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Health Care Reform: The Agent's Evolving Role

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As health care reform begins to take full effect, your clients will have many questions, including: Will I need to offer health care benefits to my employees in 2014? What penalties will there be if I do not? Which is better for my business: being self-funded or fully insured? What will benefits packages look like in 2014 and beyond?

Your role as an insurance agent will grow and change as more regulation begins, and you will be asked to provide ongoing counsel and education to your clients between now and 2014. Read on for best practices on how to offer strategic guidance to your clients during this transition.

Becoming a strategist

As your clients begin to weigh their options, your role as a trusted advisor is more important than ever. By offering knowledgeable counsel and timely information, you will be able to walk your clients through some of the most challenging health care issues faced by our country. In addition, you can help them make financially sound decisions that could positively impact the growth of the organization now and for years to come. By arming your client with the right tools to educate employees, you can help make the health care reform transition easier to understand and easier to prepare for over the next three years.

Below are best practice tips for guiding your client through health care reform regulations.

Tip No. 1: Act short-term; think long-term.

Health care reform is a topic that is best considered in light of overall corporate planning, because of its large impact on financial and human resources. As an agent, your clients will be looking to you for advice about the best ways to plan and make decisions. These decisions will be based on a multitude of factors, depending on your client’s particular operational needs. For instance, companies with a larger percentage of part-time workers may be less impacted by the upcoming regulations than companies that employ mostly full-time workers.

While a company’s immediate need for a comprehensive health plan is necessary to comply with the upcoming federal mandates, a long-term, measurable and strategic approach can have a significant impact on the financial burden placed on your clients. By providing your clients with choices that focus on not just health care, but wellness and other initiatives, the potential future costs to your clients can possibly be controlled. These options tie a long-term approach to short-term decisions, and are programs that can be used as a comprehensive package to improve the wellness of your client’s organization. A good approach is to implement programs that are based on client-specific data, so you can continually review and improve claims costs and outcomes whenever possible.

Tip No. 2: Educate yourself and your clients.

Even before your client first approaches you, being well-versed on health care regulations and how they will impact your client’s business is vital. Anticipating potential questions and being prepared to explain complicated insurance matters will help strengthen the broker-client relationship. While you are discussing all available employee benefits packages with your client, providing an appropriate, proactive solution can help educate your client on traditional and alternative ways to mitigate costs.

Educating your clients on both traditional health plans, such as PPOs and HMOs, and alternatives, such as HSAs and HRAs, can help your client understand the many ways they might uncover potential savings. Helping your client implement an employee productivity or wellness program is also a powerful way to reduce unnecessary health care costs. Financial models and case studies can help illustrate the projected financial impact and best practices for implementation in an easy to understand format. In turn, they can help your client make effective presentations to their employees on new benefit offerings and programs.

Tip No. 3: Communication is valuable.

To be effective, employee benefits education cannot solely revolve around enrollment periods. Because of this, communication between you and your client must be an ongoing part of your relationship. As new regulations continue to take effect, your clients need to understand the financial impact throughout the entire year, not just during enrollment periods, so that they can develop long-term initiatives to mitigate costs.

Ongoing communication between you and your client not only strengthens your relationship; it helps you help your client take a proactive approach to adopting cost-effective employee benefits programs. Sharing frequent news updates or trend articles can help your client stay informed on government mandates.

The more educated you can help your client become during the heath care reform transition, the more equipped your client will be for effective, ongoing communication with employees. And, as clients become more educated, health care becomes less of a reactive requirement. Instead, it opens the door for strategic planning, and can even become an integral part of corporate culture.

Communicating clearly with your clients not only helps you package options based on client need; it also allows you to offer your clients insight that can continually improve internal processes and involve more members of the senior management team.

Cathy Harbison, RN, is the director of operations for employee benefits at Neace Lukens. She can be reached at [email protected].

For more exclusive health insurance coverage, visit ASJ’s Health Insurance Resource Center.

Past health insurance stories from ASJonline:

The Networking Dance for Health Insurance Agents

Winning the Health Care Reform Battle

Uninsured Americans Seek Alternate Health Care Options

Obama Administration Puts an End to Health Care Waivers

5 Myths About Health Insurance Exchanges


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