Broker takes wellness effort out of insurers’ hands

It’s difficult enough to get workers to participate in wellness programs, given human nature, privacy concerns, and people’s harried lives. But for an employer trying to keep insurance costs down, there’s one more challenge, broker Joel Cooper says.
What if you sign up for, say, Blue Cross & Blue Shield of Rhode Island’s Good Health Benefit, and start to make some headway, but then Blue Cross’ renewal rates come in much higher than what UnitedHealthcare of New England is offering?
Do you start from scratch with United, hoping you won’t face the reverse situation next year? Or do you stay with Blue Cross and accept the higher premiums for the sake of continuity?
Dilemmas like these arise frequently, said Cooper, president of USI New England. So his brokerage came up with an idea: to offer employers an alternative that isn’t tied to any one insurer, but rather relies on the brokerage to coordinate everything.
“It has incredibly good value, because the insurance companies are finally beginning to develop more sophisticated wellness initiatives … but they’re also trying to do it in a way that helps persistency, that helps preserve their clients,” Cooper said.
“These are not one-year initiatives,” he added. “And in this day and age of incredibly volatile premiums, how are you going to commit to multiple years?”
USI, a national company, developed its broker-based model at the national level, but what the regional office began offering to clients this month is tailored specifically to New England employers, who tend to be more reluctant than their peers elsewhere to pass on costs to their workers, Cooper said.
The service comes in three basic forms:
• For about $2 per week, paid for by each worker, USI will bring in experts to provide individual health risk assessments, including a 15-point blood analysis; develop individual “health improvement plans”; provide 24/7 online and telephone support, and – if the employer wishes, for an extra fee – design a rewards system, such as cash bonuses or lower deductibles.
• At no charge at all to employer or employee, USI will conduct, online or by fax, an individual health risk assessment and develop an individual action plan; provide coaching by phone to tackle specific issues; provide newsletters; and provide participation data to the employer; again, rewards systems may also be designed for an extra fee.
• For about $1.50 per employee per month, paid by the employer, USI will provide individual health risk assessments, individual wellness plans (without blood work), and phone-based coaching, with the option to “buy up” and design rewards programs.
The low rates are possible, Cooper said, because USI nationally and the regional office both negotiated really good deals with local contractors. But to maximize the chances of success with these initiatives, he acknowledged, it really pays to invest a bit more and include the rewards component, so workers have an incentive to participate.
Rewards can include lower premium co-pays, deductible “backfills” (say, if the deductible is $500, making it $250 for program participants), or even extra days off, Cooper said. For an extra fee, USI will administer the rewards – through an outside contractor. And more important, because strict laws apply to these things, USI will design the plan documents to comply with the Employee Retirement Income Security Act (ERISA) and other laws.
One of the key components of the new program is the option to have a third party monitor participation and success rates, Cooper said (as an insurer could also do). That’s because under federal and state privacy laws, an employer can’t ask a worker, say, whether she quit smoking as she vowed to do, or whether she lost the 20 pounds she needed to lose.
Even with the extra charges for program setup, monitoring and rewards administration, however, the costs have been kept very low, Cooper said. The setup fees are about $500 to $1,000, and administration is about $1 per worker per month.
For those who might still be reluctant to make the investment, USI brings out the reams of statistics that researchers have been compiling in recent years to gauge the cost of chronic disease, smoking, obesity, etc.
For example, at a recent presentation, the brokerage told employers that an obese employee costs them $460 to $2,500 per year in additional medical expenditures and absenteeism; men who are 60 pounds or more overweight, employers were told, miss an average of five workdays per year.
In the first two weeks of offering the program to local employers, Cooper said, about a dozen companies signed up.
“I’ve been overwhelmed by the response,” he said. “Every one has a little twist, their own corporate culture, and we adjust to that.”
For Cooper, whose background is in clinical social work – though he’s been a benefits brokerage executive for years now – taking this new initiative on the road has been energizing.
“It’s been exciting,” he said. “I’ve gotten the best reception we’ve ever had for anything we’ve put on the table for employers.” •