by taking action to educate and build quality programs, which drive better care. For example, we launched a comprehensive free public Health Equity Series to address maternal health.  Moreover, employers are recognizing the critical role they play in how we fully defeat COVID-19 by committing to education and creating more access for marginalized communities, communities can truly thrive in the months and years to come.

Another area we are focused on is mental health. During COVID, it became apparent women paid a higher price–shouldering the burden of childcare, playing the role of teacher, cooking, feeding, household chores and elder parent care. It took a toll on their mental health. Recently, about 53% of 256 employers surveyed by the National Alliance of Healthcare Purchaser Coalitions reported providing, “special emotional and mental health programs for employees because of the pandemic.”

Employers concerned about their workforce have begun to reshape their commitment to employee mental health, such as encouraging workers to create work-life balance – taking breaks or vacations. Some employers may even shut down email servers at certain times to help employees unplug.

Health equity and mental health are two areas in which employers must step up and lean in.

Jessica Brooks, Pittsburgh Business Group on Health