Over the past quarter century, health plan deductibles have skyrocketed nearly 800% and premiums have increased over 300%, forcing employees to take on higher out of pocket costs for their insurance and health care. In the face of increased health risks due to the pandemic, this creates an environment where American families who have health insurance still face financial strain when they seek care for an unexpected health issue. These rising costs are obstacles for employers and employees alike, and benefit advisors are responsible for bringing better solutions to the table.
Although everyone is eager for change, diverging from traditional health benefit models can be daunting for employers and brokers, too, since benefit dollars have been stretched thin and technical complexities are so often a challenge. So how do the most successful brokers chart a path for their clients in this market environment? And where do they start?
Megan Zimmerman has a reputation for challenging the most impossible paradox in insurance by helping organizations lower their healthcare costs while improving employee coverage. With her unique approach, she built the biggest book of business in the Milwaukee office and was named a finalist in Benefits Pro’s Broker of the Year Award in 2021.
We chatted with Megan to get her take on how to be a great broker and help employer clients navigate the unknown in 2022. Here are some of the highlights from our conversation.
Use Data for Actionable Insights
When Megan looks to engage a client around a new benefits solution, she starts with data. This often means repositioning her clients to get the data they need to make informed decisions.
Structurally, employers need to have access to their group’s health care data, which usually means being self-funded and having partners in place, such as a third party administrator (TPA), who can share data that passes through their systems. Once an employer is set up this way, Megan and her team can begin to help the employer client make informed, data-driven changes to improve their benefits program.
This is where the real fun starts. It’s about using data in the right way. Megan spoke about how she has seen an industry wide data dump, where TPAs and third-party analytics platforms are offering employers and clients books of data when what they really need are the actionable insights of what’s happening and what needs to change. Insights like these can help define actions that the employer can take to drive a result. Megan emphasizes that larger sets of data often overwhelm decision makers and don’t allow them to drive better decisions and better health outcomes for employees.
In order to make strategic decisions differently, brokers need to start choosing the right data, and doing the analysis to surface a sound strategy.
How 2021 Changed the Insurance Industry
Firstly, health care costs continued to be top of mind. This triggered conversations about stop loss increases, and the type of programs and strategies that could be put in place to mitigate a lot of those costs. Another pain point was pharmacy benefits— and 2021 brought on several PBMs innovating by creating advocacy programs to bring costs of expensive medications down.
Undeniably, another of the largest conversations across healthcare in 2021 was the unknown. Cost increases around COVID, delayed care, and various other new factors were difficult to quantify with less than a year’s worth of data to establish trends on how the market might react. Megan emphasized that for her and many others like her, 2021 was uncharted territory.
Megan also noted that mental health entered the picture for healthcare in a much bigger way— with not only new legislation being passed, such as the Dr. Lorna Breen Health Care Provider Protection Act, but with a significant uptick of her clients introducing resources for awareness around mental health for employees to have better overall support during the pandemic.
Finally, Megan highlighted that in the Midwest (and in Wisconsin in particular), more and more employers were for the first time willing to embrace change by moving to self funded plans instead of the status quo approach that didn’t allow employees to have a feeling of control or insights about their benefits. In other words, organizations finally understood the importance of having an affordable, accessible, and quality health plan that enabled them to take care of their employees and their family members, and to create a sense of greater security amongst employees as well.
Megan’s Advice for Brokers Approaching the Unknown
To benefits advisors and brokers who are accustomed to success via traditional models of health coverage, transitioning to a self funded healthcare model may seem daunting. But Megan encourages industry veterans and experts to ask themselves important questions such as “why can’t my client have access to their data?” or “why do we allow a status quo approach of getting renewals without insights?” in response to these concerns. She emphasizes that once these questions are asked, and once curiosity to get to the root of the problem in health coverage is sparked, it becomes clear that there’s a reason to consider doing things a little differently.
Megan reminds us that the best way to understand the unknown when facing challenges such as these is to find a tribe of collaborators. Whether they are mentors, vendors, or other experts, these people bring fresh ideas and support for brokers through their journey to find a different approach to advising. They can help you acclimate faster and make a more meaningful impact by sharing important lessons.
How can we expect to see health benefits evolve in 2022?
There are a number of things that we can expect to see cause meaningful shifts in the industry in 2022, one of which has to do with how the CAA (Consolidated Appropriations Act) unfolds, which in 2021 included $50 billion in additional health care-specific COVID relief funding. This legislation will likely cement several of the philosophies and intentions Megan holds around benefits and will force employers to look at their own data and have a sound process to understand their fiduciary responsibility as plan sponsors for their employees.
Megan is also bullish on primary care, and how that will develop and flourish in the coming year. DPC (direct primary care) was once largely unknown, and now holds promise to see tremendous growth and acceptance across the employer market. This, alongside the CAA- could allow for much more accessible and affordable benefits for employees nationwide.
Finally, we can expect to see better navigation and price transparency around health plans with a number of resources proliferating to help employees and members make sound and confident healthcare decisions. Megan emphasizes that now, more than ever, the user experience of employees accessing their benefits is top of mind.
To hear more insights from Megan, including what led her to her current role at Marsh & McLennan, listen to Episode 35 of Better Benefits now. If you enjoy the episode, don’t forget to subscribe and leave us a review on your favorite podcast platform.
Megan’s Recommended Resource
On every episode of Better Benefits, we ask our expert guests for a book or resource they’d recommend to others working in the benefits space. This week, Megan recommended:
Your 168: Finding Purpose and Satisfaction in a Values Based Life by Harry Janssen Kraemer. Published in 2020, this is a book for aspiring changemakers. Kraemer teaches readers how to pursue a values-based life by identifying and committing to key values and priorities. By using personal stories and insights, he helps people identify the dissonance between what they say is most important and where they actually devote their time. Some lessons he teaches us include: the art of self-reflection and prioritizing career, family, health, recreation, spirituality, and making a difference; how to avoid “unpleasant surprises or hitting a brick wall”; and how to be inspired.
Note, this episode is for informational and educational purposes only. Megan Zimmerman and Marsh & McLennan are not endorsed, affiliated with, nor compensated by Brella Insurance Inc.