I was born in Canada the year nationalized health care started there (that was 1967 for you history buffs). It was well-funded and provided great care for a few decades. But medical inflation was out of control. By 1991, when I moved to the U.S., the medical plans started to get stripped down to the bare minimum.

Would it surprise you to know that today Canada has a thriving employee benefits market? Brokers sell multiple products and services that keep them busy and profitable. This growth hasn’t been with medical plans — instead, it’s come from services not covered by the national health plan.

I’m sharing four categories that hold tremendous growth opportunities because they’re not part of the Affordable Care Act minimum plans. Some are already on the market, and some are yet to be developed by carriers. So, sit back, grab a coffee and find a few things you can get behind!

1. Services stripped out from traditional medical plans: Many things that used to be covered for most Americans are no longer included in the typical employer-paid or individual plan. Also in this category are services that were optional on some plan designs and I don’t foresee them ever returning. Many Americans would happily pay separately for these services. Some are already available and others may show up in carrier offerings in the future:  

  • Cosmetic surgery
  • Infertility treatment
  • Long-term care
  • Home health
  • Private nursing
  • Weight-loss surgery
  • Medical equipment
  • Podiatry
  • Chemical dependency
  • Adult dental
  • Adult vision
  • Hearing treatment

2. Complementary and alternative medicine: For more than a decade, the American health care industry has been driving citizens to become better consumers. Some people have responded by finding sources outside of traditional Western medicine. Entertainment shows like The Biggest Loser have made many of these services mainstream. For those of you who think you’d never try something from this category, raise your hand if you’ve ever had a chiropractic visit. Then, consider the opportunity in selling such programs to your clients:

  • Chiropractic
  • Acupuncture
  • Naturopathic
  • Herbal therapy
  • Massage therapy
  • Aromatherapy
  • Homeopathy
  • Holistic therapy
  • Reflexology
  • Relaxation therapy
  • Movement therapy

3. Filling the financial holes: We can all agree that medical rates are skyrocketing. Therefore, out of pocket costs are also increasing drastically. The biggest need is to help employers and/or employees fill those ‘holes’ in medical plans with other services that keep cash in people’s pockets - or services that help people be better consumers.  These needs have been serviced through Worksite and Voluntary Sales for decades. It’s a category that will continue to develop:

  • First dollar services
  • Accident
  • Critical Illness
  • Gap
  • Medical tourism
  • Rx buy-ups
  • Mental health/EAPs
  • Wellness / Fitness
  • Centers of excellence
  • Price transparency/negotiation
  • Patient advocacy

4. Future trends and advancements: The speed of advancement will also bring new opportunity for those in the employee benefits industry. I see three main trends:

  • More product choices: The volume of product choices is driving the need to simply, efficiently and effectively present those elections at the employee level. By level, I mean: 1) at their understanding (this business is complicated stuff), and 2) personalized for each individual. Many new opportunities will appear including: benefits technology, exchanges, single-billing services and enrollment services
  • New advancements: As new medical advancements developed over the past 15 to 20 years, the goal of the developer was to have it included under health insurance plans. Mandated coverage was the objective — it was also one of the drivers of medical inflation. No longer. I believe that many future advancements will take a lesson from industries such as cosmetic surgery — they won’t even try to be included under health insurance. Some of the obvious trends on the immediate horizon include: more cosmetic treatments, specialty drugs and genetic testing/therapies.
  • Doctor shortage: All the projections say there aren’t going to be enough doctors to serve Americans in the coming years. By 2020, we’ll be short 19,500 family physicians. Imagine your medical-plan clients trying to squeeze in an appointment for the flu or a urinary tract infection — how will they respond when told they can’t get in for two weeks? We’re also seeing (and expect to continue to see) the shrinking of networks. How do you serve a group that doesn’t have near the same access as before?  Both of these trends will expand the opportunity to access providers in unique ways like concierge nurses/PAs/doctors and telemedicine.

We’re entering a time like the Wild West — there will be a lot of changes and advancements. Keep your eyes open for some new opportunities you can get behind and sell.
Rasmussen will be speaking at the Workplace Benefits Mania conference on Thursday, July 31 at 10:30 a.m. in Las Vegas. To find out more about WBM, hosted by EBA’s parent company SourceMedia, click here.

Rasmussen is owner of freshbenies, a health discount card that includes the ability to call a doctor 24/7 and get a prescription, if needed. Reach him at reid@freshbenies.com.

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