See Demo – The Most Comprehensive ICHRA Consulting Tool for Benefits Brokers


Live Demo Every Monday and Thursday at 11:30 EDT

Provided by N4one HR and Benefits, LLC
http://www.n4onehr.com

We Guarantee You Will Say Wow!

Live Demo Every Monday and Thursday at 11:30 EDT


Register Now

The Individual Coverage HRA is a viable option for employers and their employees in many States across the U.S. This 4th quarter it will be important for brokers to properly advise their clients and let them choose as to whether this is something of interest. We have developed what we believe is the most comprehensive ICHRA Consulting Tool for Benefits brokers on the market. See for yourself by watching the demo and then you can judge. 

Sample Features
Compare Group Costs to Individual in Minutes (All 50 States)
Develop Contribution Models
Affordability Testing
Disruption Analysis
Our Unique ACA Risk/Reward Report
10 Comprehensive Reports
And 5 Other Relevant Variables Most Brokers Aren’t Thinking Of
 

Elevate Your Skills
Become the ICHRA Expert Overnight
Wow Your Clients

If you have questions give Mike a call at 508-446-7142 or send an email to mikemarkland@n4onehr.com
 

Rapidly Grow Your Benefits Business This 4th Quarter – Webinar July 28th – 12 – 12:30 EDT


Register Now

The opportunity to deliver whole new employee benefits solution to market and create rapid growth is here. In this webinar we will introduce a model that is designed to help brokers grow by 20% annually while helping employers reduce health care costs, forever. And this is NOT the short-term type solutions most other brokers are delivering.

This webinar is by invite only as we are looking for just 2 brokers per market to deliver this new model. We think leads will be rolling in. Without giving up too many secrets the agenda is as follows:

• Review of the Changing Market Trends
• Gaps in the Market and Opportunities
• The Broker Blind Spots – What Many are Missing
• How Brokers Can Grow Revenues
• The Marketing and Sales Plan Overview

The time to act is now. Getting the message out in advance of the 4th quarter is an important to generating activity. To participate in this webinar just click on the Register Now button. If you have questions, feel free to give me a call at 508-498-7591.

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Webinar – The Transformation of Employer-based Health Insurance – Jun 30 and Jul 9 12:00 – 12:30 EDT


Register Now June 30 – 12:00 – 12:30 EDT

Register Now July 9 – 12:00 – 12:30 EDT

The U.S. Health Insurance and Health Care Systems are broken. Costs continues to rise and the number of uninsured or under-insured continues to grow. The technology, resources, and opportunity exist today to improve health care and reduce costs; however, it requires a change in thinking.

This webinar may change your approach to employer-based health insurance forever. We will provide the data; introduce the technology; identify today’s obstacles; and provide a step by step approach on how any employer can begin the process to a much brighter health insurance and health care future.

The Agenda is as follows:

Quick Market Review
Health Care Financing vs Health Care
New Technology and Resources
Obstacle to Change
Reducing Costs
The Path to Health Care Freedom and Better Health Care

This presentation is intended to get you thinking. It is time to break the mold and launch your business into a new and brighter future. To attend this webinar, just click on the Register Now Button. If you have any questions feel free to give us a call at 508-498-7591.

Webinar Replay – Grow Your Benefits Business 20%


Between changing tax laws, the Coronavirus, a growing budget deficit, and escalating health care costs, I believe employer health insurance is about to change, and maybe faster than many think . I presented a webinar last fall that applies more today than it did then. It is a plan for brokers to grow their business in these uncertain times. Take a look and start the process today.

Click Here to See the Recording

Webinar – Why the Coronavirus Could End Employer-based Health Insurance


June 2nd – 12:00 – 12:45 EDT

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Employer-based health-insurance participation has been going down for the past 20 years and with this pandemic, those numbers are going down even more at a rapid rate. The Coronavirus pandemic has exposed major flaws in our current system that need to be addressed. In this webinar we will discuss why employer-based health insurance could and maybe should come to an end and present a solution that can drive costs down while improving health care delivery. The good thing is employers can start this transition to a new system right now.

The Agenda for the Webinar is as follows:

  • The Current Problems with Employed-based Insurance
  • The Number One Cause for Skyrocketing Health Insurance Costs
  • How the Coronavirus has exposed the problems
  • A Post-Coronavirus Solution
  • The Bright Future for Health Insurance and Health Care

To register for the webinar just click on the Register Now Button. If you have any questions, feel free to give us a call at 508-498-7591.

How MA Can Lead the Way to Better Healthcare and Lower Costs


For those interested check out my latest webinar. It has been recorded. The link to see it is here.

Click HERE to VIEW

 

Webinar Invite – The ICHRA Webinar That Gets into the Weeds – April 15 from 12-1


Everything a Broker Needs to Know

And Many Things You Didn’t 

April 15th 12:00 – 1:00 EDT

Register Now

You have probably gotten invited to many ICHRA Webinars. This webinar will be different. We get into the weeds. We identify the gotcha’s. We bring ideas that most have never thought of. We will identify sales tips that can make a difference.

In this webinar we will cover the following:

– Review the Consulting Process
– Steps to Execute an ICHRA
 – 5 Gotcha’s that Cause Problems
– Review of the Vendors
– The Future – What to Expect This Coming 4th Quarter
– Demonstration of Our Proprietary Consulting and Modeling Tool

  • Comparing Group to Individual Costs
  • Affordability Calculation
  • Contribution Modeling
  • Disruption Analysis
  • Bottom-Up Consulting Model (An N4one HR Creation)

Don’t ignore the ICHRA. This will be bigger than most think. We get into the weeds identifying things few have considered. To register just click on the Register Now Button. If you have questions give us a call at 508-498-7591.

Webinar Invite – Employers Have Alternative Health Insurance Savings Options During Coronavirus


Webinar Invite

Employers Have Alternative Health Insurance Savings Options During Coronavirus

Save Employee Dollars

We realize these are tough times. As employers and employees navigate this “new world”, maintaining one’s financial viability, which includes health insurance, is an issue to deal with. We would like to invite you to a webinar that can ease this burden by taking advantage of new health insurance tax laws that you may not have heard about. It is an opportunity to possibly save your employees substantial dollars.

April 21

12:00 – 12:30 EDT

Register Now

Agenda
• Review of the Tax Laws and Opportunity
• Examples of Saving Employees $4000+ Annually
• Why During the Coronavirus Should You Consider This
• An Alternative way to think of Employee Health Insurance
• Employee Cost Modeling to Save Money
• Communicating a New Program to Employees

It is time to think outside the box and this webinar is outside the box thinking. Our mission is to help employees who may be struggling financially. We think this new approach to employer-based health insurance can deliver on that mission. To attend click on the Register Now button. If you have questions, please feel free to reach out to us at 508-498-7591.

An Alternative to National Health Care


During the worldwide crisis from the Coronavirus many countries are recognizing problems with their current healthcare systems and the U.S. is no exception. In the U.S. this has prompted new calls for a national health care system. I read an article titled, “There’s Never Been a Better Time for Us to End Private Health Insurance Than Right Now” by Tim Higginbotham from the Jacobin. Tim made a compelling argument that those on the left will support. Others will reject the arguments and claim “Don’t take away my healthcare”. The narrative in the media is an ongoing debate between two options, keep what we have, or move to a national health insurance program. I think there is a middle of the road solution that I would like to propose.

I agree with Tim that change is inevitable because the Coronavirus has exposed some major problems in our current system, though my solution does not go as far as Tim does. In his article he said the following:

“But the pandemic has already disrupted the status quo. We no longer face a choice between keeping things as they were and implementing a major change. Change is coming, no matter what, and it’s our choice whether we respond to it by using public funds to prop up a broken system that constantly kills and bankrupts Americans in the name of profit, or by using those same funds to create a stable, single-payer program designed in the interest of public health.”

I agree that the status quo has been disrupted. The problems with our current system are exposed and the system is broken. It is bankrupting America and what will follow this pandemic will be a system looking to recoup the losses being incurred right now.

Let me start with a basic premise as a U.S. citizen. I think we would all agree that we want every citizen to have access to healthcare. We don’t want people suffering and dying in the streets. On the other side, we also don’t want endless healthcare consumption with no consideration of costs or quality. With healthcare costs skyrocketing something needs to be done. Inaction is no longer an option.

The United States has the highest healthcare costs in the world and there is one thing we do that no other country does. In those markets where there is private health insurance, we are the only country where someone other than an individual chooses the insurance for the individual. In a recent conversation I had with an ex-member of the Trump administration that worked on the recent changes in the health insurance laws that brought the Individual Coverage HRA to market, we agreed that “employer-based insurance” is inflationary. It must change too.

Number 1 Problem: Fee for Service Healthcare

Before getting into the details there is one component to our healthcare financing system that simply doesn’t work. Fee for Service healthcare is probably the number one problem with our current system. Fee for Service incents the system to perform more care. My doctor makes more money when I am sick, and my insurance company makes more money when I am healthy. I want my doctor to make more money to keep me healthy. It also incents employers to hire younger and healthier people. Fee for service healthcare is the impediment to fixing most of the issues in our healthcare system as I will point out throughout this article.

The Coronavirus outbreak has exposed some of the issues related to our current system. The first question I pose is:

What should our healthcare capacity be?

I see our healthcare system much like the fire department. We need to maintain a certain capacity of trained people, equipment, facilities, and drugs, regardless if there is a fire. Usage of our healthcare system increases in the winter and goes down in the summer. Are we supposed to lay-off doctors and nurses in the summer? What would the costs be to put out a fire if it were fee for service? Everyone would complain. The thing is, we need to pay these people when there is no fire.

The Coronavirus has made the shortage of facemasks, ventilators, testing equipment, and hand sanitizers part of our daily news. How many ventilators should we have had in storage? Who should have paid for them to be there? Is there some other equipment we need to start buying and storing now for some other type of virus that could hit next year? I hear everyone complaining now while over the past 5 years the same people were complaining about spending too much.

These are all tough questions that need to be asked and answered. What I do know is that paying for a certain healthcare capacity is inconsistent with a fee for service model. We all need to be regularly supporting our healthcare system. We can’t have money going through the system that doesn’t build and maintain capacity or provide care. In the U.S., only 4% of Medicare funds go to administration. In the Private Health Insurance market, it ranges from 12% to 20%. This money is simply lost. It pays people incomes who are working for insurance companies and other administrators, but it does not contribute in any meaningful way to providing healthcare or build and maintain our capacity.

Over the past several years I have been reading regular entries in LinkedIn by people attacking the Hospital systems including their costs and inconsistent billing practices. Price transparency has been in the headlines for months. I would contend that it is our healthcare financing system that causes this broken billing system. Between hundreds of different payors, different funding mechanisms, cost shifting from government programs, and having to take care of the uninsured, it is no wonder. Everyone wants better care, but everyone is also looking for some way to pay less. However, over the past several years the healthcare financers have declared war on the hospital system beating up the costs and reducing our hospital bed capacity in the U.S.

Use of Technology

Another thing exposed during this crisis is the use of technology. Telehealth has moved to the forefront as we all practice social distancing. Prior to the current conditions, most telehealth services were purchased through an employer. The problem with that is the doctor on the other end of the line would be someone other than my primary care doctor. And the consumer would have to download the telehealth app that the employer provided.

Now imagine I am a primary care doctor with 1500 patients coming from a wide range of employers. If I were to participate in telehealth would I have to accommodate all these different apps? Is the Primary Care doctor even involved? As a consumer, when do I go to a CVS clinic, versus my primary care doctor, versus telehealth? And if I receive some type of care from all 3 how does my data get consolidated?

Fragmented Market and Disconnected Care

Use of technology can be a valuable resource in healthcare and can save lives. Artificial Intelligence can be used to identify health conditions before they become too serious. The problem is, artificial Intelligence requires access to one’s data. At this time, my insurance changes for two reasons out of my control. It changes when I change jobs and it changes when my employer chooses to change it. As a result, there are times I had to change doctors and other medical facilities simply to have coverage. Who knows where my data is? I imagine it is scattered all over, giving me little value. And my new employer may have a different telehealth company with a different app and different providers.

There are other problems with the current system as Tim Higginbotham points out.
“The major flaw in tethering healthcare to employment has never been clearer: workers are constantly at risk of losing their employer-sponsored insurance.”
With the Coronavirus employers are laying off people creating the administrative burden of converting employees to COBRA, if they can afford health insurance at all. Employers, on average(at least in Massachusetts) provide health insurance plans that are 33.7% more expensive than what employees purchase when making an individual purchase. Massachusetts happens to do it right and have a viable individual insurance market. Employees going on COBRA would benefit from having an option to choose lower cost plans as finances get tight. Our current system does not allow that. And worse yet, if an employee chooses COBRA the premiums must be paid on a post-tax basis. This is simply wrong. All insurance should be on a pre-tax basis of our government wants us to buy it. It is a societal obligation.

Bernie Sanders and Elizabeth Warren have pushed national healthcare for years. However, when answering the question of “how are you going to pay for it?” I never hear them give what I would say the right answer is. Well here is what my answer would be.

“We are already paying for it through many means. When you add up the government expenditures from existing government programs, payments from employers and employees, costs absorbed by hospitals to treat patients with no insurance, free services from non-profits, and administrative costs incurred by hospitals and other providers, you would get a number that in the end is larger than a national health insurance program. So yes, people will have to pay more in taxes. However, they will pay less in employee contributions and have higher wages because employers would not have to pay for insurance. In the end, we can reduce costs through efficiencies, adopting technologies, and creating incentives for healthcare systems and consumers to practice better health. Rewarding the healthcare system for keeping people healthy will align the incentives of most consumers who want to live a happier and healthier life.”

I am not a proponent of national health care. I believe that when the incentives are aligned with what we want our outcomes to be you have the best solution. The current system rewards the health care system that provides more health care. Insurance companies are rewarded when they provide less. This is backwards. Government programs simply don’t reward excellence anywhere in the system. I know that may be too broad of a statement but in most government systems that is the case.

The Solution

I will start by saying fee for service needs to end and there needs to be a move towards full capitation. Kaiser is the model of the future. (Capitation is where the insured pays into the healthcare system a fixed monthly fee rather than to an insurance company who then disperses funds to healthcare providers on a fee for service basis or in some limited capitation basis.) This is no different than the way we fund the fire department. Fee for service also cannot coexist with capitation as the young and healthy would gravitate towards fee for service programs which essentially leaves them not supporting the system. In California and other markets, Kaiser competes with other fee for service insurance plans which leaves problems to contend with. The best solution puts everyone into the same type of risk pool.

The solution I propose is a private health insurance system where consumers buy their own insurance policy. This is similar to Switzerland though we can do it better. Employers may provide funds for employees, and for those in need, there can be a government subsidy. The key component is the consistency of having the individual own their own policy so they can keep it wherever they go. This is also similar to what the Goodman Institute proposed. I suggest looking at the Goodman Institute website at www.goodmaninsitute.org.

The move to an individual market should help local healthcare systems. Employers often choose PPO type programs from national companies to accommodate an employee population that may be in different locations. Individuals will be able to choose local healthcare plans. This shift will enable local systems to get into the risk business and begin benefitting from keeping people healthy and leveraging technology for efficiencies. Aetna is partnering with local systems to create these types of programs. If employees buy their health insurance from the same company that provides the healthcare then that system can use dollars to invest in technology, wellness, and proper capacity.

Other things we need to do:

• Decide and establish what is needed healthcare capacity locally and nationally.
• Set goal of administrative expense at no more than 5%. It is possible.
• Develop 5-10 standard insurance programs. The country only needs 10. By doing this, systems can be pre-programmed to accommodate these 10, significantly reducing administrative costs.
• Make individually purchased health insurance tax deductible with a more progressive program. Full deduction for lower paid employees and less for higher income earners.
• Allow all employees to use employer funds as they choose versus having the employer chose insurance for them. Today, the employer is choosing whether they will allow employees to buy their own.
• Eliminate employer-based insurance. The employer tax advantage is a main reason for health care inflation. (This is another article.)
• Develop standards for managing health data and leverage blockchain technology for data control and security. It is time individuals start controlling all their own data and have this data used to maybe save their lives. (This is also another article.)
• Develop standards for telehealth enabling consumers to use the devices they have in a more secure way with the healthcare provider of their choice. Apple or Android can have secure “Facetime” rather than download a new app.

The move away from the current paternalistic health insurance system is inevitable. The Coronavirus pandemic has exposed the problems in the system and will be one of the catalysts to change. I believe the only way to save the private healthcare system is to move away from defending the current employer-based system and propose and defend a new system that solves many of the existing problems. Let the debate be between single-payor and something more reasonable. Digging in to protect the status quo will only open the door to a government run program. I believe the solution is in the middle.

The Status Quo is “The Other Guy”


What is the status quo? In the benefits business, there are many who like to label the “other guy” as protecting the status quo. Yet, after I learn about what the person making the proclamation about his/her competitor is really doing, I conclude that they are protecting the status quo too. I know there is a desire to be different in business. Many books have been written about needing to be different. However, one is not different through a simple proclamation.

I hear new ideas every day. In the health insurance and health care businesses some of these proclaimed “new ideas” are really repackaged “old ideas”. Private Exchanges promoted as new in 2014 were recreations of cafeteria plans sold in 1986. Level-funded plans are similar to minimum premium plans sold in the early 90’s. GAP type plans were being administered in the late 80’s. On many occasions, these were promoted as new and if you didn’t sell these products, you were protecting the status quo.

Now we have an army of benefits advisors promoting things like direct provider contracting, direct primary care, referenced-based pricing, as the new savior of the health insurance system. Yet, according to one-person I quote and trust, Mark Bertolini, ex-CEO of Aetna, “direct contracting will be a failed model”. Those promoting these programs are claiming that those that don’t promote them are “protecting the status quo” while a respected insurance executive says they won’t work. Who is one to believe?

I am taking a different perspective. What if protecting employer-based insurance in general is protecting the status quo? There are brokers running around saying “Mr./Ms. Employer, you are in the health insurance business, get over it and take control”. Put in all these programs to micro-manage your claims. Well I am pretty sure employers don’t want to be in the health insurance business and be in the claim’s management business. (Though they don’t mind giving the employee some money.) If given the option to get out they would.

I am also pretty sure most employees would like more health insurance options versus having the limited options provided by employers. I know I would want more options. Yet I see no lobbying to get the employer out of the middle of health insurance, other than from the likes of Mark Bertolini and President Trump. So, if virtually everyone wants the employer out of the middle, then I would conclude that protecting employer-based insurance is protecting the status quo?

President Trump, through Executive Order, made the biggest change to our health insurance system in the last 60 years. However, rather than embrace it and deliver what most employers and employees want, the industry is somewhat ignoring it. I have some news though; this is not going away. The train has left the station. Employers and employees will eventually get what they want, and when they get it, they won’t go back.

So as one wanders through this health insurance maze, pause before you label “the other guy” as the one who is protecting the status quo. In some eyes, the one protecting the status quo may be the one in the mirror.