BEWARE OF “EXTRA” BENEFITS: SHORT-TERM GAINS MAY NOT PROVIDE LONG-TERM STABILITY
BY JILL SELBY
If there’s one thing Medicare beneficiaries in California have, it’s choice. As of 2022, there are 458 Medicare Advantage plans in the state. That’s a lot of plans competing for your clients, many of them offering very enticing benefits. However, as attractive as some of these benefits may be — think rebates and flex cards — they aren’t all that you and your clients should be considering when making a plan choice, like provider networks or formulary coverage. So, what more should you take into account when guiding your client to make a health plan decision?
In the thirty years I’ve been in this business, I’ve talked to thousands of brokers around the country. My advice is the same regardless of where you’re located: Be an informed guide. Take a comprehensive look at the needs of your clients and the plans that you represent. Helping each client find the right plan for them is not only the right thing to do for your client, it’s also beneficial for your book of business in the long run.
Matching clients to the right plan benefits
Every one of your clients is different with different needs. This year you are going to see plans with a wide range of extra benefits — low hanging fruit, as I like to call them. Sometimes it’s easy to look at a plan and see the most enticing offerings and use those as easy selling points to close your clients.
Who wouldn’t want home-delivered meals or an over the counter (OTC) benefit? But beware: Some benefits may not be applicable to all clients. And clients who were swayed by those benefits won’t be happy should they find out they’re not only ineligible for those marquee benefits but are locked into their plan for the year.
That’s why it’s essential to understand the needs of each of your clients and think holistically. Look for plans that have the right benefits for their current needs and that can support them as their needs change. If a particular benefit is important to a client, verify that they’re either eligible now or will easily qualify when the time comes. Not everyone needs a personal emergency response system now, for example, but it’s nice to know that it will be covered by their plan should they need it.
Helping each client find the right plan for them is not only the right thing to do for your client, it’s also beneficial for your book of business in the long run.
Service is a competitive benefit
Great-sounding benefits are sometimes just that. But don’t underestimate the value of a truly committed member service organization.
As you’ve probably discovered, some health plans provide benefits that will ultimately require the member to jump through hoops. For example, after signing onto a new plan with a great drug benefit, your client discovers that the drug they’ve been on for years is not on the formulary — and it’s up to them to find out what alternative drug is covered and how to request an exception if needed. Who will they call for help? You’ve likely fielded many of these types of calls yourself.
Or maybe your client is not a native English speaker. Are you recommending a plan that can assist your client in their preferred language? Or again, will your client be calling on you when they’re having trouble getting the help they need, in a way they can understand?
These are the kinds of issues that can take your time and attention after a sale. If you steer clients to health plan organizations that are committed to helping your clients over any hurdle they may be facing, it removes the burden from you. As it should. These are the plans that build loyalty. And, ultimately, the clients that are happy with their plans will be sending their friends and family to the person who signed them up: you.
Look for plan partners for the long run
Selling a plan that provides short-term gains may not provide the long-term stability you’re striving for with your book of business. What may be the easiest sale today can mean having to resell a client next year and the year after. Or worse, the client seeking help elsewhere.
Look at it this way: Health plans that have the best member retention and satisfaction rating are the ones that are looking out for you, too.
They’re the plans that understand you’re seeking to grow your business. And, they help by making it easy for you to retain the clients you already have and to keep them on the same plan year over year. Look for plan partners that
• pay you on time;
• have good sales tools
• live, personalized support when needed.
These factors are critical to supporting your needs so that you can focus more of your efforts on new clients, continuing to build your business on a stable foundation.
Yes, benefits are key when it comes to healthcare coverage. But it’s important to identify which benefits make for an easy sale versus those which truly add value to your clients. And don’t forget to add member service to that list of considerations. That’s the best way to match a client with a health plan for the long run. Client retention leads to client referrals — and that leads to success now and in the future.
JILL SELBY is SVP of Product Development, Marketing and Market Expansion, SCAN Health Plan. In her role, she is responsible for market expansion, geographic growth opportunities, and innovative development and implementation of SCAN’s core health products, including its Medicare Advantage HMO plans. She also oversees all federal and state regulatory compliance interpretation, and merger & acquisition due diligence.