What no one tells you about being a next-generation benefits agency
When agencies start down the path of self-funding, there are a lot more questions than answers.
When agencies start down the path of self-funding, many are mesmerized by the large cost savings and the fancy cost containment strategies they can employ. However, very rarely, will agencies hear about how this impacts both internal and external business processes.
A team at J Donovan Financial tackled these topics during a morning session at BenefitsPRO Broker EXPO 2021 and said there is both a glamorous side to these strategies as well as hidden costs. “We always head big ideas on self-funded when we used to go to conferences and never understood actually how to do it,” said Chelsea Whalley, COO and partner at J Donovan Financial.
Related: How new trends help brokers build self-funded plans
Everyone talks about self-funded strategies and uses all the buzz words, but no one tells you what happens when it doesn’t work, she continued. “We would always leave a conference with more questions than answers. I wondered how the employee experience was different,” she said. “We always heard about all the savings, savings, savings, but that is all we heard.”
Internal process
On the service side, self funded is five times the amount of work, she explained. “You are going to get a ton of calls where providers don’t understand if they are in-network or out of network. You have to be ready for people to be angry and confused so training your team is key.” On the internal process side, buy-in from the team is the key to success and you need a good CRM to track the amount of work, said Whalley. “The account management side is a lot of work. There has to be buy-in into why you are doing this.”
She noted that your team has to understand self-funding, why people are doing it, and why it works. “You have to take the time on the front end before you acquire clients to make sure your team understands all of that… you have to get the processes in place first.”
She suggests starting about six months out. “When you are asking for data from the groups, you are asking for things they have never seen before. Getting data from the client is one of the most frustrating parts of this whole process so start early.”
Another process that takes time is the actual marketing. “To put that into a simplified proposal is hard and mistakes are everywhere. We would get quotes from the wrong client and if we didn’t look at it, it could have been disastrous.”
Donovan Ryckis, employee benefits consultant, CEO and partner of J Donovan Financial added that when customizing plans, it is easy to make mistakes.
Sales
Ryckis explained that you don’t have to do everything all at once when selling. “Show them how the experience will be different the first year. You have to set those conversations up early and set up the expectations. You have to explain complex ideas and understand tolerance.”
One of the most important questions to ask a prospective client is “what is the purpose of healthcare in your business,” said Whalley. “Figuring out where they are at prior to doing your thing is important.” Another key to do is simplify things. “You have to tell a story… You have to make it clear and visual. You have to show per employee per year premium graphs to understand.”
Be ‘pro client’
The role of an advisor is to be strategic and to listen to your client, said Whalley. “You have to be insightful and pro client. “What do they want? Be transparent. What do they need and what can they handle?”
Another key is not to say the word self-funded,” said Ryckis. “When we are selling, we never say self-funded. It is a health care plan, like your 401k is guided by ERISA. You are not self-funding, you yourself are choosing how to FUND with insurance.”
It is a complex idea, he added. “You have to simplify the proposal to explain the different parts of the health plan such as the third party administrator, network, insurance ‘stop loss’ and pharmacy benefit manager. It is the same as fully insured, but diagrams go a long way. And don’t throw all of your solutions into a plan the first year. Bring in less for less disruption but also have something to deliver in future years.”
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