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Sharing the health care burden

Insurance agents support business leaders’ efforts to up their benefits

SPONSORED BY MICHIGAN ASSOCIATION OF HEALTH PLANS

By Leslie D. Green

After a health insurance carrier pre-approved one woman for a lap-band procedure to help with weight loss, but before she could undergo the surgery, her employer transitioned to a new carrier.

The new carrier didn’t cover the procedure. Seeking advice, the employee called the insurance agent who represented her employer.

“At one point, the employee kind of said, ‘Forget it, I’m not going to get (the procedure). It’s okay. I’ll just deal with it,’” recalled that agent, Dave Sokol, president of Troy-based insurance agency Wilshire Benefits Group.

Sokol and his team couldn’t let the employee give up that easily. They fought on her behalf for the carrier to fund the surgery. They were successful. During the procedure, doctors found a cancerous tumor in the woman’s stomach.

She probably would have died had she not been able to go through with the procedure, Sokol said. The story illustrates the significant role an agent has as a company’s strategic partner. Agents are more than consultants who stop by during open enrollment season and pitch a package of benefits. They are extensions of a company’s HR team; they are trusted advisors; they are, in many cases, therapists.

“Insurance agents work for their clients. They don’t work for the carriers,” said Cathy Cooper, legislative director for Lansing-based Michigan Association of Health Underwriters. The organization advocates on behalf of agents to make health insurance more affordable and accessible.

Lansing-based Michigan Association of Health Plans, with the help of MAHU, partnered with Crain’s Content Studio, the marketing storytelling arm of Crain’s Detroit Business, to gather leaders from seven Michigan-based benefits groups to discuss the role of an agent today’s business climate. MAHP works to improve access to health insurance for consumers and to improve value, choice, affordability and competition in the health insurance market.

The group shared the benefits and best practices of insurance agents and dispelled myths about the agent’s role.

“Rising healthcare costs have put health insurance in the top three expenses at most businesses,” said Jeff Romback, MAHP deputy director. “It affects employee retention, attraction and health. Your agent or broker is the gatekeeper for this expense who marries your interests to the changing landscape. Agents can be strategic partners; reviewing their performance against your goals should be at the front of a CFO’s mind.”

Agents know what keeps C-suite execs up at night

Leading organizations is challenging enough without having to worry about the rapidly increasing cost of health benefits, choosing the right plans and educating potential and existing employees — as well as unions — on the value of those benefits.

Because insurance agents understand these concerns, they work to relieve some of the burden of their clients’ executive team.

“Employers are not wanting to be in the health insurance business,” said Kareim Cade, president and CEO of Southfield-based Great Lakes Benefit Group LLC. “They don’t have the (time) to gather all the facts they need to be able to get through the health insurance process right.”

Stacey LaFay, president of Franklin Benefits Solutions in Grand Blanc, said insurance agents strive to offer clients the best coverage options available.

“We look at self-funding. We look at what can we do with prescription costs,” said LaFay. “We look at reference-based pricing (provider reimbursement based on a percentage of what Medicare would typically pay).”

At the same time, they look beyond mainstream insurance carriers, such as Blue Cross Blue Shield of Michigan and Blue Care Network, to find clients the most beneficial and cost-effective coverage, explained Jeff Romback, deputy director of MAHP.

“Smart shopping for health insurance means looking at all the options,” Romback said. “Knowing what’s available at different carriers with different structures makes for a full picture.”

The insurance agent’s job is to make sure they are exposing clients to all the benefits, health or otherwise, that will help them attract and retain top talent, said Michele Bolser, director of benefits for VTC Insurance Group.

There are 7.3 million job openings, which is about 1 million more jobs than there are workers to fill them, according to a June report from the U.S. Bureau of Labor Statistics. HRDive.com suggests employers offer benefits, such as flexible work schedules, remote work options and paid family leave, that are in high-demand among employees and job seekers.

“Is it a student loan payoff benefit? Is it a college tuition benefit? Is it pay-on-demand?” Bolser asked. “Even if we don’t think it’s necessarily something that substantial, (that new benefit) could be the difference.”

Agents also know that explaining health benefit changes to unions just adds to the complexity of negotiations between the administration and union leaders.

Great Lakes Benefit Group, which works with public sector organizations, strives to lessen tension in those conversations. “We sit between the union and the administration and say, ‘Hey, we all want to get to the same place,’” Cade said.

“We’re saying, ‘If you go to the least expensive facility, we’re going to give you a $100 gift certificate,’” said Stacey LaFay, President of Franklin Benefits Solutions. Photo by Sarah Barthlow.

“We’re saying, ‘If you go to the least expensive facility, we’re going to give you a $100 gift certificate,’” said Stacey LaFay, President of Franklin Benefits Solutions. Photo by Sarah Barthlow.

Agents support the HR team

Human resources professionals do a lot.

They interview, recruit, hire and onboard staff. They work with executives on strategic plans for attracting and retaining talent. They address employment-related issues, such as harassment allegations or other complaints, along with developing and administering health and safety programs.

At the same time, they juggle employee training, payroll and benefits administration.

Navigating the health care system takes time and resources away from those other responsibilities; and high costs, changing regulations, and the plethora of choices can overwhelm even the savviest of professionals.

Simultaneously, though, offering the right benefits is crucial to a company’s bottom line and often a key to attracting and retaining top talent.

“Eight or nine years ago, the economy took a dive in Michigan, and companies cut back substantially on support staff for HR departments. We have HR managers and directors out there doing a lot more than before,” Sokol said.

Insurance agents can help fill the gaps on a company’s HR team in terms of educating employees during open enrollment season and servicing employee benefits plans all year long.

They can answer employees’ questions about their benefits, help solve insurance-related problems and be the “voice of knowledge, experience and reason in a confusing area,” Sokol said.

Agents also operate with a sense of flexibility, always ready to respond to their clients’ HR needs.

When Tyrone Jordan II, vice president of Adrian-based Kapnick Insurance Group, visited one of his large clients during open enrollment a couple of years ago, he witnessed a staff member answering the phone every two minutes.

Afterward, Kapnick built a client call center so employees could ask agents questions about their benefits.

“That’s really been huge for staff to free up time to do other things they really want to do,” Jordan said.

Agents help employers – and staff – understand the value of benefits

An agent’s job isn’t done after identifying the best benefits for a business. They also help that organization’s HR team communicate the significant worth of those benefits to employees and illustrate how they stack up to what the competition offers.

“The national unemployment rate is at 3.6 percent. Those who are unemployed are not employable. So, you’re only going to get good people by stealing them from competitors,” said Greg Liposky, president of Troy-based Creative Benefit Solutions. “Benefits help illustrate the compensation package better. So, their paycheck might be x, but the percentage of the benefits the employer is funding or subsidizing could be 25 percent to 40 percent of their W2.

“We help the HR team disseminate that information in an effective way.”

Although organizations pay nearly $15,000 a year per employee for health insurance, employers often say their staff complain the insurance is junk.

Before, during and after open enrollment, insurance agents can help combat misconceptions by educating employees about how the plans might affect them, said Micah Widder, president of Security First Benefits Corp. in Flint.

“We take a very difficult topic and explain how it works,” Widder said. “We help them understand what is the deductible, what is coinsurance, what is a copay.”

DEBUNKING MYTHS ABOUT INSURANCE AGENTS

Agents don’t:

  • Work for insurance carriers.
  • Charge employees a fee for their services.

Agents do:

  • Act as a free resource for employees.
  • Sell value and educate clients.
  • Undergo compliance training to learn codes, ethics and other nuances of the industry.
  • Provide services for independent contractors, freelancers and those otherwise self-employed.

Beyond open enrollment season, agents can research viable cost-effective alternatives to a company’s current plan and even directly float the possibilities of different plans to the employees to get feedback on whether their providers would be in the new network.

“By the time we get in front of them to do the enrollment meeting, they understand the benefits of the plan,” Sokol said.

Wilshire Benefits holds a pre-enrollment education session on how high-deductible health plans and health savings accounts work for some of its clients. Liposky has seen the benefits of this education. His organization found that pre-education meetings increased employee participation in HSA plans by 20 percent to 25 percent.

Jordan said education is also crucial to union negotiations. When Kapnick held separate meetings with unions and administration for a school district client, messages weren’t being spread across the entire district, he said. “So, I started hand-picking people to work within the group. I said, we need one custodian, we need a secretary, we need people that are going to be talking to each other,” Jordan said.

“Negotiations became easier … It took away a lot of the fears of change because they understood the differences between the networks, between the plans, deductibles and coinsurance options, and they were telling the rest of their members. By the time it came to a vote, it was very quick and easy because people understood it at a level they never had before.”

Jeff Romback, photo by Sarah Barthlow

“Rising healthcare costs have put health insurance in the top three expenses at most businesses,” said Jeff Romback, MAHP deputy director. “It affects employee retention, attraction and health. Your agent or broker is the gatekeeper for this expense who marries your interests to the changing landscape. Agents can be strategic partners; reviewing their performance against your goals should be at the front of a CFO’s mind.”

Agents help employers encourage cost-effective insurance use

Education and transparency are also vital to lowering health-related expenses.

A single person earning a $50,000 salary who receives an employer-sponsored health plan generally spends 11 percent, or $5,250, out of pocket on health care, according to Kaiser Family Foundation. Insurance agents participate with nonprofits, such as MAHU, to help lower those costs.

MAHU, an advocacy group for insurance underwriters, takes the concerns of insurance agents and agents’ clients to Lansing and Washington, D.C. The agency also endeavors to acquire data about coverage costs — for pharmaceuticals, emergency room procedures and out-of-network care and more — for companies of all sizes.

Agents armed with information from MAHU can provide employers with a clear and thorough understanding of tools and benefits available through their selected coverage. Employers then can help employees comprehend cost and care implications.

Employees need to understand that the doctors they see or places they go for tests and procedures may not be the most cost effective or of the highest quality, said Cade, of Great Lakes Benefit.

Transparency allows them to inform employers and employees when there is a different location that provides high-quality care at a lower cost.

Franklin Benefits Solutions’ LaFay said a limited number of insurance carriers have transparency tools, such as cost estimators. Still, agents often work with organizations to incentivize wise choices that keep costs down.

For instance, LaFay said Franklin Benefits is incentivizing participants in some of its self-funded groups. “We’re saying, ‘If you go to the least expensive facility, we’re going to give you a $100 gift certificate,’” she said.

ADVICE FOR BUSINESS LEADERS
  • If you’re not seeing a variety of health insurance options for your employees, change agents.
  • Find an agent you trust as you would a lawyer or accountant.
  • Provide your agent the information necessary to do a solid market analysis for your organization. If you don’t trust that person with that information, change agents.
  • Keep an open mind when agents bring new concepts to the table. Those new ideas might differentiate you from your competitor and make it easier to attract and retain talent.
  • Include your insurance agent when you create your company’s three-to-five-year growth strategy.
Agents help complete the package

From one-on-one insurance consulting to high-level strategic planning, business leaders should consider the insurance agent a vital human resources partner all year long. Health benefits shouldn’t be something an organization discusses just before renewal periods.

“Health care agents should be part of any strategy for a company that is looking at growth,” Cade said. “As business leaders look at moving forward, health care should be a part of a three-to-five-year strategic vision. Organizations that are progressive are taking that type of approach.”

Your agent is relied upon to deliver high value for one of the largest expenses for your business and, more importantly, for your employees and their families. Taking time to review your agent’s performance and the services and advice they offer is worth review like any other operation.

 

‘Music Helps Me Engage’

Composer and trumpeter Kurton Harrison III plays the "Rising Stars Series with Sean Dobbins" in the Kerrytown concert House.Photo by Jeff Dunn

By Leslie D. Green

Songs are not minor in trumpeter’s life

The Ford Motor Company Fund recognizes that creativity and artistic expression enrich lives and inspire innovation and that communities which support and provide access to the arts are stronger for it. In this collection of stories, we share how and why music affects us at all ages and stages of our lives.

Diagnosed at age 5 with Autism Spectrum Disorder (ASD), Kurton Harrison III keeps defying expectations.

Rather than talk, Harrison pointed, pushed and developed his own sounds to communicate. He didn’t make eye contact and was so sensitive to some sounds and touch that he would physically respond in a negative way. Even warm water provoked a burning sensation for Harrison.

As a result, his doctor said Harrison would probably have to live in a group home.

The devastating outlook made his mother, LaJuana Harrison, cry. It also compelled her to act. She knew her son was capable of so much more.

“I would say, ‘We have to train him to do what we need him to do,'” Ms. Harrison said. “I would look in his eyes and say, ‘I know he’s in there.'”

To help him associate words with his world, LaJuana Harrison used Post-It notes to write down the names of every item in their house. She stuck them where her son would see them. Then she, her husband, and her mother dedicated nearly a year to instructing him to speak.

“If he wanted it, he had to touch it and say it before we would do it,” Ms. Harrison said.

Once Kurton Harrison started speaking, they made him spell the words before they would respond. Eventually, he started to string words together, though not always in the right order.

One day, shortly after they arrived at a family friend’s home, 6-year-old Kurton pulled himself up to the friend’s piano and started playing “Fallin'” by Alicia Keys. He had just heard the song on the car’s radio during the drive.

While Harrison’s mom was freaking out about her son bothering someone else’s property, her friend told her to stop and listen.

“He barely spoke, but he was playing this song,” LaJuana Harrison said. “I went out and bought a $700 keyboard and got fussed at. But it paid off in the long run. He played everything he heard.”

Then her son asked for a trumpet.

Pleased with his progress, his parents rented him a trumpet and enrolled him in the Detroit Academy of Arts and Sciences. Still, Harrison’s grades were poor and he would only talk if the subject was about music. He got into fights with bullies.

His mother told him the trumpet and keyboard were going to go if he didn’t stop fighting and improve his grades. Then, when he reached 7th grade, they encountered another issue.

“The music teacher said they could no longer work with him because his skills were too great,” Ms. Harrison said. “They wanted him to go to MSU Community Music School-Detroit (CMS-D).”

Operated by Michigan State University, CMS-D, an independent affiliate of Michigan State University, provides more than 60 music classes and music therapy for students of all ages, skills and incomes.

His mother enrolled him in CMS-D’s Aspiring Musicians Program (AMP) Camp. When she picked him up, she found a different kid.

“Kurton was so friendly there,” Ms. Harrison said. “He would walk into CMS with his trumpet, knowing he could play anything he wanted there, even the snare drums. Now you have a kid who can sit in a circle with these other kids and talk about music. Now he can talk about what he saw on TV because the music opened the door for him.”

Kurton Harrison said that he didn’t feel as if he had an opportunity to talk with people before AMP Camp. “Music helps me engage,” Kurton said.

“Before I participated in the camp, people picked on me and teased me because I am different from everybody else,” Kurton said. “Meeting more people that are engaged with what I want to do made me able to have a conversation. They are open to each other. Networking with other musicians is easier than talking with classmates who aren’t in your industry.”

Most teachers were willing to just pass Harrison to the next grade or class without challenging him because of his diagnosis, his mother said. However, his grades increased from Cs and Ds to As and Bs, landing him in the National Honor Society because of his participation in CMS-D.

CMS-D also helped get Harrison in the Detroit School of the Arts high school and in the Detroit Symphony Orchestra’s Civic Youth programs, which are all within walking distance of each other. As a result of these musical connections, Kurton would perform his own composition at the Detroit Jazz Festival.

Doctors once didn’t think it possible, but Kurton Harrison received his high school diploma in June. What’s more, rather than living in a group home, he will be living in a college dorm this fall.

Harrison was awarded a full ride – a $73,000 a year scholarship — to Oberlin Conservatory of Music in Ohio to play trumpet as his primary instrument. He also plays piano, bass guitar, and most horns. Plus, he composes jazz, classical, orchestral, big band, and modern music.

“I can’t say where he would have been if it hadn’t been for that MSU program,” Ms. Harrison said. “I don’t think he would have grown like this without the music. Put an instrument in their hands and their minds will wake up.”

About Autism


• Autism is a bio-neurological developmental disability that usually appears before age 3

• Autism affects 1 in 59 children

• Autism effects the normal development of social interaction, communication skills and cognitive function

• More than half of children diagnosed with autism are classified as having an intellectual disability or borderline intellectual disability

• 40% of children with autism do not speak

• 25%-30% of children with autism have some words at 12-18 months of age but lose them

• No two people with autism are alike

• Children with autism can progress but early intervention is key

Source: National Autism Association

 

This story was originally published on fordfund.org. The Ford Motor Company Fund supports a range of music-rich programming, including the Detroit Symphony Orchestra, the Mosaic Youth Theatre of Detroit, the Sphinx Organization, The Ark in Ann Arbor, Michigan, the League of American Orchestras in Washington, D.C., the GRAMMY Museum’s GRAMMY in the Schools program and Latin GRAMMY Cultural Foundation’s Latin GRAMMY in The Schools program.

Keeping neighborhoods safer, healthier

Genevive Meeks was 19 when AmeriCorps members began boarding up abandoned homes in her Detroit neighborhood.

“There were open holes where there was a lot of drug trafficking,” she says.

Afterward, she says the neighborhood felt different. “I know the kids felt safer going to school. It wasn’t just every person for themselves anymore.”

While working on her street, a volunteer told Meeks about Wayne State University’s Center for Urban Studies and its AmeriCorps Urban Safety Program. Meeks joined the one-year program. Now 22, she has renewed her commitment twice.

The AmeriCorps safety program is just one of many at the Center for Urban Studies. The center, which collects and disseminates data related to urban policy in metro Detroit, seeks not only to understand the challenges urban areas face — such as health and safety — but also to test and implement programs that can alleviate those challenges. WSU created the center in the aftermath of the 1967 Detroit riot.

“We are a research center, but we also experiment and try to figure out what programs are effective. Then we seek to intervene and help the communities of Detroit,” explains Lyke Thompson, director for the center and professor in WSU’s Department of Political Science.

With a federal grant, the center started the AmeriCorps Urban Safety Program to reduce susceptibility to criminal activity in Detroit’s communities. More than 100 AmeriCorps members, like Meeks, create block clubs, expand or establish neighborhood patrols, clean up lots, and board vacant homes.

“A lot is education. A lot is intervention. Criminals often case houses before they try to break in, and we try to educate people and give them tools to make it harder,” Thompson says.

Meeks enjoys interacting with the police as they assess residents’ homes and, if necessary, install deadbolt locks and battery-operated alarms on their doors and windows.

“I never thought about how some people didn’t have locks and stayed up all night worrying that someone might break in,” she says.

As part of the Detroit Fire Prevention and Safety Project, Center for Urban Studies volunteers install smoke alarms and carbon monoxide detectors in homes and educate residents on ways to reduce their risk of a house fire. In addition to crime prevention, the center is heavily involved in Detroit’s crime-fighting efforts.

Thompson says they began working with the WSU and Detroit police departments about nine years ago to create a model for patrolling neighborhoods. The center facilitated meetings between police agencies, community organizations and businesses to get a handle on crime in Midtown.

As a result, Thompson says, crime in the area has decreased 55 to 60 percent.

WSU implemented the model in the city’s 11 police precincts, where the center facilitates monthly meetings with precinct officers, businesses, community leaders and the Department of Corrections to examine strategies and tactics to fight crime specific to those neighborhoods. Every two weeks, the center holds crime-mapping and analysis meetings with commanders and captains who focus on solving one or two tough issues.

Raising awareness of health issues

Even more powerful than volunteering with the center’s public safety programs is working with its healthy homes programs, says Meeks.

A large number of illnesses, injuries and deaths are caused by deteriorating housing conditions. So, the Center for Urban Studies is working with HUD and other partners to identify dangerous homes. That includes looking for homes with pest, water and lead problems.

A healthy homes assessment indicates 17 percent of kids living in the 48214 ZIP code have lead poisoning, for instance.

“If residents have kids in the house, we refer them to programs that can help them abate the lead and urge them to take the child to a primary care physician or to the health department for testing so they can get the lead levels down in the child as soon as possible,” Thompson says.

Because Detroit has one of the worst problems with asthma of any city in the country, his group is working in southwest Detroit to reduce asthma and related conditions by helping families control pests and get new roofs on old houses so they don’t leak and grow mold. The center has already assessed about 2,200 houses this year.

“I always wanted to make the community better,” Meeks says. “You have to make a change to see a change.” Still, she’s surprised by how much she and the city’s residents have grown since she started volunteering with the Center for Urban Studies.

“Being a part of this empowers me and seems to have a positive effect on the people we encounter. Being part of this has helped me also see the growth of Detroit, how it’s changing for the better and how people are trying to make a difference.”


This story was originally published by Crain Content Studio for Wayne State University.

Special section – 2016 Eureka Index: Breaking with traditional technologies

Telephones have evolved from tools that just make calls to mobile instruments that entertain, inform and help users complete myriad transactions. Medical products have become smart. “And people no longer buy cars for horsepower but for their electronics,” said James Malackowski, CEO of Ocean Tomo LLC.

For this reason, he said, automakers and suppliers are consolidating their technologies and outnumbering life science companies on this year’s Eureka Index, Crain’s annual look at the top 25 most innovative companies. Crain’s worked with Ocean Tomo, a Chicago-based intellectual property valuation firm, to rank 2015 patent portfolios for companies in Southeast Michigan.

Rankings are based on patent quality, the projected ability to bring the patents to market, and whether patent owners keep their patents or make them public domain. In 2015, there were 4,182 patent awards in Southeast Michigan, which for this report includes Wayne, Oakland, Macomb, Washtenaw, Livingston, St. Clair and Genesee counties, up from 3,957 in 2014. Total patent awards in the U.S. last year dropped slightly to 325,979 from 326,032 in 2014.

Read the full intro story here.

Five patent holders worth noting:

Find the entire special section here.

CoolCalifornia participant logs miles and energy usage in his quest to lower his carbon footprint

Helping his city win the CoolCalifornia Challenge was nice, but David Sawhill of Claremont knows the real prize is acquiring habits that improve our environment.

“It’s not about the number of people participating; it’s about encouraging your neighbors to make a difference, even if it is a small difference,” says the 36-year-old. “My environmental impact is what fuels me every day as I think about the future of my children.”

Seeing the documentary “An Inconvenient Truth” some 12 years ago spurred David and his wife to begin making lifestyle changes, including changing their diets — they are nutritarians — and switching to energy-efficient lightbulbs.

“The first year, my wife and I traded in both of our cars to get one hybrid vehicle,” he says. “We moved closer to work to have less of an impact on the environment.” His wife drives to work. David bikes. But he doesn’t go it alone. He hitches a baby trailer to the back and pedals his 4-year-old son and 6-year-old daughter to school before heading to teach at the local high school.

Now, his passion for living a greener life is rubbing off on his daughter.

Read full story here.

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