Our Key Challenge And Opportunity Of 2021: Affordable, Accessible Group Healthcare
Although 2020 presented nearly unfathomable challenges, the employee benefits brokerage community responded with agility and grace. As a result of such resiliency and professionalism, we at Pan-American Benefits Solutions begin 2021 with strength and positivity. From this vantage point, we’re tackling one of the industry’s most pressing pain points: The continued lack of uniform access to affordable healthcare in the U.S.
Last year, dual national fixations—the pandemic and the presidential election—precluded any possibility of meaningful healthcare reform. According to KFF’s most recent figures, 29 million Americans remain uninsured. While it’s true that the majority of workers are offered health benefits by their employers, 22 percent decline it—primarily because the cost is too high.
This impacts all of us, not just as health insurance professionals, but as friends, neighbors, and Americans. I believe that—just as it’s the responsibility as broker consultants to offer their corporate clients informed guidance regarding their health plans—it’s the responsibility of health insurance industry leaders to offer solutions to this ongoing national problem.
You may be surprised to learn that my company, Pan-American Benefits Solutions, was created for this express purpose. A subsidiary of Pan-American Life Insurance Group, a 109-year-old, A-rated global carrier, our mission is to develop and provide innovative group benefit programs that ease the pressures of rising health insurance costs.
Our overarching goal is to respond to the evolving needs of underserved populations targeted through our brokers. To this end, we’re developing strategic partnerships that allow us to explore new possibilities. We’re accelerating our digital capabilities. And we’re prioritizing the creation and distribution of products that allow employers to offer their employees—especially their low-wage workers—quality health plans they can truly afford.
An Affordable Alternative: Limited Medical/DPC Plans
In an ideal world, every employer would be able to offer broad major medical plans—and every employee would be able to buy one. However, between high premiums and high deductibles, it’s simply not feasible, particularly for employers with a largely hourly-paid workforce.
Prior to the Affordable Care Act, old-school “mini-med” plans—those with low annual and/or lifetime benefit maximums—were popular alternatives. However, these are no longer an option under the ACA.
What’s the alternative? At Pan-American Benefits Solutions we’ve witnessed strong acceptance of our combined Limited Medical/Direct Primary Care (DPC) plan in the hourly workforce sector. For one thing, there are no copays or deductibles—and premiums start as low as a $100 per worker per month.
How is this possible? As a result of our partnership with Healthcare 2U—a fast-growing direct primary care organization—workers gain access to a national network of more than 500,000 PCPs. As members, they enjoy same-day/next-day doctor appointments for $10 per visit, urgent care appointments for $25 per visit, and 24/7 telehealth visits for no out-of-pocket cost.
And when they need additional healthcare, our limited benefit plan, PANAMED, kicks in. PANAMED provides fixed indemnities for specialists’ visits, diagnostic tests, hospitalizations, ER visits, surgery, and more. In addition, preventive screenings, exams, and immunizations are covered at no cost, promoting employee wellness.
We’re finding that such plans satisfy the typical medical needs of most of the population. DPC provides concierge-type access—imagine, for low-wage workers!—while the continuum of medical services reduces the physical and financial impact of chronic diseases both through preventive services and structured managed care.
In addition, because they can be written under Section 125 plans, they offer tax advantages to both employers and employees.
End result: Individuals and families can meet their everyday healthcare needs while staying within their budget. The result can be transformational. Our partner Healthcare2U, an early entrant into this space, has received heartfelt testimonials from many low-wage earners whose families’ lives and futures changed dramatically for the better when they gained access to healthcare.
The Expansion of Telehealth Services
As a result of the pandemic, utilization of telehealth services increased dramatically in 2020. However, while individual doctors’ adoption of tele visits is a step forward for homebound patients, it should not be confused with robust, fully-developed telehealth programs. They are two different things.
The reality is, 25 percent of Americans don’t have primary care physicians. That’s an issue only true telehealth programs address. For this reason, we partnered with HealthiestYou by Teledoc Health, the global leader in virtual health, to offer telehealth services.
Through HealthiestYou, we give covered workers the ability to talk to a physician 24/7—by phone or video—receive a diagnosis, and often have a pharmacy prescription filled in moments without missing worktime.
Workers can download the HeathiestYou app, create an account, complete their medical history, and talk to a doctor whenever they need to—a breakthrough in healthcare for those lacking a primary physician relationship. Thanks to volume pricing, the program can provide unlimited zero-cost physician consultations for a minimal additional monthly premium.
For this reason, we are now encouraging all of our Limited Medical and Stop Loss plan sponsors to include telehealth with their plans—a suggestion that has been warmly received by employers and their employees.
Here’s to a Healthy, Prosperous New Year
While the political debate surrounding healthcare will undoubtedly continue, talk alone won’t help employers solve their chronic healthcare challenges. However, in the meantime, the employee brokerage community can.
Creative, innovative brokers—those who are open to embracing new products and markets—can make an immediate difference while strengthening their client relationships and growing their book of business.
The fact is, simply quoting a different price for the same old traditional major medical plan won’t really help your client—or differentiate you. And you can only sweeten the service value proposition so far before its objective value is no longer competitive.
However, we’re finding that when brokers are willing to introduce their clients to affordable, innovative alternatives—like direct primary care plans and telehealth services—they enjoy higher close rates and better client retention. These are real solutions, they work, and they are available now.
Why not start the new year by offering your clients something new—something that not only benefits your bottom line but can truly benefit your clients and their people, too?
Here’s to a healthy, creative, prosperous 2021! [CM]