An employee benefit broker can be overwhelmed by the number of carriers that are pursing the voluntary worksite benefits market today.  Over the past decade, especially since the introduction of health care reform, health and group ancillary insurers are developing new products to align themselves with seasoned veterans in a rapidly growing marketplace.
 
There is no question, benefit brokers want to take part in the opportunity, since the voluntary worksite market continues to increase with double-digit growth.
 
How does the typical benefit broker, who has specialized primarily in health insurance, know what to do and what carrier to use?
It is not an easy decision. Many factors come into play in deciding what carriers/products will be a good fit.  Following are some elements to consider:
 
Is there preferred underwriting?
Preferred underwriting is offered  by carriers to increase participation and can differ drastically from carrier to carrier.  It is common for carriers to offer some form of guaranteed or simplified issue, but the participation requirements may vary based on the number of employees enrolled and/or as a percentage.  Some carriers allow for a one time guaranteed issue for all eligible employees and new hires thereafter.  Other carriers may offer two annual guaranteed issue open enrollments.
 
Does the carrier offer liberal participation requirements?
If the working conditions are there, the participation requirements are a non-factor.  Recently, some carriers have realized this by offering guaranteed issue as long as a high percentage of employees are met with individually.
 
How easy is the carrier to work with in case setup and application submission?
Case setup is the foundation for billing and may differ based on products being offered and enrollment method.  Some case setups may involve a two0page application that includes a teleconference with the employer.  Other may have a lengthier application process that includes mutiple forms and employer signatures.  To make the employee application submission easier, some carriers offer electronic submission with online underwriting tracking to let an agent know exactly what the application status is.
 
What are the enrollment options and support?
Enrollment options can consist of traditional paper applications, pre-populated applications with employee information, voice over internet protocol (VoIP), PIN signature, and electronic signature, among others.  Ultimately the method of choice is dictated by the demographics of the employer and available methods supported by the carrier.
 
How competitive are the products?
With all the new carriers in the marketplace, plan benefits and pricing continue to be enhanced.  Comparing competitiveness of products can be a challenging task, especially when you factor in all the elements that make up some of the today's plans.
 
Are claims easy to submit, and what is typical turnaround?
If claims are not easy to submit, employees will spread their dissatisfaction quickly with other employees and to their employer.  To make wellness claims easy, many carriers allow for wellness claims to be filed over the phone without the hassle of all the paperwork.  Claims turnaround can vary from carrier to carrier, and delays may develop when a carrier is checking for per-existing conditions during the look-back period.
 
What are the billing options: online, paper, carrier reconciliation?
Online billing in definitely the preferred method for employers.  There are a few that still do it old-school with paper billing, which is effective but can potentially lead to billing concerns.  In recent years, many carriers began offering to reconcile from a payroll deduction spreadsheet to speed up and simplify remittance.
 
If a carrier has products filed as group as well as individual, which should be used?
Several carriers are going to the group cassis to allow agents to be licensed only in the state the employer is domiciled.  The group platform products also have more competitive underwriting, but have more stringent participation requirements, which are sometimes not suitable for the smaller groups under 50 employees.  The individual products work will for all sized groups, but especially for smaller groups that want a variety of product options with minimal participation requirements.
 
Do you go with a carrier that has a one size fits all approach, but doesn't have the preferred underwriting? This may work in some instances, but may not be as price competitive.  Do you go with best-in-class for each product line?  This may work, but billing and claims may be a little cumbersome.  What about compensation?  Clearly, a part of every type of business is how income is derived.  Carriers often offer as earned commission: advanced commission, level commission, heaped commission with lower renewals, bonuses based on premium, bonuses based on number of cases in a year, and bonuses based on persistency.  Many carriers' commission rates will also vary based on underwriting and whether group or individual products are being used.
 
A voluntary worksite specialist can serve as a "virtual" division of your agency providing the knowledge and experience to develop the most comprehensive benefit package for employer groups.  Frequently benefit brokers rely on a voluntary worksite specialist to ease the burden.  Partnering with a specialist allows for ease of implementation and ongoing service without having to be an expert.  Many times it can be as simple as letting the specialist know the client-company's type of industry, number of employees and current benefits structure.
 
With health care reform, the voluntary worksite benefits will continue to change.
However, the need employees have to protect themselves from financial hardship will never change.  Clearly the benefit brokers that move to higher ground will remain stable in this unstable environment.
 

Tags: