Will Health Insurance Technology Simplify the Complex?

by Cathy Miller on March 25, 2014

in Health Insurance

Employee Benefits TechnologyIs health insurance technology an answer to employers’ prayers?

Will technology convert apathetic individuals into active participants in their health care decisions?

Health reform and rising costs tossed employee benefits and health insurance on their ear.

  • Businesses push employees to make their own coverage decisions
  • Health reform strives for greater individual enrollment
  • Changes require better communications – and better tools

Health insurance technology could be a game-changer.

Health Insurance Technology Revolution

As someone who paid health insurance claims before God invented computers, I understand the value of technology.

In the ideal world~

  • Technology increases productivity
  • Improves accuracy
  • And enhances analysis

On the flip side, poorly programmed technology spawns serious problems.

Just ask Healthcare.gov.

In the late 1990s, einsurance changed the way individuals purchased insurance. Early marketing of Healthcare.gov promised a similar ease of enrollment. Ah, the best laid plans.

Health insurance technology has a critical role in the successful transition of apathetic individuals and employer-dependent workers to savvy healthcare consumers.

The Complex

Most brokerage firms have an employee benefits division and a property/casualty (risk management) division.

My property and casualty colleagues from my brokerage days were baffled at the level of work in responding to a Request for Proposal for Employee Benefits.

Health insurance is complex. It has many moving parts.

Employer sponsors of health benefits have multiple decisions to make.

  • Plan types – including delivery model such as Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), etc.
  • Savings accounts – if offered, plans like Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), Flexible Spending Accounts (FSAs), etc.
  • Plan designs – deductibles, coinsurance and/or copayments, limits and exclusions
  • Provider networks – broad-based or narrow networks
  • Funding – fully insured versus partially or fully self-funded by employer
  • Contributions – the employer portion versus the employee share

Tack on health reform and other legislative compliance issues.

Now, picture a healthy portion of those decisions placed on the individual’s shoulders.

How’s that for an opportunity?

The Simple

Enter health insurance technology. Attempting a simpler process.

MetLife’s 11th annual Study of Employee Benefits Trends reveals the importance of a simple enrollment process (as illustrated below).

The simpler the process – the higher the level of engagement.

Health insurance technology

Several online enrollment firms emerged as our lives moved online.

The following are a few examples. Note: I have no affiliation with any of those listed.

Jellyvision logoJellyvision®

Jellyvision® introduced Alex® in 2009, what they call the Cure to Boring Benefits Communication. Click on the link and you can watch a video (geared toward employer sponsors).

I love the simplicity of Alex® and its interactive features.

The individual user chooses the topics he or she wants expanded. I hope they introduce Alex® to the individual marketplace. Seems like a simple guy.

getinsured-logoGetInsured

GetInsured  announced its integration with the Centers for Medicare & Medicaid Services (CMS), providing an online alternative to Healthcare.gov.

The information technology company is also the software vendor for California’s insurance exchange, Covered California.

In case you hadn’t heard, Covered California had far fewer hiccups than other online enrollment. The exchange surpassed the 1 million mark in enrollment.

GetInsured was recently awarded the contract for Your Health Idaho. Perhaps I’ll have an opportunity at first-hand use.

Private Exchanges

Private exchanges offer their own enrollment platforms.

Private exchanges are not new; however, health reform produced a surge in popularity and new vendors. Estimates place the number at well over 100.

  • Some cater to individuals purchasing insurance
  • Others focus on group insurance
  • And some market to both individuals and groups

Private exchanges fall into one of two categories.

  1. Single carrier (offering one carrier’s products)
  2. Multi-carrier (with access to multiple carriers and their products)

Some private exchanges have in-house enrollment technology. Others partner with a health insurance technology company. The following are a few examples.

Bright_Choices_Logo__2Bright Choices®

Bright Choices® is the online marketplace for Liazon, a company operating private exchanges.

Liazon has been busy partnering with brokerage firms to market its services to employers.

Empyrean logoEmpyrean

Empyrean Benefit Solutions is the technology partner for private exchange, Bloom Health®, and offers enrollment and interactive online access for human resources’ functions.

BenefitFocusBenefitFocus®

BenefitFocus® offers a cloud-based employee benefits technology platform. The company partners with insurance carriers, brokerage firms, and employers in multiple services related to human resources, employee benefits, and private exchanges.

Keep it Simple

As someone passionate about simplifying the complex world of health insurance, I appreciate good technology.

We used to say health insurance is not rocket science; however, you do need the rocket to make it work.

Does health insurance technology possess the right rocket?

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Helping you Keep it simple, clear & uniquely yours – contact me for help with your business writing needs. Visit my business blog, Simply stated business.

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Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues.

BigStock Photo Credit

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