In part one of a two-part blog series Robert Winslow, principal of Elm Street Partners,  blogs about some of the opportunity that the new health care legislation has brought apart. Do you agree with Winslow that there is an opportunity in all the changes?


While it’s been nearly a year and a half since passage of the Patient Protection and Affordable Care Act, I’m frankly amazed at how many people still seem caught in the headlights of this legislation. 

The Act is big, bulky and complex. Many would argue it does little to meaningfully address the root issues of rising health care costs. That said, PPACA is our new reality, and as employee benefits professionals, our job is to help clients navigate the Act’s requirements and make the best benefits decisions for their organizations. Doing that, we also can capitalize on the opportunities presented by PPACA.

Yes, I said “opportunities.” While the sky is falling in the minds of many, as seems to be the case with most major federal legislation, I’m convinced more opportunity is created here than lost. To find it, though, we must overcome a couple of obstacles:  1) our fear of giving up what we have and know, and 2) our lack of familiarity with different benefit options. It’s time to become a student again.

Client Relationships. We’re comfortable doing what we do, the way we do it, and making more money each year as our clients’ health plan expenses go up. PPACA changes that playbook. We need to understand our clients, understand the shifting rules of the game, and understand that there’s more than one way to skin this cat. 

For larger clients, explore self-funding with its flexibility and attractive cost structure. Approach your client relationships differently — perhaps entering into a consulting contract rather than a broker-of-record, commission-paid arrangement. Or maybe it makes sense to voluntarily forego commissions on the primary health plan in favor of a fixed fee with the opportunity to represent other offerings.

Roll up your sleeves with your clients. Be a strategic partner. Show them you can think creatively and find solutions that address their needs. Your goal is to help current and prospective clients comply with PPACA, not let them walk away. In doing so, you’ll grow your business.

Clients with so called “mini-med” plans offer a unique opportunity. With mini-med carriers required to obtain special waivers and jump through a number of other hoops to provide coverage (most egregious of which is the requirement to notify insured’s that the mini-med plan is not compliant with federal law), the question you have to ask is:  ‘Why deal with uncertainty and burdensome rules when you can move your clients out of an expense-based plan into a high-quality fixed payment (indemnity-style) limited medical plan that isn’t subject to PPACA requirements?’ If you’re not familiar with fixed payment-style limited medical plans, get educated. They represent a viable alternative to mini-meds for now. And while not PPACA-compliant as a group health plan, fixed-payment limited medical plans can play a variety of supporting roles in your clients’ “big strategy” for 2014 and beyond.

Value-Added Support. Employers must constantly improve their operating efficiencies and margins. Delivering workplace benefits that reduce internal costs and improve results are a win-win. You can drive that winning combination. If you already offer consolidated enrollment, aggregation and electronic communications capabilities, you’re ahead of the game. If not, there are excellent firms that specialize in this work. Find one with a good reputation for quality work and that is committed to continuous improvement. Newer technology firms likely will be more flexible and cost-competitive.

Winslow is principal of Elm Street Partners, a group benefits consulting firm.

Come back to BeAdvised Thursday for part two of this series, when Winslow will share tips on the opportunity in supplemental coverage and engaging clients.

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