As a Texas-based benefit adviser, I can speak from experience about the article Building value through health data transparency. In January 2008, Texas passed House Bill 2015, under which for groups between two and 50 lives I can get data on month-by-month covered lives, premium paid and claims paid. I can also get a listing of large claims in excess of $15,000. On groups with 50+ lives, I get all kinds of information on ER visits, office visits, prescription drugs, etc.
Insurance carriers here will accept the HB2015 reports in lieu of employees answering medical questions on small group applications, which has really sped up the underwriting process. My clients and I can also make informed decisions at renewal, but more importantly, we can help reduce claims through education. Too many ER visits? We can educate employees on urgent care centers, which are more cost effective. Large claims due to preventable disease? Voila - a wellness program!
As an adviser, I have to guide and educate clients on HB2015 - most don't know it's available, and they sure don't know how to request it.
Congratulations to Joe, Anne and Heather for participating in the 2010 EBA Wellness Challenge! I used to spend three to six hours a day on a bicycle, so fitness is part of my DNA. I could relate to all the comments about trying to find the time, motivation, and balance to add - or return - wellness and exercise to their lives. That is a difficult thing to do. I'm having the same struggle right now and I can really feel the difference. Exercise is vital - it energizes your body and mind. Joe Ellis was right on when he said that after going to the gym, "my mind is sharper when I'm dealing with clients."
One of the ways I've been able to combine business and exercise is to take an issue, presentation, or idea with me when I'm on a run or a bike ride. I work through the problem, do visualization, or just let my mind clear so that I can get a fresh perspective.
It's MLR time
One thought about medical loss ratios (Producers remain in the admin category of the MLR - now what?). I've seen many changes, as we all have, with commission agreements due to MLR. An active broker group here in Texas has been working closely with one carrier in particular on the 50+ life commission structure. This carrier currently has removed commissions, but will bill broker fees that the client and broker agree upon. The jury is still out on this, but it does show how commissions might be handled in the future. Remember, some state insurance licensing issues may crop up relating to charging fees, so review your license and be ready to make changes if you have to do so.
Finally, Craig Davidson asks a great question: Why should an employer buy from you?. At my first insurance sales job, I was taught our sales story - what made us unique, different, and, most importantly, why a client would want to hire us. My boss taught me a visual diagram of self-funded medical, and then he taught me to draw it upside down, so the client across from me could see it develop! I'm still using it 17 years later.
Do you have a sales story? As Davidson says, ask yourself the tough questions and do some soul searching. Be different. Be memorable. And look to where benefits are going - not where they've been.
Reach Bryant, founder of Woodlands, Texas-based SB&K Benefits, at firstname.lastname@example.org.
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