Health Insurance: Near-Record Panic?

Those health advisers who emerge on the other side will find there has NEVER been a more exciting or rewarding time to be in this industry.

I’ve been caught a little off guard recently. I am seeing a level of panic in the industry that I don’t think I’ve seen since Parker Conrad was threatening to drink the industry’s milkshake. Chances are, you have been reading about the exciting trend taking root in the industry. Advisers are reengineering how they build medical plans for their clients. Direct primary care (DPC), bundled services and transparent pharmacy are just a few of the ideas strategies being put into place. The result? Advisers now have a way to improve the level of benefits their clients receive while actually, and significantly, reducing the overall cost. That’s freakin’ awesome!! Putting on a brave face As awesome as I think most of us can agree this trend is for the industry and employers/employees, I can’t tell you how many times I’ve had verge-of-breakdown conversations with very sophisticated advisers. Many of you are convinced you are the last in the industry to be learning these approaches. You are reading about the success stories of other advisers online and hearing about their implementation victories from the stages of conferences. Many of you have drawn the conclusion that the rest of the industry is putting every one of these solutions in place for every client they have. Friends, the reality could not be further from the truth!!! First, it’s only a very small part of the industry that is even aware of these new solutions. Trust me, we talk to agencies big and small that are sometimes not even aware of these trends, let alone putting them in place. Second, a significant percentage of the ones talking about the solutions are talking a big game but have yet to take the first step of any meaningful walk. Third, even the most advanced advisers are only putting these strategies together for a relatively small portion of their book. (I’m sure there are exceptions. If that’s you, congratulations; you are a pink unicorn.) Now, don’t get me wrong, I am not saying you shouldn’t make learning these strategies a priority. Maintain a sense of urgency, but take a deep breath, relax a bit and lay out an overall strategy as to how you will position yourself to use these ideas most effectively. But make a conscious decision to move forward with a realistic sense of the effort actually required. Way too many talking a big game have yet to figure this out for themselves. See also: How Likely Is Zenefits to Change?  The unintended consequence? Too many advisers see the new trend as a silver bullet that will separate them from their competitors and drive growth. Those who try to hunt with a silver bullet are destined to shoot themselves in the foot. As much as advisers need to be arming themselves with this new strategy, there are a few things you need to remember.
  1. Not every client or market is ready for these strategies.
  2. No one solution satisfies all the HR/benefit needs of a client.
  3. You (still) have to ensure that the foundation of your agency is strong.
Are clients really ready? Many of these new strategies are dependent on moving clients to a partially self-insured program. Of course, this idea isn’t new at all, and you likely already know it can take a long time to get a prospect/client comfortable with this idea. And, that’s okay, educating them to the point of comfort/confidence with this idea is a critical part of your job. But, if this is a prospect you’re talking to and you are depending on this as your single strategy to earn their business, it’s going to take a while to uncheck the Prospect box and check the New Client box. Of course, these ideas aren’t just about moving to self-insured; there is additional education to take place as to how direct primary care, bundled services and transparent pharmacy can be managed effectively and successfully. The thing is, even once they understand, some employers just don’t want to be that involved in the management of their benefits program. Right or wrong, some will only want a plug-and-play program regardless of how tilted that game is against them. That’s just the reality, regardless of how much you may want to help them make the change. And then it’s up to you to decide if you’re going to help them in their fully insured program or walk away. But, if you choose to walk away at this point, you’re missing out on a lot of opportunities – opportunities to still help and opportunities to grow your business. Finally, some markets just aren’t ready to allow these solutions to be implemented. If you believe, as I do, that a strong network of direct primary care (DPC) physicians is a key to this new direction, you also understand that the framework/infrastructure of those DPC practices doesn’t yet exist and will take a while to build. Live by a single solution, die by a single solution I have watched many times as this industry gets giddy with excitement over a solution being introduced to the market; this isn’t the first silver bullet for the industry. It’s happened with technology solutions, compliance solutions, HR resources. The list is long. If you put all of your chips on any single solution, no matter how important it might be, you’ll eventually lose. As an adviser, you will never be differentiated by the solutions you offer. Your greatest chance for sustainable and meaningful differentiation is in how you use those solutions. Even if you are the first to market with a solution, the advantage will be short-lived. Every viable competitor will soon be promoting the same solution. Besides, your clients need WAY more than any single solution. It is more difficult to run a business today than ever before, and your clients need guidance in ways they never have before. I wouldn’t criticize anyone for a moment leading with new strategies and solutions, but I strongly advise that you better be plugging any solution you offer into a value proposition that addresses the broader needs of your prospects and clients. Face the obvious: Just because you have a powerful strategy to control healthcare doesn’t diminish your clients’ needs for help with compliance, technology and HR, to name a few. And, with more complex solutions being put in place, the need for compliance and an effective employee communication strategy has never been greater. If you’re going to try to live on a single idea, just know it will only work until one of the following inevitably happens:
  • You run into prospects/clients/market that just aren’t ready;
  • Every competitor arms itself with the same idea;
  • Competitors show up with the same idea and have built it into a broader platform of solutions (again, compliance, technology, etc.).
See also: Zenefits’ Troubles Don’t Let Brokers Off Are YOU really ready? When your value proposition and solutions become more complex, it is more important than ever to ensure that the foundation of the agency is strong enough to support it. Here are a few areas you need to evaluate to determine if you can really support these new solutions/strategies: Sales Process — One of the things that concerns me about these new solutions/strategies is that advisers will simply see them as another insurance solution and feel the right time to talk about them is at renewal. Now more than ever, it is critical to be meeting with buyers off renewal to prepare them for the ideas and strategies you can bring at renewal. And, with off-renewal conversations, having a structured sales process in place is an absolute requirement. And, no, going out to get quotes is not an effective process. You have to have a process that allows you to help the buyer effectively evaluate the insurance and non-insurance parts of the business to determine what is working and what isn’t working and create an overall plan of improvement. Marketing — But, for that sales process to be effective, you have to have an effective marketing strategy in place. These ideas need to be featured on your website. You need to be writing about them regularly in your blog. You need to be out on social media sharing these ideas and participating in conversations. You have to integrate these ideas into your automated marketing campaigns. Team education/training — You must have a plan for how are you going to educate your team to sell and service these more complex solutions. You must develop more effective team structures/processes to ensure your sales and service teams work together effectively enough to sell/service these programs. Compensation — Because these new strategies are outside the traditional insurance products with attached commissions, you have to be comfortable with charging fees, discussing how much you need to get paid and articulating what you do in return for that compensation. I know this is pretty scary for many of you. Take a deep breath The world of employee benefits is going through one of those transformational eras that redefines an industry.
  • Yes, it's a bit scary
  • No, not all of the answers are clear
  • Yes, it's a lot of freakin' hard work
  • No, doing more of what you've always done isn't the answer
  • Yes, you are going to have to reengineer your agency
  • No, not everyone is going to survive
Don't curse these facts, celebrate them. Celebrate because very few of your competitors have the courage, curiosity, work ethic, creativity, grit or resilience it will take. Those of you who emerge on the other side will find there has NEVER been a more exciting or rewarding time to be in this industry. The destination is exciting, but let's not forget to enjoy the journey. Finally, don’t make your journey any more difficult than it needs to be. There are many groups out there working together to help one another learn these ideas and put them into practice. My advice is to find a group that fits with your style and get started sooner rather than later. Your success, and that of your clients, may very well depend on it. This article originally appeared on

Kevin Trokey

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Kevin Trokey

Kevin Trokey is founding partner and coach at Q4intelligence. He is driven to ignite curiosity and to push the industry through the barriers that hold it back. As a student of the insurance industry, he channels his own curiosity by observing and studying the players, the changing regulations, and the business climate that influence us all.


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