DHill Financial

Trusted Insurance Adviser since 1990

Category: Insurance Partner

4 Benefits Blunders by 1 National Payroll Co.

4 Benefit Blunders by 1 National Payroll CoMost business owners started their businesses to address market needs, serve the community, possibly to create generational wealth.  I haven’t met one business owner yet who told me they started the business because they like compliance and administration.

It’s more common that they might view these areas as a barrier to entry, or at least to company growth.  Companies know that in order to grow, they’re going to need good people which only amplifies the administrative responsibilities of the business.

So, it’s no wonder that when companies start adding people, that they look for efficiencies and expanded sophistication in payroll and benefits.  Having a strong payroll system to support process and compliance is critical as a company grows, and payroll companies have deep expertise in this area.

A dedicated and visible health insurance broker can enhance the employee value proposition by making sure the employees feel connected to their benefits.  On site meetings, one to one consultations, and visibility during open enrollment help employees to feel valued.

While marketing experts stress specialization, there has been a move for payroll companies to offer insurance benefits as an additional service.  Here are four blunders I’ve witnessed from one national payroll vendor from the least egregious to just unacceptable.

  1. Mismatched Benefit Plans – the benefit plans should match the financial needs and culture goals of the company, the type of employee they are targeting, and the experience they want to provide the employee. If you want a Platinum health insurance plan, make sure you pay 100% of the premium for the employee and rich vision and dental benefits.  The vision and dental does not add much cost, but keeps the program consistent in terms of quality.  Gold and Silver plans also have a place for employees responsible for dependent costs.
  2. COBRA / Continuation of Benefit – Departed employees who wish to continue coverage pay the premium to the employer, and the employer submits the premium to the insurance carrier. When using a payroll company, the premium may get paid to the payroll company.  In one case, a terminated employee found a new job with benefits, the payroll company didn’t collect premium from the employee once new coverage was secured but continued to bill and pay the premium on behalf of the employer.  When the employer submits premium directly to the insurance carrier, they can see if the money has been collected.
  3. Failure to Terminate Coverage – Not terminating employees in a timely fashion can create administrative and compliance problems and the responsibility remains with the employer. Having direct access to an online system either at the insurance carrier level, or preferably through a Third Party Administrator who handles insurance benefit administration, ensures there is a process in place with checks and balances.
  4. Letting Coverage Lapse – If the employer is not sending in the premium payments, how do they know if coverage goes unpaid? While it seems unlikely that this would occur, this happened with a new client as of January 1 who found that one of the plans had lapsed for non-payment some time the previous year.

In fact, all four of these issues came up with the same client last year, a key reason they needed to make a change.  So why change to an insurance broker for benefits management instead of a payroll company?

This business owner wanted a vendor partner who is attentive to their business, cares about their people, understands their value proposition, and find ways to work towards that mission.  If you don’t feel like your benefits broker understands your mission, consider making a change and see how powerful it could be if they did.

David Hillelsohn founded DHill Financial, LLC with the mission of enhancing the cohesion among families and businesses by prioritizing meeting obligations and taking steps to ensure people know you care.  His vision is for people to want to do for others thereby doing for themselves.  David is an independent agent licensed in the majority states around the country, and he can be reached at 703.435.6028 or by email at david@dhillfinancial.com.

4 Reasons PEOs are Killing Health Insurance

DHill Financial, PEO, Health Insurance, Local Broker

Anthem Blue Cross Blue Shield  announced their departure from the individual health insurance marketplace in most major county areas in Virginia at the start of 2018.  Concern is growing about the state of the health insurance marketplace, and what the changes mean for affordable healthcare to consumers across the nation.

Increasing health insurance premiums and rising plan co-pays are just part of the issue. More and more people will find local and regional insurance agents reluctant to provide needed guidance and service to families looking for individual health insurance.

Anthem has maintained their plan to stay in the small group employer marketplace.  However, Anthem and other regional insurance providers face competitive pressures from a new type of buying consortium, some of which provide small employers access to carriers and benefits historically restricted to larger employers (500 employees and above).

These consortium’s, called Professional Employer Organizations (PEOs) are often payroll service companies who have developed ways to provide additional services to the small employer clients.  Through the PEO platform, small employers (down to just a few employees) can also access HR consulting and business consulting, providing non regulated services and in core areas of need for small business owners.

The insurance products offered through a PEO range from workers compensation to more complex commercial needs, health insurance, 401(k), and other core employee benefits.  These products, however, require additional licensing by the provider instances of companies selling health insurance to clients without the proper licensing have already been reported.  This has resulted in failure to meet compliance standards as part of their service offering.

However, there are PEO firms in the marketplace like BBSI, who partner with licensed local health insurance brokers as a way to leverage not only their relationships, but also their understanding of the local healthcare marketplace.  Thus they can provide a more tailored, compliant, and effective solution to better meet the specific needs of individual small businesses.

Here are 4 reasons I believe that some PEOs are not helpful for the survival of the health insurance industry.

  1. Larger employers are more similar to one another than small employers – when buying insurance on a group basis, one of the first items the insurance company will request is the SIC code or Standard Industrial Classification. This is requested because the insurance companies can predict with reasonable certainty how different industries will perform from a risk and experience standpoint.  That predictability is lost with the blended group, and thus businesses in certain industries with better claims experience are going to be financially supporting other industries with higher claims rates.
  2. Smaller employers need dedicated attention – looking at the federal health insurance exchange, there is a reason that experienced insurance agents are still needed to assist participants with enrolling in the plans.  A licensed agent who knows the local networks and trends in the marketplace, along with legal requirements, can properly match the types of plans available to the specific needs of the employer. In a competitive staffing marketplace, health insurance and employee benefits need to be tailored to the employer’s goal for offering the benefit.  The right benefits package can enhance the culture they want to nurture within their organization.
  3. Owners/Employers value local relationships – when is the last time the health representative from your PEO sent you a client referral, or found innovative ways to remind you that your business is a priority? Employers often depend on a local network to help build their business.  Once established, the business has the opportunity to invest in the relationships knowing there is a long-term value in the trust and knowledge built over time.  Health insurance brokers offer the same value to clients, providing an opportunity for business owners to build a long-term relationship with someone who keeps tabs on what is going on in their business. Better yet, the best insurance brokers look for ways to help grow their business on a local level, and offer a single point of contact if issues arise reducing the overall cost of business.
  4. The PEO model is a poor business match for long term success – business owners want to build a practice that is stable and predictable with little employee turnover thereby reducing costs over time. Many of the national payroll/PEO firms offering health insurance hire talent just out of college with little industry experience, and no track record of problem resolution – a key need for small employers who will encounter turbulence in their business. Further, the structure does not lend itself to long-term relationships  if the sales representative on whom the employer decided to make the initial purchase (of services) moves on to the next opportunity.

As a business owner, you want your business to be recognized as the gold standard.  If you don’t feel like you’re number one with your health insurance broker, or PEO, perhaps it is time to evaluate other options that can provide better, more tailored services to you and your employees.

David Hillelsohn is an insurance broker who prioritizes building long term relationships with clients that is built upon trust, knowledge, and compassion.  David is the president of DHill Financial, LLC which specializes in health insurance and life insurance and he can be reached at 703/435-6028 or david@dhillfinancial.com. Contact David with questions.

© 2018 DHill Financial

Theme by Anders NorenUp ↑