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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To see all 2014 Power Broker winners, click here.

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

RIMS Conference Opens in Birthplace of Insurance in US

Carriers continue their vital role of helping insureds mitigate risks and promote safety.
By: | April 21, 2017 • 4 min read

As RIMS begins its annual conference in Philadelphia, it’s worth remembering that the City of Brotherly Love is not just the birthplace of liberty, but it is the birthplace of insurance in the United States as well.

In 1751, Benjamin Franklin and members of Philadelphia’s first volunteer fire brigade conceived of an insurance company, eventually named The Philadelphia Contributionship for the Insurance of Houses from Loss by Fire.

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For the first time in America — but certainly not for the last time – insurers became instrumental in protecting businesses by requiring safety inspections before agreeing to issue policies.

“That included fire brigades and the knowledge that a brick house was less susceptible to fire than a wood house,” said Martin Frappolli, director of knowledge resources at The Institutes.

It also included good hygiene habits, such as not placing oily rags next to a furnace and having a trap door to the roof to help the fire brigade fight roof and chimney blazes.

Businesses with high risk of fire, such as apothecary shops and brewers, were either denied policies or insured at significantly higher rates, according to the Independence Hall Association.

Robert Hartwig, co-director, Center of Risk and Uncertainty Management at the Darla Moore School of Business, University of South Carolina

Before that, fire was generally “not considered an insurable risk because it was so common and so destructive,” Frappolli said.

“Over the years, we have developed a lot of really good hygiene habits regarding the risk of fire and a lot of those were prompted by the insurance considerations,” he said. “There are parallels in a lot of other areas.”

Insurance companies were instrumental in the creation of Underwriters Laboratories (UL), which helps create standards for electrical devices, and the Insurance Institute for Highway Safety, which works to improve the safety of vehicles and highways, said Robert Hartwig, co-director, Center of Risk and Uncertainty Management at the Darla Moore School of Business at the University of South Carolina and former president of the Insurance Information Institute.

Insurers have also been active through the years in strengthening building codes and promoting wiser land use and zoning rules, he said.

When shipping was the predominant mode of commercial transport, insurers were active in ports, making sure vessels were seaworthy, captains were experienced and cargoes were stored safety, particularly since it was the common, but hazardous, practice to transport oil in barrels, Hartwig said.

Some underwriters refused to insure ships that carried oil, he said.

When commercial enterprises engaged in hazardous activities and were charged more for insurance, “insurers were sending a message about risk,” he said.

In the industrial area, the common risk of boiler and machinery explosions led insurers to insist on inspections. “The idea was to prevent an accident from occurring,” Hartwig said. Insurers of the day – and some like FM Global and Hartford Steam Boiler continue to exist today — “took a very active and early role in prevention and risk management.”

Whenever insurance gets involved in business, the emphasis on safety, loss control and risk mitigation takes on a higher priority, Frappolli said.

“It’s a really good example of how consideration for insurance has driven the nature of what needs to be insured and leads to better and safer habits,” he said.

Workers’ compensation insurance prompted the same response, he said. When workers’ compensation laws were passed in the early 1900s, employee injuries were frequent and costly, especially in factories and for other physical types of work.

Because insurers wanted to reduce losses and employers wanted reduced insurance premiums, safety procedures were introduced.

“Employers knew insurance would cost a lot more if they didn’t do the things necessary to reduce employee injury,” Frappolli said.

Martin J. Frappolli, senior director of knowledge resources, The Institutes

Cyber risk, he said, is another example where insurance companies are helping employers reduce their risk of loss by increasing cyber hygiene.

Cyber risk is immature now, Frappolli said, but it’s similar in some ways to boiler and machinery explosions. “That was once horribly damaging, unpredictable and expensive,” he said. “With prompting from risk management and insurance, people were educated about it and learned how to mitigate that risk.

“Insurance is just one tool in the toolbox. A true risk manager appreciates and cares about mitigating the risk and not just securing a lower insurance rate.

“Someone looking at managing risk for the long term will take a longer view, and as a byproduct, that will lead to lower insurance rates.”

Whenever technology has evolved, Hartwig said, insurance has been instrumental in increasing safety, whether it was when railroads eclipsed sailing ships for commerce, or when trucking and aviation took precedence.

The risks of terrorism and cyber attacks have led insurance companies and brokers to partner with outside companies with expertise in prevention and reduction of potential losses, he said. That knowledge is transmitted to insureds, who are provided insurance coverage that results in financial resources even when the risk management methods fail to prevent a cyber attack.

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This year’s RIMS Conference in Philadelphia shares with risk managers much of the knowledge that has been developed on so many critical exposures. Interestingly enough, the opening reception is at The Franklin Institute, which celebrates some of Ben Franklin’s innovations.

But in-depth sessions on a variety of industry sectors as well as presentations on emerging risks, cyber risk management, risk finance, technology and claims management, as well as other issues of concern help risk managers prepare their organizations to face continuing disruption, and take advantage of successful mitigation techniques.

“This is just the next iteration of the insurance world,” Hartwig said. “The insurance industry constantly reinvents itself. It is always on the cutting edge of insuring new and different risks and that will never change.” &

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