The provision of healthcare insurance is commonly recognized as the primary benefit an employer can offer their staff. Even so, many employers only begrudgingly offer the benefit and many employees treat healthcare plan selection as a chore.
Why Brokers Should offer Self-Funded Health PlansAs a healthcare broker, you have the ability to break down the often complex and frustrating relationship between employers and their health plans. Employers and plan participants increasingly see themselves as consumers. Therefore, diversifying your offerings — and making those offerings easier to understand — is especially important. To accomplish that, you need to understand each company, its industry, and it's workforce, as well as the various plan and strategies available in the market.
Offering self-funded health plans is one way to differentiate yourself and ensure you provide your clients with the best possible solutions for their employees. Here’s what you need to know before you add self-insurance to your services.
THE SELF-INSURANCE BOOM
For large employers, self-insurance has become the standard, not the exception. According to the Kaiser Family Foundation–Health Research & Educational Trust (HRET) survey on employer health benefits, 94 percent of employers with 5,000 employees or more self-insure. Self-funding provides many added benefits to plan participants, including reduced costs and improved engagement. And while the popularity of self-insurance has trended upward for large insurers for years, mid-market companies are also getting in on the act. The same survey found that the overall percentage of employers who fully or partially self-insure increased to 63 percent in 2015.
WHAT YOU NEED TO KNOW TO BE AN EFFECTIVE HEALTHCARE ADVOCATE
Offering self-funded insurance is not as simple as adding it to your list of options. Self-funding is not always the right fit. To determine if a client is a possible candidate to gain value from a self-funding program, ask the right questions, including:
What’s your client’s risk tolerance?
How stable is their employee base?
How steady is their cash flow?
Do they have a desire to take more control over their health plan?
Are they looking for a reactive or proactive approach?
Based on the answers to these questions, you can start to determine which clients should consider a self-insured health plan as one of their options.
HOW TO DIFFERENTIATE YOURSELF FROM COMPETITORS
In the crowded healthcare market, it’s critical to differentiate yourself from your competition. While offering self-funded insurance is one way to do that, not all self-funded plans are created equally. Some elements to consider include:
Care coordination and navigation. True care coordination and navigation have not been available to mid-market employers until recently. The primary point of contact in the care coordination model is the care coordinator, who advocates for plan participants and helps navigate the healthcare landscape. Care coordinators provide a trusted and knowledgeable resource to guide participants through the often confusing process of getting the best healthcare services.
Stop-loss coverage. Stop-loss insurance caps risk by providing insurance for catastrophic high-cost claims. This brings a level of comfort to employers because they know that the carrier will assume the risk above their deductible limit.
Telemedicine. Telemedicine saves time and money, helps prevent illness and brings top quality care to remote areas by connecting patients with doctors via video conferencing.
Apta Health works only through the broker community. We partner with brokers and act as an extension of their team for any group that places the Apta Health program. Our extraordinary program combines the best solutions in the industry with cutting-edge technology to reduce wasteful spending and drastically bend the trend of rising healthcare costs.
Contact us to help your clients proactively manage their health plans and reduce wasteful spending.
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