Saturday, August 18, 2012


It is that time of year again!  The Owners, CFOs, HR Departments must sit down and make the important - and often expensive decisions - about Employee Benefits.  Before deciding on the Design, Plans, Programs, and Services many Organizations consider changing a Broker(s) or working with a Broker(s) for the first time.  Many Organizations utilize several Brokers/Agents to gain more specific focused expertise.  These area of expertise may include: 
  • Selecting and Pricing Traditional Core Benefits 
  • Selecting and Implementing Voluntary Worksite Plans
  • Selecting and Implementing Retirement Plans
We, and would suggest the following when making these important selections.

Core Benefit Brokers should have the following:
  1. Qualities - Should include: Flexibility, Creativity, Broad-Based Knowledge, Experience. 
  2. References -- From people in your Industry and of Organizations with a similar size and Employee mix.  
  3. Carriers -- A broad Based knowledge of Carriers.
  4. Licensing -- A willingness to become licensed with the Carriers, State-by-State, that can best meet the needs of the Organization and the Employees.
  5. Design Strategies -- Fully knowledgeable about the advantages and disadvantages of traditional Fully Insured Health Plans, HMOs, PPOs, HRAs, HSAs, Self-Funding, Stop-Loss Coverage, TPAs, Captives, Defined Contribution (DC), and other options.
  6. Plan Choices -- Including: Medical/Health, Limited Health Plans, Life Insurance Plans, Dental, Vision, Long Term Disability ( LTD), Long Term Care (LTCI), AD&D, RX Plans, Wellness Plans.
  7. Openness -- A willingness to integrate his/her Plans with a Voluntary Benefit Broker.
  8. Regulations - Capable of assisting with State and Federal Regulations.
  9. Focused on Needs -- Willing to spend the time to understand the specific needs of your Organization and the Employees including job descriptions, income levels, geographic distribution, languages spoken, and other demographics.
  10. Participation -- A willingness to participate in the Employee Education, Communication, Enrollment, and Data Management Processes.
  11. Cost-Sharing - - A willingness to share on the Cost of the overall Education, Communication and Enrollment Processes. 
  12. Availability- - A willingness and capacity to assist with new hires and interim enrollments.
  13. Financially Savvy -- A willingness to work within the Organization's and Employee's "Price Points". 
  14. Administration -- A willingness to assist in Claim Administration.
  15. Futurist --  As best possible, fully knowledgeable about the impact of PPACA between 2012 and 2114 and beyond.
Voluntary/Worksite Benefit Plan Brokers should have the following:
  1. Qualities -- Flexibility, Creativity, Availability, Broad-Based Knowledge, Experience, Empathy for the time constraints on Management and Employees.
  2. References -- Will they provide references from Employers in similar Industries and Organization sizes.
  3. Openness -- A willingness to integrate his/her Plans, Programs, and Services with the traditional Core Benefit Brokers.
  4. Plan Design -  A thorough understanding of Cafeteria Plans, Flex Plans, and Defined Contribution (DC) Strategies. 
  5. Insurance based Voluntary/Worksite Plan Choices -- A broad based knowledge of the various Carriers and their Plans, Programs, and Services.  No one carrier has the best-of-all Plans including: Short Term Disability (STD)), Long Term Disability (LTD), Critical Illness (CI), Hospital Income (HI), Cancer, Life Insurance, Dental, Vision, Pet Insurance, Auto and Home. 
  6. Organizational Buy-In -- The capacity to generate interest and participation within the Employer's Executives, Managers, Department Heads, and Unions as applicable.
  7. Licensing -- A willingness to become licensed with the Carriers, State-by-State, that can best meet the needs of the Organization and the Employees.
  8. Tax Advantaged Plans, Reporting, and Regulations - - These include, Section 125; Reimbursement Accounts - Medical/Health, Dependent Care, and Transportation. 
  9. Experience with Qualified TPAs for Flex Plans - For implementation of the above Tax Advantaged Plans (8).
  10. Non-Insurance Based Benefit Plans and Services -- Including: Vision, Dental, Legal, Pet Coverage, Consumer Discount Cards, RX Cards. 
  11. Financially Savvy -- Must thoroughly understand the Financial Capacities and "Price Points" of the Organization and the Employees.
  12. Focused on Needs -- Willing to spend the time to understand the specific needs of your Organization and the Employees including job descriptions and income levels. 
  13. Enrollment - - Capable of delivering a well-orchestrated Employee Benefits, Education, Communication, Enrollment, and Data Management Process that is inclusive of all Carriers, Plans, Programs, and Services.  The Broker (s) should be knowledgeable of the various Communication and Enrollment Choices: Group Meetings, One-on One, Internet Based, Paper Based, Call Center Based, or a an integration of the Systems.  
  14. Cost Sharing -- Capable of working with all of the Carriers and Providers of Plans, Programs, and Services to share in the cost of the Education, Communication, and Enrollment Process.    
  15. Focused on Employee's and Their Families' Financial Capacities -- A sensitivity to the the Employee's and their Families' combined income capacity to afford additional Plans, Programs, and Services. A willingness to Monitor the Enrollment Process.
  16. Trouble Shooting -- A willingness to meet with Managers and Department Heads during the Enrollment process, "Pulse Meetings" to isolate and resolve problem and concerns. 
  17. Presence -- The ability to be onsite to assist in resolving problems before, during, and directly following the enrollment - including the fist date when the payroll is issued following the first Payroll Deductions.
  18. Working with New Hires, Change in Status, and New Eligibility --  Assist in Explaining and Enrolling the Plans, Programs  and Services offered.
  19. Futurist --  As best possible, fully knowledgeable about the impact of PPACA between 2012 and 2114 and beyond.
Retirement Plan Brokers and Consultants should have the following capabilities. While I do not have significant experience in selecting a Retirement Plan Broker a SHRM Report of 6/7/2011 titled "Benefits Broker: What should my company consider when selecting a benefits broker?" offered the following: 
  1. Services -- What services and knowledge does the broker provide?
  2. Cost and Plan Design -- Will they evaluate the costs and plan designs of several major insurance carriers in your region?
  3. Compliance Issues -- Are they able to provide compliance advice regarding relevant federal and state laws? How familiar are they with the Patient Protection and Affordable Care Act (PPACA) requirements? Can they explain what changes current plans should make to ensure compliance?
  4. Evaluating Risk -- Will they assist with evaluating health-related risks and offer suggestions how to reduce the company’s exposure?
  5. Enrollment -- Will they assist with open enrollment communications?
  6. Problems -- Will they assist with claim resolution and/or problems?
  7. Licenses -- What licenses has the broker obtained, and are they current?
  8. Cost of Services -- What are the costs of the broker’s services? Are they paid commissions by the insurance companies, or do they operate on a flat fee structure?
  9. Industry Knowledge -- Are they familiar with the company’s industry?
  10. References -- Are they willing to provide references from existing and former clients?
  11. Disciplinary Record -- Are there disciplinary actions that might be on file with the state insurance commissioner?
  12. Needs Based Understanding -- Does the broker have a good understanding of your company needs?  Do they ask you relevant questions about benefits preferences and likes/dislikes about current benefits plans?  Do they ask about the company culture? Do they address company needs and/or summarize the overall needs or wants appropriately?
  13. Recommendations -- How will they determine what benefits recommendations will be made to the company? 
  14. Communications -- What is the broker’s communication method (e.g., mostly by phone or email); frequency (e.g., weekly, monthly, bi-monthly) and response time?
As organizations begin this part of the decision-making process, it is very important to select Brokers with whom the CFO, HR Department, Department Managers, and Employees can work comfortably.  The selection of the Brokers, Plans, Programs, and Services - as well as the Education, Communication, Enrollment, and Data Management Processes - protect the well being of the Employees for the near and longer term.

For more information about  Insurance, Benefits, and Selecting a Broker - as well as Plan, Program and/or Service decisions --  Visit -, Email - or Call 216.577.5579  


BenefitPlace hopes you will use this forum to respond to posted comments and share your ideas, questions and expertise related to the overall Employee Benefits and Individual insurance marketplace. Thanks for joining us!