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Where the Oklahoma Court Went Wrong

The problem with the Oklahoma Option decision isn't simply that the state Supreme Court reached the wrong conclusion.

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This essay takes issue with the Oklahoma Supreme Court’s recent decision in Torres v. Seaboard Foods to declare some workers’ compensation (WC) laws unconstitutional. The problem with the opinions of Justices Edmonson, Combs and Colbert isn’t simply that they reached the wrong conclusion — but that they reached it for the wrong reasons. To justify their decision, all three justices went out of their way to invoke the grand bargain, a historic compromise between employers and employees that guarantees medical and wage replacement benefits to injured workers. Before the grand bargain was struck in 1917, most U.S. employees injured on the job had to sue their employers for damages. The process was often prohibitively expensive, onerous and time-consuming for hardworking citizens who found themselves unable to earn a paycheck — when they needed funds to cover medical bills and other expenses during their convalescence. The grand bargain is worth championing because it put an end to this intolerable state of affairs, thanks, in part, to luminaries such as Crystal Eastman, who thought an injured worker shouldn’t have to spend “nearly half of (his settlement) to pay the cost of fighting for it.” See also: Taking a New Look at the ‘Grand Bargain’ Eastman’s emphasis on avoiding long, costly court battles was typical of the thinking that guided the U.S. into embracing the grand bargain. It is therefore disappointing to see Justice Colbert argue that he is “forced to insure that claimants and employers in the (WC) system have their day in court." Colbert’s rationale is contrary to grand bargain principles. The only thing forcing Colbert to such a conclusion is his decision to put the interests of injury lawyers ahead of the interests of injured workers and of the employers who provide the benefits those workers deserve. If the Oklahoma Supreme Court is as committed to preserving grand bargain principles as Justice Colbert claims, it doesn’t need to do anything revolutionary. It only needs to rule in the same way that it did in 1917, when it initially recognized the state legislature's ability to pass special legislation concerning WC in the interest of the general public. This article is the summary of a much longer essay on the topic, which draws on numerous primary and secondary sources and which you can find here.

Daryl Davis

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Daryl Davis

Daryl Davis is a member of the American College of Occupational and Environmental Medicine and is sought after by governmental agencies, insurance carriers, risk managers and others in this field. Davis founded www.WorkersCompensationOptions.com, a company committed to WC and legal alternatives to WC.

How to Plant in the Greenfields

Insurers once asked, How do we do what we do better? Now, it's, How do we do what we haven't ever done before?

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If insurance were a map, we would be surveying a whole new world. The fences and boundaries of tradition have fallen. The snow-capped mountains of certainty are melting away. The rivers of market share are changing course, and streams of data are coming directly to our doors. We know there are still products to plant and fields to harvest, but how will our planting change in the months and years to come? Many insurers will be looking at greenfields for the answer. Greenfields, start-ups and incubators are different ways of looking at the same essential concept — starting from scratch. Each is a new beginning. Greenfields are new initiatives often aimed at developing new markets. Start-ups are most often new initiatives that will reach existing markets. Incubators are designed to test new products within new or existing markets. For our purposes, we will lump them all together under the title of greenfields, because from an organizational perspective the need for them and preparation for them are similar. See also: Start-Ups Set Sights on Small Businesses Cultivating the soil Think about how insurance has grown, just based on the questions we have asked ourselves over time. Insurers used to ask, “How do we do what we do better?” They were thinking of underwriting, selling and meeting market demand. As the internet and the digital realm arose, they began asking themselves, “How do we do what we do differently?” They needed to know how to reach the same people with better channel management and improved customer service. Now, they are asking, “How do we do what we don’t currently do at all?” They want to know how to identify, build and capitalize on new risk needs, new markets and social networks, how to use technology to its fullest, how to become a trusted resource for services outside of insurance and how to reinvent the organization and brand so that it is prepared to be profitable no matter what initiatives lie on the horizon. It is the preparation that is an important first step. A great idea can’t take root in an organization that won’t support it. How can insurers prepare for greenfield development? Abandoning silos Greenfield insurance companies that are starting outside of a traditional insurance organization and those that are starting under the umbrella of traditional insurance companies both value “fresh air” and an environment that is unclouded by tradition. Starting from scratch allows them to think without constraint, test without constraint and operate without constraint. They do have barriers. Most are operating within a window of opportunity, and all are operating under the assumption that investments need to pay off. But for the most part, greenfields take advantage of the fact that organizational politics, processes, traditional technologies and time-honored ideals are all open to reassessment, replacement or removal. Organizational silos need to be bridged, if not completely abandoned. The new opportunities where greenfields will work best will be created by cross-functional teams that understand how to integrate new technologies with the best ideas. This is one reason hackathons have recently grown in popularity. They are simply borrowing a common concept from ad agencies, TedX events and jazz musicians…the idea that walls and ideas aren’t compatible. The best fertilizer for ideas is a diverse set of perspectives on how the idea will be constructed and how it will work in practice. Teams need functional area experts, but they also need general leadership with a holistic perspective as well as input from technology partners who grasp what is technologically possible. Investing in seeds Seeds are investments, and most investments have phases. The greenfields in insurance are ripe for these investments, and they are bearing fruit. But those that will be most successful will pay close attention to planting methods. For example, farmers don’t take the newest seeds and plant 1,000 acres. They test them in plots. In insurance, our ideas need to be cultivated quickly, first in small pots, in our incubators and centers of excellence — we can call these our insurance greenhouses. If they appear to be working, we test them in small geographies, then roll them out to larger segments. Seed planting is speed planting. The idea works, or it doesn’t. We scale up quickly or toss the idea out. We invest wisely by investing small, until the investment proves itself and then we invest more. As we watch seed money flowing into InsurTech, we know that some of these investments won’t pay off. Many venture firms will have invested more in a proof of concept than they should have. Some will attempt a rollout before the concept is mature. The best growth will happen through organizations that know how to phase greenfield investment. See also: Investment Oversight: Look Beyond Scores! Greenfields will be capitalizing on technology to save investment funding. This includes reusing technologies and sharing systems. Cloud platforms with a “pay as you go” pricing model are perfect for greenfield development because they answer the demand for agility, innovation and speed (low implementation time, quick speed to market, light or no customization) with lower investment and maintenance costs … allowing the investment to focus on the business, not the infrastructure. Greenfields are creative pursuits to new opportunities. Their back-end solutions will require just as much creativity as their front-end marketing, but they will want solutions that don’t require massive customization. Greenfields will therefore capitalize on what they don’t need to build from scratch. Modern core platforms will allow them to use pre-built, integrated content and data sources, pre-built best practices and products and pre-built channel options. They will use their creativity to build new business models around pre-built infrastructures, instead of building new systems from the ground up. The passion for planting In the coming weeks, we will take a more in-depth look at greenfields, start-ups and incubators. We’ll look at the surprising growth of insurance innovation investment and what it means to existing businesses. We will discuss how deeply the choice of platform can affect insurer preparation, and we’ll also look at the greenfield spectrum that includes new value-chain technologies, new aggregator channels and completely new types of insurance. Our goal is not to gawk at the high number of entrants into the market, but to glean a whole new perspective on opportunities. You may find that your unique position will allow you to have market-capturing ideas ahead of others. And you may develop a passion for planting your own seeds in the greenfields of opportunity. Is your organization ready for your team’s next great idea?

Denise Garth

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Denise Garth

Denise Garth is senior vice president, strategic marketing, responsible for leading marketing, industry relations and innovation in support of Majesco's client-centric strategy.

Paradigm Shift on Cyber Security

A sea change in awareness is underway, driven by intensifying cyber exposures. But organizational change won’t happen overnight.

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You’ll get no argument from anyone in the global cybersecurity community if you make this statement: “There needs to be a paradigm shift in the way organizations of all sizes view information security.” There are unmistakable signs that such a sea change is underway, driven by intensifying cyber exposures. But organizational change at a macro level won’t happen overnight. And a certain level of turmoil can be expected as the productivity side of the house battles for budget with the security side. That’s the upshot of an impromptu discussion I recently had with three top cybersecurity experts from consulting giant Deloitte. Ed Powers and Scott Keoseyan—U.S. managing principal and cyber threat intelligence director, respectively, at Deloitte’s Cyber Risk Services practice—and Adnan Amjad, a partner with Deloitte’s U.S. Cyber Threat Risk Management practice, helped lead Deloitte’s cybersecurity consulting services, which last year assisted nearly 1,000 clients with cybersecurity planning, including numerous large enterprises and federal agencies. See also: How to Eliminate Cybersecurity Clutter What Powers, Keoseyan and Amjad continue to hear is that the frustration level among senior management is rising. Despite truckloads of cash being spent on the latest defensive technologies, cyber risks continue to intensify, seemingly with no end in sight. Keeping tabs on information Powers told me many organizations have been unsuccessful because they “predominantly use technologies for sharing information rather than protecting it.” That approach includes virtualized data centers and cloud computing. While both can boost productivity, collaboration and innovation, they also introduce complexity, which translates into new exposures to intruders with malicious intent. Organizations must remember that they often are using technologies that have not—from a security standpoint—kept up with the pace of broader business innovation, Powers said. See also: How Good Is Your Cybersecurity? A very fundamental shift—the organizational thinking—must take root, Amjad said. Security must be built into systems from the beginning, and organizations must be more vigilant monitoring them. It’s also critical that the systems have capabilities to respond to cyber attacks. Not just an IT problem And the productivity side of the house needs to work more in concert with the security side of the house. People must be cognizant that cybersecurity is a business issue— not just a technology issue. Of the nearly 1,000 cyber clients Deloitte served last year, many said security is a first-order business risk. That way of thinking may be a difficult transition for lots of companies, so it must start at the top of the organization and permeate down. Security landscape evolves Some industries have caught on. Big banks recognize that security is a business issue for them. They are aware that the safety of their and their customers’ data is important. And some companies in the health care, manufacturing and energy industries have come to understand that cybersecurity is a critical part of their operations. Many organizations, however, lag way behind in cybersecurity and must catch up. Like their counterparts with better security measures, they should determine the actual risk they face. Even the board members should be trying to understand this. Organizations—even sophisticated ones—also must realize that protecting their own four walls is not sufficient. There are too many bad actors using numerous methods and routes to penetrate through the barriers and get access to critical information. Organizations must understand the vulnerability footprint of the people with whom they do business on a regular basis and be certain their supply chains also are secure. This article first appeared at Third Certainty.

Byron Acohido

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Byron Acohido

Byron Acohido is a business journalist who has been writing about cybersecurity and privacy since 2004, and currently blogs at LastWatchdog.com.

Differentiation – Real Advantage or a Lie?

Agencies tell themselves they stand out from the competition, but when you try a little test the differentiation disappears very quickly.

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In 1965, as college freshmen in the Deep South, we were oblivious to the cultural revolution that was starting to sweep campuses around the country. We were tradition-bound and institutionally managed by a dress code. Our hair could not touch our shirt collars (shirts with collars were mandatory) or cover our ears. Our shirts had to be tucked in, and a belt was required, as were socks. We were free to dress anyway we wanted within those restrictions, and we did. Most chose blue shirts with blue socks or yellow shirts with yellow socks, and, for the bold members of our class, there were pink shirts with pink socks. We wore the same uniforms; only the colors differed. Obviously, these clothes were so “1964 and high school.” So as we grew into sophisticated freshmen with a larger world view we advanced our wardrobe to include Madras (bleeding Madras) in shirts, shorts and some slacks. At last we were different – we were all different – just in the same way. In less than another 18 months, the craziness that was the West Coast – the hippie movement – arrived on campus. Our dress code was gone as fast as our belts and socks. Our bleeding Madras was replaced by cut-offs and tie-dyed T-shirts. At last, we were free to be individuals – to do our own thing – and we did. All of us did our own thing – just the same thing. Fast forward 40 years, and I’m in an agency board room listening to an agency’s management team discussing plans for a new website and a new proposal format to showcase the agency's uniqueness – how it differs from competitors. My question was simple: What makes you different? Give me five or six real, definable and measurable examples of offerings that you bring to the market that your competitors don’t or can’t. The discussions were bold (like college freshmen) and the ideas as diverse as our then-new wardrobes, but to me the sameness was obvious. As they bragged – I gagged. What they saw as “bleeding” Madras, a revolutionary new look, I saw as yellow socks and yellow shirts – and I knew that the competitors were wearing the same wardrobe, because I had been in their closets, too. After several hours and more “styling,” the team agreed on what made them different. I listened politely, then restated their list to be sure that what I heard was what they said. All agreed. Now the challenge was to bring this list to life in a website and presentation. I could live their delusion no longer. I stated, “I know most of your competitors, and they make these same claims and provide the same offerings. In fact, some of them use the same resources to deliver these same offerings. Where’s the difference?” I hit a nerve. One of the producers said, with significant frustration, “Yeah, but we really do it.” With equal frustration, I stated confidently, “I can call each of the principals of all of your competitors and ask them if they really do these things, and I promise you they will each say, Yes.” To prove the point, I created a spreadsheet with the nine major competitors of their agency listed. I then studied the website of each and captured two or three of the most significant “brag points.” Finally, I hid the names and brought the spreadsheet with me to the next meeting. I said, “Tell me which is your agency - it should be easy because you are unique.” After many attempts, they acknowledged that they couldn’t because they weren’t. Before you discount this article and this challenge as not applying to your shop, I have one suggestion. Try it. Can you find your uniqueness? Would your clients find it? Would they believe it? How long have you had that nice Madras shirt? See also: Dare to Be Different: It's the Only Approach That Works

Mike Manes

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Mike Manes

Mike Manes was branded by Jack Burke as a “Cajun Philosopher.” He self-defines as a storyteller – “a guy with some brain tissue and much more scar tissue.” His organizational and life mantra is Carpe Mañana.

Fast and Slow: the Changing Landscape

Instead of spending hours filling in data and searching for quotes one at a time, I can get four quotes from four carriers within 90 seconds.

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From tracking our steps and calorie intake to the way we request taxis, technology has bled into almost every area of our existence. But not every industry has been able to move to a digital experience. The insurance industry is one of the least tech-savvy industries out there -- but it’s also a $1.1 trillion market. That is is why investors and entrepreneurs have begun tackling it, vowing to make every process within the insurance realm friendlier, easier and, most of all, digital. Where the industry stands today Emerging technologies have had little impact on improving the carrier side of things. Though carriers have built systems to make a broker’s life easier, these systems are largely outdated and clunky. These systems also have not addressed a larger issue: Small businesses are largely underserved in the commercial insurance world. Because the cost of acquiring a customer is high, brokers spend the majority of their time serving bigger businesses, which have more risk and higher premiums. Insurance brokers do not have the means to acquire small businesses in a cost-effective way, nor do they have the structures in place to support the digital customer. See also: Technology and the Economic Divide Unless you’re a company like Apple, you likely don’t have the luxury of innovating quickly; that is because there are often many layers of management standing in the way of making a quick decision. The insurance industry has found itself woefully unprepared to respond to the drastic change in our economy. The scrappiness you see in corporate innovators was absent; the status quo of bad process was king. Customers have higher expectations today than they did 20 years ago; couple that with changing demographics, and insurance companies start to feel the burn. Customers expect a seamless experience: that is, easily educating themselves, getting a quote, purchasing insurance and easily managing that insurance. However, insurance is a much more complex buying process than consumers are used to. Customer expectations are mismatched with the way insurance is currently purchased, and Insurtech start-ups are seizing the opportunity to redefine this process. Insurance is necessary. It allows us to protect ourselves, our businesses and our worldly possessions. But the process is outdated. So, nothing has changed? No one entity owns the insurance buying process, which makes it a slow-moving and often disjointed experience for customers. Things ARE heading for a change, though; it’s just been a slower change than other industries because of the complicated web of reinsurers, insurers, intermediaries and retail agencies that all have a stake in crafting the process. The right financial resources are being allocated to figuring out this process; insights are being learned from making consumer applications intuitive; and the incredible power of the internet is becoming easier to access within the insurance industry. Here’s what we’re already seeing:
  • Data: Carriers are using data in a smarter, better way. Machine learning and the computational power that is available nowadays allow carriers to slice and dice data in ways that were never a possibility before. As a result, rates are better matched to a customer’s risk.
The use of data in insurance has been game-changing from a customer perspective, a carrier perspective and a broker perspective. One of the earliest ways data was adopted by the industry? Price comparison tools for auto insurance. Now? Progressive is offering cheaper pricing for safe drivers by measuring things like speed and braking through a tool called Snapshot--which plugs directly into a consumer’s vehicle. See also: Blockchain Technology and Insurance In life and health, carriers are using data gleaned from wearables, such as the ever-popular Fitbit, to create an experience that encourages insureds to participate in less risky behavior and provides incentives to participate in healthy activities.
  • Speed and Ease: The use of third-party data has also opened the door for carriers to ask only the most relevant questions during the application process, which means shorter, better and less nitpicky applications overall.
SEMCI, or Single Entry Multiple Company Inquiry, is something we see more and more carriers take advantage of. The SEMCI approach enables brokers to obtain quotes from their markets. So, instead of spending hours filling in data and searching for quotes one at a time, I can get four quotes from four carriers within 90 seconds. Customers are now used to driving to their agent’s office and signing paperwork or faxing paperwork directly to a carrier, but this has become too arduous in a world where everything is fast-moving. So, companies like CoverWallet are creating a more digital experience for business owners seeking insurance. CoverWallet allows customers to buy and manage insurance from the comfort of their own homes by leveraging technology and taking a more intuitive approach to interviewing the customer. Paper applications were replaced by carrier portals where agencies manually entered data into their systems. Now, portals are being replaced by APIs and web services to stream information in an efficient and low-cost way. There’s still a long way to go It would be unfair to say that start-ups alone will change the face of the industry; the truth is carriers, brokers and innovators will all have to work together to create real, lasting change. The industry has taken steps in the right direction, but it’s nowhere near game over for innovation. Over the next year we’ll see:
  • Improvements in accessing information and education: The information that’s found online surrounding insurance will become more personalized. For instance, what insurance does your business need if you live in a certain state and work in a specific industry?
  • Emerging technologies present new opportunities: From data breaches to drones, new technologies have made carriers and start-ups take a look second look. How do you access risk and intelligently price new technologies with little information?
  • Even smarter incentives: Wearables might be just the beginning for incentive-based pricing. We’re looking at an untapped market for incentive-based commercial insurance, but expect that to change in the near future.
  • Friendlier service, any way you want it: Most carriers are providing service on the phone, but it’s impossible to think that won’t change, and fast. Expect to get in touch with a carrier or broker via email and chat--sooner rather than later.
See also: 4 Technology Trends to Watch for   At some point, change becomes easier than staying the same, and that’s where the insurance industry is now, if for no other reason than the consumer demanding it. Venture capitalists and entrepreneurs who have entered the space see the opportunity, and it’s up to carriers and brokers to seize it by working with entrepreneurs or innovating themselves. What they’ll choose is yet to be seen.

Rashmi Melgiri

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Rashmi Melgiri

Rashmi Melgiri is CEO and founder of Functional Finance.

She was previously COO and co-founder of CoverWallet. She was also a strategy consultant at the largest North American TMT (technology, media and telecom) consulting group, Altman & Vilandrie.

More Transparency Needed on Premiums

A continuing lack of transparency around premiums can only be bad for business in the long run: The customer is now in control.

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Benjamin Franklin famously said, “In this world, nothing can be sure to be certain except death and taxes.” If he was alive today, he might want to rewrite that quote to include increasing insurance premiums. Every year, without fail, premiums rise. That's great news if you’re an insurance company, but it's not so great when you’re renewing your annual policy. And while there’s a weary public acceptance that insurance premiums will inevitably go up because insurance companies do, after all, have to make money like any other business, transparency around premiums and how they are calculated is an issue. Insurers still fall short when it comes to explaining to their customers about rates. Jargon is rife in communications to customers and is often indecipherable, which just makes matters worse. Consider my own recent experience: I purchased travel insurance online and was sent a 22-page policy document to decipher — most of which would have benefited from a lawyer’s expertise to help me understand it. Nine pages of the document were spent explaining what wasn’t included in my policy!    See also: The Insurance Renaissance, Part 2 More insurance companies could ensure greater customer loyalty and instill trust by doing a better job at explaining some of the policies and clauses. For example, some international health insurance clauses that consumers may not be aware of but which are highly beneficial:
  • Many health insurers will provide protection for any unexpected cost in the future and keep providing cover even when a condition develops. They will keep paying the cost of any treatment required, up until the policy limits.
  • International health insurance will cover medical costs abroad, even if the insured chooses to travel for surgery outside her country of residence. So if there is a famous specialist in another country and someone wants to have surgery there, their insurance will pay the medical costs.
  • Most insurance companies will provide cover until very old age, 80 to 120-plus. This is important to know because if someone has an insurance policy that only provides cover up to the age of 60, it will be difficult to find insurance to cover any conditions subsequently developed. And this is the age when health insurance is more useful than ever.
  • There are now insurers that are rewarding customers who don’t make a claim with a "No Claims Discount."  
And one that could cause confusion:
  • A person may think he is covered for as much as $1 million under health insurance for hospital bills and treatment etc., but what is often unclear is what conditions are not covered by that sum.    
See also: Important Alliance to Fight Health Costs At the end of the day, buying insurance should be viewed as an investment that provides peace of mind and reduces a person’s financial liabilities — and everyone would agree that this is worth paying for. But consumers should be given the opportunity to make a much more informed choice when renewing a policy by having much greater visibility on how premiums are determined. For the insurance industry, a continuing lack of transparency around the calculations of premiums can only be bad for business in the long run. In a fiercely competitive industry like insurance, consumers now have more choice than ever when choosing a policy. So maintaining customer loyalty is everything and, together with consistently good customer service and swift settling of claims, the key to ensuring customer loyalty is better communication and transparency across the industry. After all, it’s much harder to win new business than to retain existing customers. A more consumer-focused insurance industry will also encourage more people to purchase their products, so getting better at communicating can only be a win-win situation. It’s also about making the process simpler, easier, transparent and giving an online experience that customers would expect. Most people can take bad or difficult news if it is explained to them properly — and getting a clear, jargon-free and understandable explanation for insurance premiums puts the purchasing decision power back where it should be: in the hands of the consumer.  

Andre Hesselink

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Andre Hesselink

Andre Hesselink is the CEO of GoBear.com, Asia’s first and only meta search engine for finance and insurance products. He launched the company in 2015 when, after moving to Singapore in 2011 to set up the Asian branch of Travix, his frustrations trying to purchase car insurance inspired him to launch GoBear.

A Look at 3 Leading Next-Gen Insurers

Haven Life, John Hancock and USAA demonstrate to rethink and reinvent the business of insurance.

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As the June 30 deadline approaches for the 2016 SMA Innovation in Action Award submissions, let’s take a look back at our insurer winners from 2015: Haven Life Insurance Agency, John Hancock and USAA. Their innovative projects and initiatives have demonstrated how they are rethinking and reinventing the business of insurance and furthering their progress toward becoming a Next-Gen insurer. Insurers that are considering submitting an application to the 2016 Innovation in Action Awards program can see from these examples what a winning business and technology project/initiative might look like. See also: How to Enable the Next-Gen Insurer The Next-Gen insurer model is based on five foundational areas of transformation: customer, products and services, technology and data, business model and innovative culture. (For more information on the Next-Gen Insurer model and its foundational areas, click here.) Insurers are taking creative approaches in all of these areas, and the 2015 winners are no exception. Winners are listed in alphabetical order. Next Gen
  • Haven Life Insurance Agency made a real leap forward for the entire insurance industry in the area of products and services by offering medically underwritten life insurance that can be purchased online. Haven simplified an arduous paper-based application process of four to six weeks to better meet the expectations of today’s customer. The company did this by leveraging technology and data – specifically, external data fed through sophisticated algorithms – to greatly reduce the amount of information that the customer has to provide to receive a quote. A partnership with MassMutual gives Haven Life access to the resources of a large organization while retaining the innovative culture that sparked the transformative approach to selling, underwriting and administering life insurance.
  • The John Hancock Vitality Program reimagined the relationship between an insurer and its policyholders, creating a unique customer experience in the traditionally low-touch world of life insurance. The program rewards policyholders for healthy behavior such as exercising and getting annual physicals. These activities can be tracked through wearables technology and data via a free Fitbit or logged online through a computer or a mobile app. John Hancock uses this data in an online rewards program that offers premium savings, among other rewards, changing the business model for this life insurance product. In addition to rewards, policyholders can receive individualized encouragement toward further healthy behavior, a value-added service that represents a real advance in life insurance products and services.
  • USAA pioneered the use of drones in the insurance industry, showing what this technology and data can do for insurers, especially in P&C claims. After mudslides hit Oso, WA, USAA’s deployment of drones for damage assessment established a new and vital service for policyholders in post-disaster situations, pushing the envelope in the foundational area of products and services.
See also: 6 Key Ways to Drive Innovation The real progress that these three insurers are making toward becoming Next-Gen insurers is evident in the effects these groundbreaking initiatives have on the five Next-Gen Insurer foundational areas. They are also fantastic examples of how thoughtful approaches to innovation can make insurers stand out from the crowd in the industry. 2016 Awards Logo This is the fifth year of our SMA Innovation in Action Awards program, which honors insurers and solution providers that are putting innovation into action with creative projects, initiatives, technologies or solutions that further insurers’ progress toward the goal of becoming Next-Gen Insurers. We encourage you to apply for the SMA Innovation in Action Insurer Award or the Solution Provider Award to share your successful innovations! Submissions are due by June 30, 2016. A full program description, FAQs and links to the applications for both awards can all be found on the SMA website.

Karen Furtado

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Karen Furtado

Karen Furtado, a partner at SMA, is a recognized industry expert in the core systems space. Given her exceptional knowledge of policy administration, rating, billing and claims, insurers seek her unparalleled knowledge in mapping solutions to business requirements and IT needs.

5 Ways to Onboard New CSRs

The right onboarding is crucial for CSRs, whose duties include being the face of the company, answering questions for customers.

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After going through the process of finding candidates, interviewing prospects and eventually choosing the individual who's perfect for the customer service representative (CSR) position you're trying to fill, it may be tempting to take a deep breath, sit back and think that the hard part is mostly over. And while taking a deep breath is certainly never a bad idea, thinking that new employees will simply figure everything out on their own is. This is especially true for CSRs, whose main responsibilities include being the face of the company, answering questions and helping clients and customers through their issues. In this case, proper onboarding couldn't be more critical. Providing CSRs with the information and tools they need to feel comfortable on the phone, via chat or in person, will not only make them better at their own jobs, but it will ensure that the image your company portrays is accurate at all levels of the business. Here are five ways to onboard new CSRs to help make their transition much smoother and to make them productive team members sooner.
  • Create or customize a customer service employee handbook
Having a go-to source for every question and concern, while a sizable undertaking to start from scratch, can be extremely helpful for new employees. Fill a CSR handbook with information about the company, policies, FAQs, insights about customers and anything else that would help new CSRs feel as though they've been with the company for years. Or personalize an existing handbook by adding notes with tips, tricks and helpful message points. Your advice and suggestions can help new hires feel welcome and comfortable with you as a colleague or boss. See also: How to Redesign Customer Experience
  • Set up new employee meet-and-greets
Usually during the first few days on the job, employees are bombarded with countless names and titles, making it stressful for them if they believe they are expected to remember everyone immediately. By organizing ice-breaking meet-and-greets between new and current employees, supervisors can provide everyone with the chance to learn a bit more about each other, and new hires may more quickly feel like part of the collective group.
  • Organize regular check-ins
Starting a new job is overwhelming. It's often difficult to know how you're doing, if you're doing the job right and if there's anything you should be doing differently. By setting up weekly check-ins with new hires, even just for 10 minutes in the morning, employees can ask any questions they have, and you can provide helpful feedback on their performance. This can also be a great time to review customer service reports or calls to ensure that all steps are being taken to solve customers' issues. This small time commitment can help employees stay on track early in their development.
  • Write an onboarding checklist
During the first few weeks of a new job, there are seemingly dozens of forms, meetings, technology setups and more that an employee has to complete. Developing a checklist for new employees to make sure they are prepared to do their job is a great way to take the full onboarding onus off of you or HR. This checklist can also be a great place to set immediate, concrete goals that you'd like new employees to achieve within a scheduled timeframe. To ensure that the checklist doesn't seem like one more piece of paperwork, make it a little less formal by adding a few must-visit lunch spots, important people to meet or other fun aspects of your corporate culture.
  • Run through some mock customer service calls
New CSRs are ideally hired for interpersonal skills and their ability to solve problems. However, the way those things are conveyed to customers can vary dramatically from one company to the next, and new employees will often default to the methods and messages they used at their last employer. To gauge how new employees will respond to your company's calls and test whether they're staying on message, run through some mock customer service calls — from simple to exasperating — before allowing them to answer phones on behalf of the company. If adjustments need to be made, you can alert them to how things are done at your company and correct any issues before they present themselves during a live call. See also: Are We Listening to Our Customers? These suggestions are surely just a few ways to optimize your onboarding process. Do you have anything to add that you've found helpful? Please share your advice below so other professionals can learn from your experience. Thanks!

Susan Kearney

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Susan Kearney

Susan Kearney joined The Institutes in 2007 as a senior director of knowledge resources. In her current role, Kearney is a key source for industry issues and technical insurance, providing content for trade publications and leading workshops and seminars.

How to Set Benefits in Different Nations

For companies operating in more than one country, setting benefits can be complex. Here are benchmarks that will help.

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With a growing recognition that employees are a company’s greatest asset, it is increasingly important to consider how to keep staff in different countries happy and engaged. According to some studies, happy, comfortable employees are 12% more productive. Further studies suggest that benefits such as health insurance can reduce employee turnover by up to 25%. There is also increasing evidence that ensuring employees get enough time off and don’t work too many hours can boost productivity — as well as your workforce’s long-term health. A recent Aon survey of multinational companies found that 56% don’t have a global benefits database, despite global benefit reviews being a top priority. For companies operating in more than one country, setting benefits centrally can cut administrative costs, while simplifying reporting and reducing resentment between cross-border teams who may perceive the perks their colleagues receive to be unfair. Understanding what is normal in different countries is the best starting point to work out how to develop appropriate packages, from local working cultures — such as working hours, vacation time, salaries, levels of tax on earnings — to indirect benefits like the availability of state healthcare, statutory sick days and age of retirement. But when considering a working location, remember that simple top-level overviews like those shown below are never sufficient to make a decision — the devil is in the details, so seek out expert advice. In Depth Most in-demand employee benefits Universal health care Paid sick day entitlement Retirement and savings planning State retirement ages Leave benefits Flexible schedules Average wages Other benefits that employees love Talking Points “There is a clear trend of centralization at multinationals, yet it isn’t flowing through to the way that employee benefits are managed…. The vast majority of decisions are still being taken by local stakeholders. [Effectiveness of global planning] is generally being restricted by a lack of up-to-date information and administration activities.” – Carl Redondo, Aon Global Benefits “When considering the impact of local laws, care should be taken to note cultural differences and issues of discrimination. Employers should question whether or not a particular benefit will integrate with cultural norms.” – Personnel Today “You need to understand what impact [benefit schemes] are having on behavior… a big alarm bell should be ringing if they perceive it to be unfair” – Jonny Gifford, Chartered Institute of Personnel and DevelopmentThis article originally appeared on TheOneBrief.com, Aon’s weekly guide to the most important issues affecting business, the economy and people’s lives in the world today.” Further Reading

François Choquette

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François Choquette

François Choquette leads the global benefits consulting team for Aon Hewitt. He has 25 years of experience assisting multinationals with a broad range of international human resources areas. He is one of the key architects of Aon Hewitt Global Benefit Solution (GBS).

Key Misconceptions on Health Insurance

Small- and medium-sized businesses really can avoid overpaying, lowering health costs and gaining a competitive edge.

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As the Obamacare compliance clock ticked down, a Phoenix-area CEO lay wide awake at 2 a.m., worrying he might have to consider laying off more than 70% of his 170-employee workforce. Earlier that day, his insurance broker told him that companies with more than 50 full-time employees would be fined heavily if they didn’t provide health insurance under Obamacare. His lawyer confirmed it — the fine would be as high as $5,000 per employee. None of his options looked good. The cost of the health insurance his broker proposed exceeded his company’s profits; ignoring the law’s reporting requirements would increase his fines even more. Reducing his staff to avoid the Obamacare mandate meant splitting up his company or laying off 120 employees. Except for one thing: His broker and lawyer were wrong about the law. Obamacare does not require employers to offer health insurance. Since Obamacare became law, blue collar, service, construction and other such companies nationwide have grappled with providing employer-sponsored healthcare that wouldn’t completely bankrupt their business — a seemingly impossible challenge given the skyrocketing cost of medical insurance. Here in Arizona, CEOs are confronting the issue head-on. Like these CEOs, you have to start by arming yourself with the truth. Then, you realize that, if structured correctly, healthcare can become a huge competitive advantage for companies of all shapes and sizes. Say what? Healthcare is usually one of the biggest expenses for a company. Most people would consider it a major impediment to profitability — not a competitive advantage. But that’s where they’re wrong. In a previous article, I discussed how the correct place of service makes the biggest impact on healthcare costs. Simply understanding the huge difference in costs for services performed in a hospital vs. identical services received in a lab or imaging facility down the street can help companies and their employees make smart choices about getting high-quality, high-value care. But it doesn’t stop there. Beyond managing place of service, employers can take action right now to transform healthcare into a competitive edge. This might seem unbelievable — status quo healthcare is a colossal expense that’s bleeding companies dry — but small- and medium-sized businesses really can avoid overpaying, lower employees’ costs, decrease the amount of time spent away from work and provide benefits that larger competitors simply cannot match. See also: Is Transparency the Answer in Healthcare? The experts will tell you this is impossible, but these three steps are all it takes: 1. Think differently. First, businesses must decide that they are finished with the status-quo healthcare system. What would it be like for them to approach healthcare with a completely different mindset? To reconsider what they’re willing to tolerate and pay for — and what they’re not? Instead of being resigned about the burden of healthcare — helpless in controlling costs while also meeting the mandates of Obamacare — what would happen if they were to apply an entrepreneurial mindset and skill set to their healthcare problem? Despite shocking health insurance rates and a general belief that costs cannot be controlled, thinking differently about healthcare translates to an entirely different experience. With the help of a trusted broker — they’ll never think about their company’s healthcare the same way. 2. Understand the law and what’s required. Most business owners do not truly understand what the law requires or what the difference is between what’s required and what they may want to provide their employees for strategic reasons. In many cases, insurers are using Obamacare to convince companies they must provide traditional health insurance or risk massive government fines. Brokers can help their clients understand what the law requires and build a plan that meets Obamacare mandates and offers great healthcare without killing the bottom line. For example, self-insurance is a great solution for many companies. 3. Design and build a health plan that meets a company’s unique needs. Most employer-sponsored health plans are structured to benefit their insurer, but brokers can help their clients change all that. The best plan will allow the company and its employees to pocket the savings if waste, administration and overpricing are eliminated. See also: Healthcare Quality: How to Define It   Here are a few key components of a health plan that work well:
  • $0 Co-pays for routine care (the “routine 90%”): 
It might seem counterintuitive, but charging co-pays for routine care will actually cost companies a lot more money in the long run, not to mention reduce employee satisfaction. The simple solution? Businesses should steer clear of routine co-pays. Instead, they can provide the “routine 90%,” meaning 90% of the care that 90% of people need and use, 90% of the time, all at no cost to their employees. This includes things like preventive services, primary care, physical medicine and injury care, rehabilitation (including chiropractic), basic labs, X-rays and immunizations. The “routine 90%” represents a very small portion of overall claims, perhaps as low as only 10% of the costs. Purchasing traditional insurance to cover this 90% is unwise for businesses aiming to control costs and make their workforces happy; self-insurance will usually make the most sense. When these services are free and easily accessible, expensive hospital and urgent care visits will go down a meaningful amount. But be wary: This “no co-pay” tactic can also backfire; it can be used as a loss-leader tactic to guide your staff toward high-priced hospital services when a hospital system employs the primary care doctors. This is exactly why it’s important for business owners to educate their people about the huge price differentials between hospital doctors and services and identical services performed at an off-hospital lab or office.
  • Stop-loss insurance for non-routine services (the “other 10%”):
Stop-loss insurance covers the more expensive and less predictable 10% of costs for things like accidents, chronic or complex illness and catastrophic diagnoses like cancer. Such insurance will cover hospitalization, specialist care, brand-name prescriptions and other high-cost services and procedures.
  • Plan design that guides and rewards
Most people don’t know how to get the most value out of the healthcare system, but brokers can help business owners educate their employees and provide smart incentives. Giving employees $0 co-pays for the inexpensive “routine 90%” is a great way to start, but there are plenty of other incentives that will save business owners money while also improving employees’ healthcare. As an example, a smart health plan design will always discourage the quick use of elective orthopedic surgeries and procedures until inexpensive $0 co-pays in the “routine 90%” prove ineffective. A smart plan will always reward the use of generic prescriptions over expensive brand names that provide no extra benefit. In future articles, we’ll dive into some easy (and very smart) incentives that any employer can include in their plan designs to ensure they can lower the bigger, unnecessary claims costs.
  • Data analytics
A well-designed health plan includes a mechanism for continuous data collection and learning about the people who incur the most claims costs in any particular year, month or day. In a previous article, I discussed why business owners should own their company’s health data because it enables the employer and broker to negotiate fair pricing, educate their people about place of service and ensure they’re making smart decisions about care. The same is true for stop-loss insurance; companies should demand ownership of employees’ data. Collecting and leveraging this data will provide the advantage businesses and their brokers need to keep renewal costs from rising every year.
  • Free protection and support
It’s important that HR managers and employees know where to start when they have questions or need care. Doctors and other health industry professionals may direct their patients to hospitals and other needlessly expensive places of service. And if the providers are affiliated with a hospital system, they may be obligated to refer patients to a hospital, even if the services they need are available at an offsite clinic at a much lower cost. Business owners have the power to disrupt this status quo process. By providing their people with free, 24-7 assistance in navigating the healthcare landscape, they can improve employee care and satisfaction and can protect their business from overpaying. Knowing the costs of services, where to find value and how to avoid waste before a service is needed is a critical part of the protection and support employees need and appreciate. In a future article I'll share some very valuable healthcare “hacks” that business owners and employees will find empowering. In the meantime, I encourage you to visit redirecthealth.com/HealthPlanScorecard to complete the free Health Plan Scorecard. In 10 minutes or less, you’ll be able to score your healthcare mindset and make immediate improvements.

David Berg

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David Berg

David Berg is co-founder and chairman of the board of Redirect Health. He helps oversee operations and develops innovative ways to enhance the company’s processes and procedures for identifying the most cost-efficient, high-quality routes for common healthcare needs.