Compliance

Ep #82: Current Regulatory and Legislative Issues – With Jessica Waltman

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Our ShiftShapers subject matter expert this week is Jessica Waltman. Jessica serves as principal at Forward Health Consulting, which she established after 16 distinguished years as Senior Vice-President of Government Affairs for the National Organization of Health Underwriters.

In this wide-ranging discussion,  Jessica discusses ACA reporting, the need for clients to have up to date plan documents, and the outlook and implications for the “Cadillac Tax”. She believes that all of these, while complex, provide an unparalleled opportunity for benefit advisors.

We also take a look into the future and the political realities in healthcare in the coming months. Since regulation and legislation never seems to end, we are excited to announce that Jessica has agreed to visit with us on a quarterly basis to keep the ShiftShapers audience current.

What You’ll Learn From This Episode:

  • Whether regulatory and legislative changes provide opportunities.
  • Whether there is an information vacuum.
  • The number 1 issue that faces employers today.
  • The two things advisors should focus on.
  • The prognosis for the PPACA Excise (a/k/a “Cadillac”) Tax.
  • The ramifications of the recent decision about defining group sizes.

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Ep #81: Transparency Without Clarity Is Like A Sink Full Of Dirty Dishes – With Robin Gelburd

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On this week’s episode of ShiftShapers, we’re excited to be speaking with Robin Gelburd, president of FAIR Health, a national independent non-profit organization that’s currently doing some interesting and effective work around the broad subject of pricing and transparency.

They have recently released a must-read study for anyone in the benefits field titled “Understanding Consumer Health Insurance Preferences” (use our SPECIAL OFFERS link on the right to download the entire study).   Robin joins us today to talk about the study and to discuss why she believes that transparency without clarity is like a sink full of dishes.

We will explore some of the most interesting findings of the study, such as how and why certain constituencies access care in different locales. We also explore common misconceptions consumers have about pricing and what they find most important when choosing a healthcare plan. You won’t want to miss  this informative episode.

What You’ll Learn From This Episode:

  • What FAIR Health and their mission are all about.
  • Significant differences in trends with diverse demographic groups.
  • Whether it is surprising that consumers find health care costs higher than imagined.
  • The most important factors to consumers when selecting a plan.
  • The recommendations that the survey suggests.

Featured On The Show:

  • www.FairHealth.org
  • “Understanding Consumer Health Insurance Preferences” Study –
    get your copy by clicking the SPECIAL OFFERS link in the right-hand column

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Ep #80: Building a Powerhouse Benefits Agency with Tim Olson

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This week we welcome Employee Benefit Adviser Magazine’s “Adviser of The Year” Tim Olson, the managing partner at The Olson Group.  He joins us today to share his journey to building a successful benefits practice and to talk about some of the innovations their agency is using to keep the at the top of their game.

We begin by discussing their beginnings and the way the agency has expanded to provide a deeper level of value to their clients. Tim chats about the variety of services they offer and how they use those to attract prospects with various needs to become full-range clients. Tim offers key insights into the powerful strategies they are using to stay on top of the changes in the industry.

From using different types of technology to the immense value of mastermind groups, you’ll discover great tips and game-changing advice that can help your agency become a powerhouse in the benefits marketplace. Don’t miss this opportunity to learn from the “Adviser of the Year.”

What You’ll Learn From This Episode:

  • How The Olson Group­­­ got its start.
  • How you can let prospects know about the full range of services offered.
  • What happens when you aren’t the “right fit.”
  • Why it is all about the value.
  • Why investing in technology is key – for all size agencies.
  • Why mastermind groups are crucial to continued development.

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Ep #77: Free Market Medicine is Disrupting and Transforming Markets – With Charlie Sauer

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In earlier episodes (see links below) we have spoken with physicians who are taking a very different, and more free-market approach to pricing health care. Their numbers are growing rapidly and while some may think that “free market medicine” is an oxymoron or an impossible dream, a new and growing association is beginning to prove otherwise.

On this episode of ShiftShapers podcast, we’re excited to welcome Charlie Sauer, co-founder and the executive director of the Free Market Medical Association. Their organization is dedicated to promoting transparency and forwarding the ideals and practice of medicine without the intervention of government and other third parties.

We invited Charlie to talk about the transformative nature of free market medicine. We asked Charlie how it can be possible to have free market in medicine in an environment where the government pays more than 50% of health care spend. We discuss the issue of whether consumers would be better off if artificial discount arrangements and multiple third parties were removed from the health care pricing landscape and why Charlie believes that our country is headed in that direction.

What You’ll Learn From This Episode:

  • Whether the health care in the United States is an economic Oz.
  • How you can promote free market solutions with the government paying more than 50% of health care expenditures.
  • How we can get out of this cycle.
  • Whether the ACA complicated the problem.
  • The tools do consumers need.

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Ep #76: What You Need To Know About Defined Contribution Plans – With Bill Hill

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From fully-insured to self-insured, a great deal of focus is on funding strategies rather than products. In previous episodes of ShiftShapers podcast, we’ve discussed everything from minimum premium to captive arrangements. In this episode Bill Hill, president and CEO of Visor Benefits, helps us take a deep dive into the defined contribution plans and some of the novel ways to deploy them with your prospects and clients.

We invited Bill to share his unique journey and some interesting things he has learned along the way about defined contribution and what role it plays in his practice today.  We explore the changes ACA has made in the design and deployment of this arrangement. We also talk about how geographic and specific market variations and needs influence plan offerings. Learn some of the insider tips you need to be aware of to best serve your clients when discussing defined contribution plans with employers.

What You’ll Learn From This Episode:

  • The regional differences of two companies Bill worked with.
  • How Alaska factored in.
  • Whether smaller groups should eliminate group coverage.
  • Whether advisors should lead employer conversations with plan design or concept.
  • Whether these approaches work in self-insured plans.

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Ep #75: Renewed Interest in On-Site and Near-Site Clinics – With Karen Hjerleid

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Increases in personal responsibility, a need to control employer costs and a desire to improve the health of employee populations are renewing an interest in the area of on-site and near-site clinics. Karen Hjerleid, the Vice-President of National Business Development at Paladina Health shares her knowledge of the area and offers insight into an old concept that may make sense for an ever-increasing number of employers.

Karen joins us to talk about how the ACA has increased populations seeking care from smaller networks and overburdened providers. Those characteristics can often result in employees not receiving care when they need it.  Coupled with deferred care due to ever-larger out of pocket amounts, Karen believes a new model of the old clinic structure can offer answers to these and other system-related problems.

We explore the different types of arrangements and how advisors can best position them with their prospects and clients. We ask Karen about the reasons that traditional carriers have not warmed to this option are beginning to come around now that the interexchange of data has become more robust and real-time.

What You’ll Learn From This Episode:

  • The perverse incentives in the system.
  • What drives the interest in employer-sponsored clinics.
  • Whether the group size matters.
  • What the medical home is and why it is important.
  • Whether there is a robust data exchange between clinics and carriers within those clinics.

Featured On The Show:

  • www.PaladinaHealth.com
  • Click the SPECIAL OFFERS button to access a free Paladina Health white paper and case study.

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Ep #74: New Opportunities in Previously Uninsured Group Markets – With Bob Gardner

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More so today than at any time in the past, benefit advisors are looking for new markets to serve. In this episode, we discuss some non-traditional markets that may be new to many of our listeners and we discuss the techniques that resonate in those markets. There’s no better person to talk about this topic than our guest, Bob Gardner, the National  Business Development Coordinator of Freedom Care Benefits.

We invited Bob to talk about the new opportunities and imperatives in previously uninsured group markets and what advisors need to know to be able to capitalize on those opportunities. In this conversation, we define these traditionally uninsured market segments and discuss the reasons why advisors should consider serving them. Don’t miss this important episode that will surely open your eyes to some new and interesting possibilities.

What You’ll Learn From This Episode:

  • What these traditionally uninsured markets are.
  • What has made them a new priority.
  • Interesting ways to solve problems while mitigating costs.
  • Whether traditional group carriers participate in these markets.
  • What the advisor/client conversation looks like.

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Ep #73: Using Reinsurance for Pharmacy Costs to Mitigate Overall Health Spend – With Crystal Williams

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In the post-ACA environment we have seen intensely increased interest in self insured financing arrangements. Some elements of self-insurance are now making their way out as stand-alone components, and are even being applied to fully-insured plans. Our guest and subject matter expert, Crystal Williams, President of RxReins joins us to discuss reinsuring one of the biggest cost drivers in any plan: pharmacy.

In this episode of The ShiftShapers podcast, Crystal explains the basics of stop loss coverage. We explore strategies and tactics that advisors can use when discussing this cost driver with prospects and clients. Crystal also gives us the carrier’s perspective on this unique strategy as applied to fully-insured plans. This is a novel conversation that will help you to differentiate yourself and deliver value-added intelligence for your clients.

What You’ll Learn From This Episode:

  • The basics of stop loss coverage.
  • Whether it is unusual to apply stop loss to pharma only.
  • How this can work with fully insured plans.
  • The impact of this type of arrangement.
  • What to benefit advisors need to know to discuss this with their prospects and clients.

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Ep #72: Best Practices and Innovative Agency Techniques – With Emily Bremer

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In today’s environment, the average age of benefit advisors and agency owners is increasing, but there are some younger people coming into the insurance business and they are bringing innovation and new best practices to the table. Emily Bremer, founder at Bremer Conley Insurance Brokers & Consultants is one of those advisors, and she joins us to discuss some of the things her agency is doing.

We discuss some of the issues with the traditional agency systems, as well as compensation compression and what Emily and other new independent benefits advisors are doing to solve those problems. While these newer advisors are “fiercely independent”, you may be surprised at how some of them are joining together to create a cooperative that maximizes resources and eliminates duplication and waste – all of which will increase profitability.

What You’ll Learn From This Episode:

  • Emily’s journey into the insurance business.
  • The problem with traditional agency compensation systems.
  • How and why she is working on forming a cooperative.
  • The new best practices she is developing.

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Ep #68: Defeat Freebies With Your Secret Weapon – With Lillian Shapiro

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At the recent NAHU Convention, we spoke with Lillian Shapiro, president of HR360, about some of the challenges that benefits advisors face from companies providing “free” stuff in exchange for Agent of Record Letters. She points out that this type of marketing is not a new hurdle, but one that has reappeared at a particularly interesting time in our business.

On this episode of ShiftShapers,Lillian shares a simple yet powerful technique brokers can employ to give them a competitive advantage over any technology platform. She offers advice and ideas to help advisors become more effective and efficient in closing new clients and retaining existing ones. Lillian believes that advisors today have a unique value proposition – they simply need to learn how to present it in a compelling and competitive manner.

What You’ll Learn From This Episode:

  • The challenges advisors have faced in the past with freebies.
  • How to ensure your clients know the full scope of the services you provide.
  • How to use checklists and newsletters.
  • Why social proof matters.
  • The secret weapon in every client relationship.

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