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Home > Insurance Broker/Health Plan Consultant Expectations

Today more than ever, employers should be demanding in their choice of a broker or health plan consultant. For example: A number of employers have found that cost-efficient healthcare programs now being offered by qualified brokers are surprisingly similar to the risk management services they've been utilizing for years in their administration of workers compensation programs.

It stands to reason that companies should look at ways to apply closer budgetary boundaries to the cost of their healthcare benefits through a buying process that integrates the strengths of both their financial management and human resources departments. A qualified broker can show you how to do this.

Here are just a few of the critical services you should expect from your health insurance broker or health plan consultant:

A strategic employee benefit plan. Your broker should create a written plan that will establish specific measurable goals and actions to serve as the foundation of your short- and long-term plan.

Medical claim data analysis capabilities. The ability of employers to understand the utilization and cost drivers of their medical plans is critical to managing future costs. Your broker should be able to provide you with detailed reporting and analytic capabilities to detect and address problems in these areas. Analysis of critical claim data components can provide answers to key questions about healthcare costs. More importantly, plan design modeling allows you to experiment with design alternatives to determine their cost-saving potential. Also, it helps to quantify the impact of such design changes on employees, allowing your HR to determine -- well beforehand -- the magnitude and advisability of proposed changes.

Periodic bid management services. Your broker should competitively re-bid all benefit plan vendors and insurance arrangements on an as-needed basis. This process should include assembling bid specifications, identifying and managing bid queries, thoroughly analyzing submitted proposals and presenting to you a set of final recommendations. By applying a risk management approach to the marketing of insurance companies and vendors, your broker should be able to clearly identify companies that can deliver cost control innovations mentioned earlier in this article.

Employee/family educational support. One of the most over-looked yet major cost-control opportunities a good broker can provide is professional assistance in communicating with employees and families. This will increase their awareness of benefit plan design and utilization, as well as wellness education. These efforts should encompass both electronic and traditional media, at your discretion. Through monthly e-mails, pamphlets and other publications, insureds can learn about things such as the effectiveness of employee assistance programs, or the cost benefits in using network clinics or doctors' offices rather than emergency rooms.

About the authors: William Moeller is president and CEO of United Healthcare of Illinois. Thomas Filippini is partner at Thilman&Filippini, which specializes in risk management services for employee benefit clients throughout the United States.

This information is compiled and provided by George S. May International Company.
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