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Getting more from your health insurer than just a bigger bill

Jim Giuliano
by Jim Giuliano
July 16, 2010
2 minute read
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New research shows there are extras you can get from your health insurer. You just have to know what to ask for.
The research comes in the form of a study, What Employers Want from Health Insurers in 2010, by the Health Research Institute of PricewaterhouseCoopers. It tracks the worst areas of dissatisfaction with insurers and what companies are demanding — and getting — from their insurers.
The key for you, in your next negotiation with your carrier, is knowing what the insurance companies are hearing from other customers so that you also know what’s reasonable and common and what’s unlikely. And then you can gauge your requests and negotiations accordingly.
Here’s what employers are typically going after, according the study of companies ranging from large (up to 11,000 workers) to tiny, including some consisting of no more than several employees:
A partnership with insurers to improve the health of the workforce. Rather than insurers’ just telling employers, “Improve your workforce’s health and we’ll limit your costs,” employers are demanding plans and assistance with health improvement — or in the vernacular of the day, “wellness.” Check with your carrier to see what programs are available or are in development.
More data in general about health and common health problems. Insurance companies have mountains of data about typical types of claims, high-risks and other situations that employers can use to benchmark against their own situation. Within the bounds of privacy, insurers can provide some of that data to you to help you benchmark your own successes and workforce tendencies. You can start by asking your insurer, “What data do you have that might help us with our wellness program or figuring out whether our claims are high, low or in the middle?”
Info about what works and what doesn’t. For instance: Is it better to reward employees for completing health risk assessments? Or is it better to reward healthy behaviors. Insurance carriers have reams of statistics on effective management of employee health — and health costs.
The study also produced a lot of statistics about employer satisfaction — or dissatisfaction — with their carriers. You can measure your own complaints against those that popped up more often in the study.
Larger companies tended to complain more about lack of health-risk profiles, not enough access to relevant records, and slow advancements in technology tools, such as debit-card interfaces.
Smaller companies griped most often about lack of health-risk profiles, not enough discounts, no disease-management programs and not enough online tools.

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