2014 Power Broker

Winning the Benefits Battle

Health care reform led to late nights and intense demands on some Power Broker® winners.
By: | February 18, 2014 • 8 min read

Employees at the national headquarters of the American Legion Auxiliary liked their health insurance plan, but they weren’t able to keep it.

Like five million other plans, their health plan was cancelled last year, leaving the Indianapolis-based veterans services organization scrambling to cover its employees.

“Anthem Blue Cross Blue Shield did away with all of their small group policies and made new ones,” said Donna Parrott, HR director of the nonprofit organization.

Fortunately for the group, they had Kevin Wiskus, an executive vice president at the Hays Cos., to protect their interests.

Wiskus, a 2014 Power Broker® winner in the Employee Benefits category, was able to find a plan that — ever mindful of the nonprofit organization’s fiscal constraints — reduced the organization’s health plan costs by about 10 percent, Parrott said.

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Wiskus was an area vice president at Gallagher Benefit Services when he put together a benefits solution for the American Legion Auxiliary. And, said Parrott, “it was about 16 percent cheaper than what Anthem recommended.”

“He goes above and beyond,” she said. “We are a small group but he doesn’t treat us as a small group. You would think we were his only client the way we get that personal touch.”

Going above and beyond is emblematic of Power Broker® winners in 2014 — and not just those focused on employee benefits plans.

But while Superstorm Sandy focused attention last year on the Power Brokers specializing in property, this year, it’s the Affordable Care Act that is taking center stage.

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Employee benefits consultants and brokers have had to find ways to dig through 11,000 pages of regulations — regulations that have been changed at the last minute — and excavate the necessary information to protect their clients.

As individuals struggled to sign up via poorly functioning online sites and health care carriers fretted about an adverse risk pool, brokers and consultants stepped in to find solutions.

“It’s creating a lot more work for us as consultants to make sure our clients are following all the laws, and making them aware of the taxes and additional costs to them,” said Kim Clark, an account director at Gallagher Benefit Services.

“I am hopeful that 2014 is easier than 2013,” she said. “I can’t imagine it getting harder than it was this past year.

“The carriers had to make changes to every single one of their plans for Jan. 1. Even if employers didn’t want to change their health plans, there were plan changes because of health care reform,” said Clark, a 2014 Power Broker® in the Employee Benefits category.

Transitioning Plans

A survey of health insurance brokers by Morgan Stanley found that quarterly-reported year-over-year rates in December 2013 were rising in excess of 6 percent in the small group market, and 9 percent in the individual market, according to an article in Forbes by Dr. Scott Gottlieb, a resident fellow at the American Enterprise Institute, a Washington think tank.

It is the largest reported increase since the firm started its quarterly surveys of brokers in 2010, he wrote. “Much of the rate increases are attributable to Obamacare.”

Deb Mangels,  Senior Vice President, ABD Insurance and Financial Services

Deb Mangels,
Senior Vice President,
ABD Insurance and Financial Services

Thanks to Deb Mangels, senior vice president at ABD Insurance and Financial Services, the results were much more positive — and affordable — at the Piedmont Unified School District.

“It’s been an amazing year for us. We have transitioned our health care plans and it’s so much more than we have had,” said Michael Brady, assistant superintendent of the district, which employs more than 360 teachers, administrators and support staff in six schools near Oakland, Calif.

Mangels, a 2014 Public Sector Power Broker®, transitioned the district’s employee coverage from a health benefits pool with unsustainable cost increases to its own carrier at the same time the district was instituting its first medical benefits cap and increased premiums, following some “very intense labor negotiations,” Brady said.

“They reworked all of the plans,” negotiated a 15-month plan year so all plans would be on the same cycle, and added an online open enrollment tool. For the same benefits as the pool plan, the district’s employees pay about $100 less each month in premiums, he said.

Plus, employees have the option of choosing among some plan options related to copay and deductibles that were not available in the pool.

“I have never felt that we were in a better place than we are right now,” Brady said.

Communication is Key

When one HR director for an oil and gas drilling services company was holding employee meetings to discuss the introduction of a high-deductible plan, she faced resistance.

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The materials she used to illustrate the changes were hampering her ability to clearly explain to employees and to foreign corporate parents the company’s new health benefit plans and options.

That’s when she called James Bernstein, a principal at Mercer and a 2014 Employee Benefits Power Broker® — at midnight that night. He’s the consultant she counts on to keep his eye on both the big picture and the gritty details necessary to keep her organization in compliance and on top of everything.

By the time she woke up in the morning, Bernstein had prepared and sent her a new set of PowerPoint slides that offered more clarity on the health benefit plans.

“I really couldn’t do this without him,” said the HR director. “I’ve got 10 balls in the air, and he will make sure I don’t drop one of them.”

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Effective communication tools and strategies are a crucial part of plan design changes, said Robert Ditty, a partner at Mercer, and a 2014 Employee Benefits Power Broker®.

“You can design a plan until you are blue in the face but if people don’t understand it, you will not get the results you want,” he said.

 Consumerism Takes Hold

Many plan design changes took place this year with his clients, Ditty said, because employers needed to make changes due to the ACA anyway. As a result, they opted to move ahead with some strategic alternatives that had been under consideration for a while.

One popular option among his mid-size and large company clients was the transition to a high-deductible health plan, coupled with health savings accounts and health reimbursement accounts.

The health care reform law “made people re-evaluate … and it really expedited that strategy for a substantial portion of clients.”

Analyzing and strategizing around health benefits isn’t going to end any time soon.

Robert Ditty Partner, Mercer, Atlanta

Robert Ditty
Partner,
Mercer, Atlanta

Ditty’s clients are already trying to prepare for a substantial excise tax that kicks in in 2018. That tax — which requires employers to pay a 40 percent tax on health care costs that exceed federally defined thresholds — is better known as a penalty on so-called Cadillac plans. He said, however, that thresholds imposed for the federal tax will fall on “employers who are not offering very generous or rich plans.”

Instead, as the regulations are now written, they will affect many employers who have older workers and higher health care costs. “A significant portion of my clients are projected to hit this threshold in 2018, and they don’t have rich plans,” Ditty said.

That tax will join the other taxes imposed this year on employers. All of these developments have made life interesting of late for employee benefits consultants — “interesting,” as in the Chinese curse: “May you live in interesting times.”

 Budgetary Concerns

It was those additional fees imposed this year that forced Gallagher’s Clark to seek out different health plan designs for her clients.

The ACA-imposed taxes — either directly borne by employers or probably passed along as increased premiums because they are paid by health insurers — are the Patient-Centered Outcomes Research Institute Fee (PCORI); a Marketplace User Fee that “could be almost 3 percent of their premium,” Clark said; a Transitional Reinsurance Program Assessment Fee; an Annual Health Insurance Industry Fee; and a Risk Adjustment Program and Fee.

Often, she said, employers had to change plan design “to help their budget to account for those additional costs.”

Also adding costs were some other requirements in the ACA, such as requiring pediatric dental benefits on all plans, even if the policyholders did not have children or their children were older than 18.

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One other wrinkle in the ACA, which is playing out in the courts, is the need for all plans to include contraception benefits. That offered a unique challenge for Jan Wigen, a principal at Mercer, who was working with a religious institution.

The faith-based organization, a Catholic college, refused to pay for the benefit. Wigen, a 2014 Employee Benefits Power Broker®, helped the college secure separate contraceptive coverage through an insurer without having to pay for it, itself. She then provided separate enrollment cards and communication tools so the college could comply with the law and employees could have the coverage, without administrators breaking the dictates of their faith.

That was a regulation that had a fairly limited employer impact, but there was plenty of fodder in the ACA for angst to be created among employers of all sizes and shapes — and their brokers as well.

“I can’t think of an employer I talked to or worked with,” Ditty said, “where the law is not driving them in many instances to be more proactive about how they manage their benefit programs. … They have really become progressive in what they are doing from a strategic standpoint.”

For those employers lucky enough to have Power Brokers as their consultants, the process will run a bit smoother and the results will likely be a bit better, even as the demands on them increase and the regulations continue to change.

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Anne Freedman is managing editor of Risk & Insurance. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

2017 RIMS

Resilience in Face of Cyber

New cyber model platforms will help insurers better manage aggregation risk within their books of business.
By: | April 26, 2017 • 3 min read

As insurers become increasingly concerned about the aggregation of cyber risk exposures in their portfolios, new tools are being developed to help them better assess and manage those exposures.

 One of those tools, a comprehensive cyber risk modeling application for the insurance and reinsurance markets, was announced on April 24 by AIR Worldwide.

Scott Stransky, assistant vice president and principal scientist, AIR Worldwide

Last year at RIMS, AIR announced the release of the industry’s first open source deterministic cyber risk scenario, subsequently releasing a series of scenarios throughout the year, and offering the service to insurers on a consulting basis.

Its latest release, ARC– Analytics of Risk from Cyber — continues that work by offering the modeling platform for license to insurance clients for internal use rather than on a consulting basis. ARC is separate from AIR’s Touchstone platform, allowing for more flexibility in the rapidly changing cyber environment.

ARC allows insurers to get a better picture of their exposures across an entire book of business, with the help of a comprehensive industry exposure database that combines data from multiple public and commercial sources.

The recent attacks on Dyn and Amazon Web Services (AWS) provide perfect examples of how the ARC platform can be used to enhance the industry’s resilience, said Scott Stransky, assistant vice president and principal scientist for AIR Worldwide.

Stransky noted that insurers don’t necessarily have visibility into which of their insureds use Dyn, Amazon Web Services, Rackspace, or other common internet services providers.

In the Dyn and AWS events, there was little insured loss because the downtime fell largely just under policy waiting periods.

But,” said Stransky, “it got our clients thinking, well it happened for a few hours – could it happen for longer? And what does that do to us if it does? … This is really where our model can be very helpful.”

The purpose of having this model is to make the world more resilient … that’s really the goal.”Scott Stransky, assistant vice president and principal scientist, AIR Worldwide

AIR has run the Dyn incident through its model, with the parameters of a single day of downtime impacting the Fortune 1000. Then it did the same with the AWS event.

When we run Fortune 1000 for Dyn for one day, we get a half a billion dollars of loss,” said Stransky. “Taking it one step further – we’ve run the same exercise for AWS for one day, through the Fortune 1000 only, and the losses are about $3 billion.”

So once you expand it out to millions of businesses, the losses would be much higher,” he added.

The ARC platform allows insurers to assess cyber exposures including “silent cyber,” across the spectrum of business, be it D&O, E&O, general liability or property. There are 18 scenarios that can be modeled, with the capability to adjust variables broadly for a better handle on events of varying severity and scope.

Looking ahead, AIR is taking a closer look at what Stransky calls “silent silent cyber,” the complex indirect and difficult to assess or insure potential impacts of any given cyber event.

Stransky cites the 2014 hack of the National Weather Service website as an example. For several days after the hack, no satellite weather imagery was available to be fed into weather models.

Imagine there was a hurricane happening during the time there was no weather service imagery,” he said. “[So] the models wouldn’t have been as accurate; people wouldn’t have had as much advance warning; they wouldn’t have evacuated as quickly or boarded up their homes.”

It’s possible that the losses would be significantly higher in such a scenario, but there would be no way to quantify how much of it could be attributed to the cyber attack and how much was strictly the result of the hurricane itself.

It’s very, very indirect,” said Stransky, citing the recent hack of the Dallas tornado sirens as another example. Not only did the situation jam up the 911 system, potentially exacerbating any number of crisis events, but such a false alarm could lead to increased losses in the future.

The next time if there’s a real tornado, people make think, ‘Oh, its just some hack,’ ” he said. “So if there’s a real tornado, who knows what’s going to happen.”

Modeling for “silent silent cyber” remains elusive. But platforms like ARC are a step in the right direction for ensuring the continued health and strength of the insurance industry in the face of the ever-changing specter of cyber exposure.

Because we have this model, insurers are now able to manage the risks better, to be more resilient against cyber attacks, to really understand their portfolios,” said Stransky. “So when it does happen, they’ll be able to respond, they’ll be able to pay out the claims properly, they’ll be prepared.

The purpose of having this model is to make the world more resilient … that’s really the goal.”

Additional stories from RIMS 2017:

Blockchain Pros and Cons

If barriers to implementation are brought down, blockchain offers potential for financial institutions.

Embrace the Internet of Things

Risk managers can use IoT for data analytics and other risk mitigation needs, but connected devices also offer a multitude of exposures.

Feeling Unprepared to Deal With Risks

Damage to brand and reputation ranked as the top risk concern of risk managers throughout the world.

Reviewing Medical Marijuana Claims

Liberty Mutual appears to be the first carrier to create a workflow process for evaluating medical marijuana expense reimbursement requests.

Cyber Threat Will Get More Difficult

Companies should focus on response, resiliency and recovery when it comes to cyber risks.

RIMS Conference Held in Birthplace of Insurance in US

Carriers continue their vital role of helping insureds mitigate risks and promote safety.

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]