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Is Your Carrier Invested In Your Company's Strategy?

The Affordable Care Act (ACA) has dominated our employer conversation for two years (if not more) with strategic planning, reporting solutions/management, and ongoing education. Currently, the conversation is fueled by changes in the rating system for employers with 50-99 eligible employees and the endless annual reporting requirement calendar. However, the most costly and time consuming changes are surrounding the 6055 and 6056 reporting.

As employee benefits consultants, our job is to simplify the complex world of employee benefits and the ever-changing health care system. This includes assisting human resource and finance departments by sitting in on calls with their payroll companies, offering quotes from reporting specialty companies, or installing a proprietary HRIS based self-service platform designed to provide solutions in the wake of the 6055 and 6056 reporting storm.

The need to focus on 6055 and 6056 reporting implies we are still offering benefits to our employees, and hopefully this was a conscious decision with a strategic framework. You should now be entering your second or third year looking to optimize a strategy similar to options 2, 3, or 4 as illustrated in the “strategic framework” below.

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While employers all started from different readiness levels to complete their strategic plan, there has been plenty of time and opportunity to start moving toward a desired outcome. An effective carrier marketing plan is one of the best ways to leverage your strategy with the best carrier for your needs.

Effective carrier marketing starts with the concept that the carrier is investing in your organization and your organization’s strategy and that you are doing the same with regards to them. It is important that your organization and strategy are represented in the best light possible, and that the carrier has the programs and platforms and will provide access to the information required to execute your strategy. Here are some potential benefits of effective carrier marketing:

    • Drive the best cost outcome: of course this can result in the need for frequent carrier changes and will eventually result in diminishing returns.
    • The ability to demand claim experience that may not have been received in the past: This is one of the most significant leverage points and will allow for a more in-depth discussion on alternative-funding options.
    • The ability to negotiate cost structure: does the carrier offer a variety of funding options, such as, level-funded, self-funded, minimum-premium, and participating contracts? What is their employee threshold for these options?
    • Leverage wellness, funding and other strategic support
    • The ability to review network access, provider discount, prescription contract and trend analysis
    • Evaluate Consumer Driven Health Plans (CDHP) and trend success
    • The opportunity to have finalist interviews:
      • Learn about management team and structure
      • How does the carrier foresee the marketplace transforming?
      • What is each carrier investing in and why?
      • Learn about customer service structure
      • Interview dedicated account management team
      • Learn about technology and administrative support
      • Effectiveness of case and disease management and cost containment

The employee benefits world continues to evolve and a carrier’s mission, strategy and product investment will largely dictate whether or not they are the correct partner for your strategy. These investments are often very large and will dictate (for better or worse) a carrier’s effectiveness for many years. Much like the automobile industry, we rarely drive the same vehicle our parents drove. Some manufacturers have gone out of business due to poor management, lack of technology, or investing in the wrong products. Others have lost market share, due to: high cost, not meeting consumer needs or sacrificed quality. At the same time, new players and even former standouts have found ways to meet our needs and be wildly successful.