Smart Business Magazine, May 2017

86 Smart Business Cleveland May 2017 Selecting a plan Health care shouldnt be a four letter word Health care plans sometimes feel like a shell game Consumer directed plans High deductible plans Health Savings Accounts Narrow networks Detailed deductibles for certain line items It may sound great but at the end of the day its often just shifting cost to your employees says Joe Turi Vice President of Benefit Solutions at Zito Insurance Agency Inc Employers want to lower their premiums while staying cognizant of the plans other variables The problem is if an employer squeezes one part of the plan the premium just like a balloon costs or a reduction in coverage pop out someplace else Turi says Its better to take air out of the balloon by lowering the total premium cost keeping the network as whole as possible and educating employees on how to best spend their health care dollars Smart Business spoke with Turi about how to manage a health plan with a focus on compliance and education to ultimately control costs and still serve employees Where do employers make mistakes Many employers are so focused on price the plan loses quality and their employees get upset Instead they need to dive into the details of potential plans to really evaluate whats covered and whats not covered Whether the company is a two person group or a 2000 person group what its actually doing is financing health care claims while assuming prudent risk How should brokers help employers manage their health plans It starts with the employee relations component The plan is a benefit that the company provides to attract and retain good talent Employees have doctors they want to continue to see and hospitals they want to continue to access The plan shouldnt disrupt patterns of care so how can the broker work with those doctors and hospitals in order to purchase health care better The answer is managed care contracting Most brokers simply look at the discount arrangement say 50 percent versus 25 percent But what if Hospital As 50 percent discount is a 1000 MRI while Hospital B charges 500 for the same imaging with a 25 percent discount After the managed care contract has re priced that claim its more cost effective to pay 350 than 500 The broker and employer need to consider Where do the employees go How much are they going to pay for that care Most importantly how do they take their knowledge and get the biggest bang for their health care dollars And how do they transfer that knowledge to their employees Many times its evaluating where the care is received even on site at work Do fully funded plans still allow access to this kind of detailed information Yes but the process is different than with self funded plans For instance a broker might need to collect Explanations of Benefits to see who is spending what and where While employers cannot see that data per the Health Insurance Portability and Accountability Act a broker can report back to help create educational materials If education is so important how can employers change employee behavior It isnt easy but over time as trust is built up there will be more adoption It typically follows a 20 60 20 rule 20 percent will be early adopters the next 60 percent will follow along because they hear good things and the last 20 percent dig their heels in A broker who brings a spreadsheet every year and says This plan with this carrier will save you 2 percent over your current rate so lets go here isnt helping minimize the risk Its better to take a consultative approach on compliance and education The broker and employer need to work together to understand the cost drivers that impact the plan over time Thats when the air starts to come out of the balloon the trend line comes down and cost increases are minimized JOE TURI Vice President Benefit Solutions Zito Insurance Agency Inc 440 299 5228 joeturi@ zitoinsurance com Insights Business Insurance is brought to you by Zito Insurance Agency Inc FOLLOW UP For more information about health care plans contact Zito Insurance or visit www zitoinsurance com INTERVIEWED BY JAYNE GEST INSIGHTS BUSINESS INSURANCE