Recovery – Yes, We Will Recover

The one certainty in this uncertain business environment is that there will be a recovery and this recovery will afford great opportunities for those who plan and execute skillful solutions. Barring the discovery of a cure, business operations will begin to heat up in the 3rd quarter of this year and eventually result in most furloughed employees being re-hired by the end of the year.

For our industry, health insurance consulting, the recovery will provide a unique chance to re-introduce yourselves to old prospects and former clients. What you say to them will determine how well you rebuild and how well you help them rebuild.

Make no mistake, we will need to change our message and modify our products to fit the new reality brought about by this pandemic. Below are some of my thoughts and predictions, I would love to hear yours:

New or Modified Benefits & Coverages

Testing – Employer-sponsored health plans will need to make testing easy and free to every employer. These tests could very likely be mandatory for any consumer industry (food, hospitality, assisted living, retail, and home health care) There must be a mechanism in each health plan to provide access to testing, possibly as a condition of employment. Cost to the employer will be built into the plan and prescriptions made though virtual doctors’ orders (telemedicine)

Enhanced Telemedicine – Plans must include free unlimited access to a doctor via telephone or computer 24 hours per day 7 days per week. This service must include (in addition to access to the doctor) instructions for acquiring test kits for self-testing or physical locations for receiving the test, access to prescription drugs at the lowest cost available and locations of health care providers, or facilities that will accept them without cost of financial considerations.

Mandatory MEC or Preventive Services at No Cost with No Limits

Although this coverage now exists, it will be expanded to include the two benefits described above and will be likely be considered mandatory by the employer. In many cases, the (modified) MEC Plus coverage will be used as a supplement to major medical or eventually even built-in. For most service-sector employers, not currently offering major medical coverage, their MEC Plus plans will need to be re-evaluated and replaced by plans that already have these features included.

Evaluate Plan Performance During the Pandemic

Unfortunately, most low-cost service sector MEC or MEC Plus plan administrators have not performed well during this crisis. We will want to take a very close look at those who did not possess the resources, or the will to work with their clients, either in adjusting premium payment requirements, increasing coverages to include testing and/or treatment or simply did not have sufficient personnel to man their phones. These deficiencies must be dealt with, explained or the plans must be replaced by carriers or administrators who did perform.

Additional MEC Evaluation Comment

Most MEC plans were not implemented with a safety net (reinsurance) with the explanation/justification, one to keep the cost down, but more importantly, told to the employer “You just don’t need it”. Those brokers and those plans are now having major issues as claims calls (request to additional funding) for the testing are now being requested. Those brokers now have to explain why the employer has to pay more than what is expected/forecasted and why they recommended they operate the plan without a safety net. Insurance is for the unexpected risk, not the budget expense, so I am happy to inform you all of the clients I have consulted with have the reinsurance component (no claims calls requesting unbudgeted funding). In the new world “Post COVID-19” you have to plan for these risks as they are going to become more common.

Let us Help

Of course, I will strongly suggest including us (Hammett Consulting) in your plans to reconstruct or reconstitute your client base. We are working daily with our preferred carrier to make these changes a reality, both affordable and viable.

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