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Tech exec: Decision support tools can keep benefits brokers in game

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A health insurance exchange system builder thinks that benefits brokers need a variation of the same kinds of decision support tools that many Web-based exchange programs offer.

VJ Bala, a senior vice president at hCentive, talked about how his company sees the benefits broker market in a recent interview.

“There’s been some talk of brokers disappearing,” Bala said. “We don’t really see that as a big issue.” Nearly three-quarters of small and midsize employers continue to use brokers, he said.

As consolidation pulls some established players out of the group health market, cross-selling efforts at property-casualty brokers and voluntary benefits sellers are pushing other players into the group health market, he added.

VJ Bala

But Bala said any brokers that want to stay in the group health space will have to be able to do more than have simple conversations with their clients about simple products.

Small and midsize employers are “looking to brokers because of the complexity of the products and the compliance issues,” Bala said. Brokers “have to be equipped with better tools.”

The company Bala works for came to life in 2009, as Congress was debating the proposals that created the Patient Protection and Affordable Care Act (PPACA) and its public exchange system.

Once the public exchange system started up, hCentive helped the Centers for Medicare & Medicaid Services (CMS) establish Small Business Health Options Program (SHOP) division systems for The company has also helped set up and run systems for the individual public exchange systems for the state-based exchanges in Colorado, Massachusetts and New York state, and it is helping to set up and run systems for a state-based SHOP exchange in Arkansas.

The company also sets up systems for private exchange programs. Fidelity has hired hCentive to help it run the Fidelity Health Marketplace program.

See also: Fidelity private exchange to compete with brokers

Bala’s company recently gained insights into the kinds of tools group health brokers, group disability brokers and other group benefits brokers need when it conducted a series of interviews and focus group sessions with small and midsize employers in the Northeastern and Mid-Atlantic states.

The hCentive marketers found that participating employers were eager to find new options they could use to cut costs. The employers also hoped to increase employee engagement by making the employees’ choices as simple and easy-to-understand as possible.

To achieve those goals, brokers need decision support tools that can help them talk with employers in a flexible way about how different choices, such as the addition of gym discounts or other fun wellness program perks, will affect plan costs, Bala said.

Brokers also need tools that can help an employer’s employees understand exactly how options, such as health saving account (HSA) programs and voluntary benefits, will affect their own personal situations as they are considering whether to sign up for those options, Bala added.

In the long run, according to hCentive analysts, employers would like to see much more integration of human resources, payroll and benefits systems, and better reports on program activity, so that they have better information about what’s working, and what’s not working, when they make decisions. 

See also: 

Private exchange firms seek PPACA exchange links

IT developer notes challenges in designing state exchanges


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