Does Your Health Insurance Broker Negotiate for You?
If you’re a small business owner or individual, finding the right health insurance plan within a reasonable premium can be frustrating. Confusing exemptions, benefits, and legislation makes it nearly impossible to keep up with your plan each year.
There is a solution that many small businesses and individuals utilize: Brokers.
Brokers are independent, meaning they can provide more options and more holistic view of the marketplace than you can on your own. They are highly trained and skilled at evaluating the costs that will affect you and can help design plans with major insurance carriers in your area.
For smaller accounts, brokers are typically free. Their advice is invaluable, however, if you’re planning long-term and want to reduce costs on your health insurance.
One of the best parts of hiring a health insurance broker is letting them handle the health insurance negotiation of your health plan costs. They can help your organization save thousands, if not millions depending on the size of your company, on healthcare costs. They do this through health insurance negotiation with carriers.
Here’s a few ways a broker goes about this, and what you can expect when you use one.
They Know What Questions to Ask
For example, if you have 50+ employees, it’s unlikely you know small details about each one that could potentially help you lower your group rate. Questions like, “Do you have any claimants who no longer work with you? Is the health of your company improving?” This is a great starting point for negotiating lower costs for your renewal.
They Analyze Your Plan’s Benefits and See Where Cuts Can Be Made
Instead of continuing to pay for services no one in your company uses, Brokers take a look at your plan and help guide the appropriate cuts to each one. This enables you to reduce costs right off the bat, without having to negotiate for different plans.
They Negotiate to Customize Plans
By speaking directly with providers, brokers can discuss and show data from your company that shows where your employees are most in need of coverage. This can be extremely beneficial if you have a generally healthy and young workforce.
They Provide Competitive Data
A health insurance broker can provide competitive data to show that your company qualifies for certain reductions especially those in the community rating. Community ratings can climb dramatically, but with the help of a trained eye, you can see where reductions can be made. Thanks to a large network of businesses under brokers, they have more power to move the rate than an individual does on their own.
They View Claims Data
Claims data shows how much of your coverage your employees are using. A broker should scrutinize your claims data to see what your insurance company paid in comparison to your premiums paid. If the two don’t add up, then they can negotiate with the insurance company for lowered costs on your behalf.
Typically, insurers are looking for a loss ratio of 85 percent to provide renewal consistent with trends. Your broker will work hard to find that ratio so you can enjoy lowered rates giving him or her more room for negotiation.
They View Medical Conditions
Your plan is based on the overall health of your group. Because of this, a broker will take a close look at the medical conditions in the group to justify lowering costs. Limited chronic illnesses and claims can assist you in leveraging a lower premium come renewal time.
The most important thing to remember about health insurance brokers is that they provide quality insight you can’t find anywhere else. They know how to analyze your group’s health insurance plan to see where holes need to be filled or where you can leverage against higher premiums. The more individuals you have on your plan the more power a broker has to negotiate lowered costs.
Health insurance negotiation is tricky, but with the right team of diligent and up-to-date brokers on your side, you can find a way to lower costs for yourself and your employees. Primary Care Insurance Solutions agents are experts at health insurance negotiation for your company.
Frequently Asked Questions
What is the role of a health insurance broker for small businesses and individuals?
A health insurance broker provides a more holistic view of the marketplace than one might get on their own. They evaluate costs, design plans with major insurance carriers in the area, and negotiate health plan costs on behalf of the client.
How do brokers help reduce costs in health insurance plans for small businesses?
Brokers analyze a company’s plan benefits, identify unnecessary services, and make appropriate cuts. They negotiate custom plans based on the company’s specific needs, provide competitive data for rate reductions, examine claims data to negotiate lower costs, and assess the overall health of the group to justify lower premiums.
What kind of questions does a broker ask to start negotiating lower costs?
Brokers may ask if there are claimants who no longer work with the company or if the company’s overall health is improving, especially for businesses with 50+ employees.
How do community ratings impact health insurance costs and how can brokers assist with them?
Community ratings can significantly increase costs. Brokers, with their access to competitive data and a broad network of businesses, can identify where reductions can be made and have more power to influence the rate than an individual alone.
Why is it essential to analyze the medical conditions within a company’s group when negotiating health insurance rates?
The insurance plan’s costs are based on the overall health of the group. Limited chronic illnesses and claims can be leveraged by a broker to negotiate a lower premium during renewal time.