Why Do Employers Agree to First Meeting with You?

[Botboy141]

As the saying goes....Ignorance is bliss.....

You are cool. Super helpful!

 

[Key2Success]

You are cool. Super helpful!

Perhaps someday you'll learn that arrogance and the "I'm holier than thou" attitude isn't the best avenue. Then again......good luck to you.

 

[leevena]

50+ lives although I want to get into the larger groups too (100+ lives) in an urban setting. I have not selected vertical markets yet.

Just a suggestion, but I would not worry about choosing a vertical market. The success rate in a vertical market strategy would be very low UNLESS you are doing something very unique, such as Davis-bacon plans, some kind of a trust plan, etc. I say this because from the sound of your post you are new to the group medical market.

Suggest you round out your portfolio (voluntary products, group ancillary, self-funded medical), develop your fact finding skills, develop your network, understand what the significant issues are for the employers you will be targeting, and keep moving forward with your prospecting.

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Selling on price in the group health insurance marketplace is a great way to achieve sub 80% retention.

Anyone can lower cost for all parties but doing so without a reduction in benefits and major employee disruption is the struggle. Instead, focus on cost-control measures and projecting future costs.

Here's some helpful information for OP:

1.) What's the biggest struggle of your market segment? ACA Reporting, technological integration, ease of administration, employee communication, and/or sustainable cost-control.

2.) How do you solve these problems?

3.) What's your differentiator, and don't you dare say customer service.

4.) How do you pro-actively manage the renewal process? What's the timeline? FFS, show the prospect a clear written (and hopefully illustrated) timeline of the renewal process.

I am curious about your suggestion. Could you explain in more detail; 1) what cost control measures do you suggest, and 2) how do you project costs, and 3) once you project costs, then what? Thanks.

 

[Botboy141]

I am curious about your suggestion. Could you explain in more detail; 1) what cost control measures do you suggest, and 2) how do you project costs, and 3) once you project costs, then what? Thanks.

Happy to shed additional detail.

1.) Is going to be highly dependent on the group and typically requires 2-5 years of detailed claims history. Recommendations will vary between network and provider discount evaluation, employee communication, plan design changes (encourage urgent care vs emergency room, etc). Sometimes telemedicine and wellness peograms can be a play here as well depending on the population.

2.) Cost projection is obviously simplest when dealing with self-funded programs. When dealing with fully insured programs, claims history, large claims activity, utilization, carrier trend and employee demographics (and expected changes to demographics). There are a few different tools out there that can assist with this, we use primarily in house metrics.

3.) Inform the employer of expected increases so they can be budgeted for. Depending on reactions to future expectations, begin implementing cost control metrics described in 1 as appropriate.

 

[leevena]

Happy to shed additional detail.

1.) Is going to be highly dependent on the group and typically requires 2-5 years of detailed claims history. Recommendations will vary between network and provider discount evaluation, employee communication, plan design changes (encourage urgent care vs emergency room, etc). Sometimes telemedicine and wellness peograms can be a play here as well depending on the population.

2.) Cost projection is obviously simplest when dealing with self-funded programs. When dealing with fully insured programs, claims history, large claims activity, utilization, carrier trend and employee demographics (and expected changes to demographics). There are a few different tools out there that can assist with this, we use primarily in house metrics.

3.) Inform the employer of expected increases so they can be budgeted for. Depending on reactions to future expectations, begin implementing cost control metrics described in 1 as appropriate.

Thanks for the reply. What types of groups are you talking about here, by that I mean size and funding mechanism?

Also, what do you mean by network evaluation? Are you actually comparing discounts and making recommendations off of that info?

 

[Botboy141]

Thanks for the reply. What types of groups are you talking about here, by that I mean size and funding mechanism?

50-500 eligible lives. (I don't touch anything with less than 30 enrolled nowadays and primarily prospect 100-500). A pretty solid mix of groups but weighted towards fully insured and level funded with only a select number of truly self-funded/ASO groups.

Also, what do you mean by network evaluation? Are you actually comparing discounts and making recommendations off of that info?

For self-funded groups absolutely. For fully insured it's more of a review of in-network versus out-of-network claims to make sure the carriers being used are appropriate for all areas the organization has its operations.

 

[leevena]

There isn't a single employer offering group health that won't listen to a proposal that will lower healthcare costs for "both" the employer AND their employees.....a win-win proposition.

You have my curiosity, but first things first, I do not agree with your comment above. There are many who would agree to listen. But beyond that your comment about saving the employer money without changing their healthcare plan needs some clarification. Can you provide some concrete examples of what you did? I am not looking for vague comments such as analyzed their network discount either. Please provide details, such as size of group, the funding mechanisms, what specific changes you instituted, etc.

Thanks.

 

[Key2Success]

You have my curiosity, but first things first, I do not agree with your comment above. There are many who would agree to listen. But beyond that your comment about saving the employer money without changing their healthcare plan needs some clarification. Can you provide some concrete examples of what you did? I am not looking for vague comments such as analyzed their network discount either. Please provide details, such as size of group, the funding mechanisms, what specific changes you instituted, etc.

Thanks.

First things first.....I never said "there weren't many who would agree to listen"....I said "they ALL would be willing to listen."

Currently, we're offering a Classic 105 add-on benefit to any employer's group plan (20-3000 lives) and it doesn't matter which plan they have.....it works with them all. We're in the process of securing funding for any size company by the 2nd quarter of 2017.

 

[leevena]

First things first.....I never said "there weren't many who would agree to listen"....I said "they ALL would be willing to listen."

Currently, we're offering a Classic 105 add-on benefit to any employer's group plan (20-3000 lives) and it doesn't matter which plan they have.....it works with them all. We're in the process of securing funding for any size company by the 2nd quarter of 2017.

I agree with your first observation, and I should have been more clear. I said many would, but not all. Your comment was that all employers would agree, which I do not believe.

I am familiar with Section 105, but am not familiar with Classic 105. Can you please add some clarification please.

 

[Botboy141]

First things first.....I never said "there weren't many who would agree to listen"....I said "they ALL would be willing to listen."

Currently, we're offering a Classic 105 add-on benefit to any employer's group plan (20-3000 lives) and it doesn't matter which plan they have.....it works with them all. We're in the process of securing funding for any size company by the 2nd quarter of 2017.

I'd love to see your opinion letter from the IRS.