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.
