Quality Benefits = Quality Recruitment and Retention of Quality Employees

Tim L Williams PHD • October 9, 2024
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Greetings, welcome to our new blog designed to help you become educated in the world of employee benefits, and how the right decisions can help you to recruit and retain top talent.

To begin, let me introduce myself. My name is Tim Williams, and I am located in Western Montana. I have a BS degree in Consumer Behavior, a MS in Healthcare Management, and a PHD in Hospital Administration. I have been coaching various healthcare facilities as well as other businesses on how to improve leadership and use that to attract top talent as well as to retain the top talent they already have on board since 1997. It is my pleasure to bring these tips to you so, let’s get started.

When it comes to getting quality benefits, it starts with the representative you will be working with. IS this person an agen t? Or a broker ? Let’s look at both options. An agent is a sales representative that represents 1 company. Their job is to sell you that company. They have high sales quotas and generous bonuses. Although they do have their place in the insurance industry, wouldn’t you prefer someone more on your side? The next is a broker. A broker is a representative that represents you to the insurance companies. This is a much better situation for small business owners as they can bring you options.

Next question, how can you tell if you are getting a quality broker ? Let’s not forget that brokers are salespeople too. They want your business in order for them to earn their commissions. I’m sure you all remember the movie, Forest Gump. In this movie he made a statement that people have joked about for years. That is “Life is like a box of chocolates, you never know what you’re going to get”. Well, brokers are the same way. How do we select a good broker? Great question, let’s check that out now.

To find a good broker, it’s s matter of asking questions. Questions such as:

How long have you been licensed? The longer the better.

Are you the main broker, or do you work for another broker? If they work in another broker’s office, how long have they been with the main brokerage? If not very long, were they with a broker before that, and for how long? This is meant to sound more like a job interview. After all, you are hiring the broker. Have they bounced around from company to company?

Does the broker handle multiple lines of insurance? A broker that handles multiple lines, such as employee benefits, property and casualty, business liability, worker’s comp, etc, more than likely does not know the full pros and cons of the plans they sell. I have been in this business since 1997. I am still so busy learning about law changes, network changes, and which insurance plans fit which areas best that I don’t have time to work anything else but employee benefits.

How many states is the broker licensed in? Of course, the more states the better they know the business.

How will they handle benefits education for your employees? Do they do face to face enrollments via in person or Zoom? Are they willing to take the time to visit with each employee about their coverage? This will prove their dedication to you are your team.

How is customer service handled? Can they call the broker directly to ask questions, or are they referred to a toll-free number?

To make a long story short, the more questions you can ask, the better of a broker you will find. You cannot ask too many questions. You need to look at this as if your are hiring a business partner. Remember, you are partnering with them when it comes to handling your employee benefits.

Stay tuned for future articles with information about benefits for your business as well as recruiting and retaining top talent for your teams.

Health Insurance 101 – Picking a Plan pt 1

January 20, 2025
When it comes to health insurance, there are many options to choose from. To begin with the most basic, there are 2 initial types. You will either be looking for group health or individual health. This seems to be simple, however it is a great place to be real careful in what your agent / broker shows you. Many agents try to sell individual plans to small groups. This is not a good idea. First, you may all qualify now with good health, but what happens if you hire an employee with type 1 diabetes? If that employee gets declined do to preexisting conditions, they may sue you. So, make sure that if you are looking for insurance for your employees, that you are getting a true employer group. For today’s discussion, let’s tackle individual health. Individual health is a fairly simple product. This insures one individual and their immediate family. There are 2 ways to go for this type of insurance. You can go through Obama care, or Healthcare.gov, or find an individual plan through a regular agent or broker. When it comes to Obama care there seems to be 2 reasons you would want to look there. One reason is affordability. Because these plans can provide subsidies through the federal government, they can be very inexpensive. Second reason is because of serious preexisting conditions. These would include cancer, heart attacks, type 1 diabetes, or any other condition that has a possibility of large medical claims. That leaves you with the second option, underwritten plans. The best thing about an underwritten plan is that the rates are anywhere from 30 to 70% lower than the Obama care plans … if you don’t qualify for a subsidy. The largest group of people that generally don’t qualify for a subsidy are self-employed individuals. The other group that normally doesn’t qualify are higher income earners or households with a dual income. There isn’t much more to say about Obama care plans as they will take anyone, so let’s do a deeper dive into the underwritten plans. In this category there are also 2 basic types of plans to choose from. They are limited benefit plans and comprehensive plans. To make this a little easier, learn to ask anytime that you speak to an agent or a broker, “Is this a limited benefit plan, or comprehensive health coverage?”. The problem with a limited benefit plan is just like the name implies, it is limited coverage. So, now for the good stuff, comprehensive health coverage. Comprehensive plans, also known as major medical, are the best plans to have as they cover 97% of everything. Now nothing covers 100% of everything as each plan has their own little quirks that will exclude something weird or different. An example is there is only one plan I have seen that covers TMJ. Meanwhile, there is another plan that will not cover a bunion. So in short, stay the route of comprehensive as a limited benefit plan may only cover 25 to 50% of An entire bill leaving you stuck with possible thousands of dollars. Within comprehensive plans there are 2 types of coverage there as well, PPO of RBP. A PPO stands for Preferred Provider Organization. In this type of plan the facility or Dr’s office has an agreement in place with the insurance company to only charge so much for their services and the insurance company in return agrees to pay that fee in full. This could be considered the least restrictive of health plans. However, the provider or facility you are wanting to see must be with the PPO network. If the provider is not in the network, your out of pocket expenses will increase quite dramatically. This leaves us with RBP plans, (Reference Based Pricing). RBP are plans that pays according to the Medicare base payment amounts. These plans are excellent for several reasons. The main 2 are that: 1 they are very affordable, 2 that you have freedom of choice of providers. The drawback is that there are a few facilities that will not accept RBP plans. The majority will however. The few that don’t are starting to understand that sometimes RBP plans can actually pay better than a PPO. We will leave that part of the discussion for a different day. As far as our agents and myself, we primarily place our clients with RBP plans as they are the most comprehensive with affordability combined. There is something much more important when it comes to the sale of an RBP plan. You will see a common response I give to most questions like this, ask more questions. The way a quality RBP plan will work is that once the insurance company is sent a bill by a facility or DR’s office, the insurance company will automatically send a payment. The base rate the company may pay can be anywhere from 125% to 176%. So, your first question is what is the percentage of the Medicare table do you pay? The next thing that happens is that a quality RBP plan will negotiate additional payment if the facility demands it. This is the most critical stage of the process. You first need to ask your agent or broker is, “does your company negotiate a balance bill?”. A balance bill is after the insurance company pays, the facility sends you a bill for an additional amount due. If the agent or broker responds yes, they do negotiate, ask them to show in the policy that it will. You want to try and avoid a plan that does not negotiate as you could be left with a big bill.  This all now comes down to the integrity of your agent or broker. In my position, I have only met just a few that know the policy they sell well enough to know whether of not they negotiate claim payments. However, a lot will tell you that they do just to get you to buy the plan. In short, always ask to see it in writing. The higher quality plans will have a guarantee that if negotiations are unsuccessful, they will pay 100%. Last tip, but not the least important, is don’t fall for the “join our association to get a discount premium”. I have been seeing videos pop up on social media now saying that they will place you in an association and get you a group rate saving you a lot of money, Well my friends, insurance premiums are set according to the amount of claims paid out as well as overhead and expenses. If they are able to show a discount for a membership to an association, then the premiums have been raised in order to lower them just to show a discount. If you research the same insurance company through a broker or agent without an association, you may find the exact dame plan through the exact same insurance company for a lower premium than the association membership is offering. In conclusion I will leave you with this thought when it comes to selecting a new health insurance plan, Socrates said, “Question everything and not stop until they were sure their beliefs were secure”.