Why leveling up member experience is a broker's 'new' job

For decades, traditional brokerage firms have been stuck in a familiar paradigm: They spend virtually all their time designing benefits plans for HR teams but devote little time to helping employees actually use their benefits. The results are telling. Only half of employees reportedly understand their benefits. And 71% of HR teams say their employees underutilize their benefits and see this as a critical problem to solve. 

This status quo is clearly broken, but a new paradigm is coming. We expect a modern class of brokerages will emerge that take ownership of the member experience by empowering employees (and their families!) to understand what benefits they have, how to effectively use them, and then support them year-round when they get stuck. It is even more imperative considering health plan costs are growing at nearly 10% a year. It's up to us to deliver a return on that investment.

But first, let's talk about how things work today.

The experience of navigating benefits for the average employee today is generally terrible. Employees have to rely on a patchwork of 40-plus page benefits-guide PDFs buried in email, getting stuck on hold with an insurance carrier customer support line and finally pinging HR in desperation after weeks of struggle. This archaic model assumes that all employees have at least some benefits knowledge when, in reality, they often have very little.

Read more: The smart ways CHROs are using healthcare navigation

HR teams care deeply and do their best to field questions as they come in from employees. These questions range from the mundane such as, "what's my dental insurance?" or "I lost my ID card, now what?" to complex and consequential ones such as, "why is my carrier blocking a surgery I need?" and "I got a large medical bill I can't afford that feels incorrect, so what should I do?"

But because many HR pros don't have deep technical expertise in benefits or healthcare navigation, they often turn to Google for answers; or more likely, forward the question to their benefits broker, kicking off an interminable game of telephone tag between employee, HR and broker. This is a massive time suck for already burned out HR teams and it's a frustrating hurry-up-and-wait experience for employees who often give up before they solve the problem. This convoluted process is needlessly slow and generally terrible for everyone involved. 

As the experts who designed the plans, benefits brokers understand the nuances of our clients' health plans and how they interact with the healthcare system. We also have unique influence with insurance carriers and other benefits vendors because they rely on us to place the business with employers. While carriers might be slow to respond to employees or even HR, they won't ignore us. 

Read more: How employers can help employees find and access healthcare 

This is why we believe that benefits brokers are the stakeholder best positioned to take ownership of the critical job of supporting members on their benefits journey, and in doing so give HR teams' back time and peace of mind.

What does great member experience look like? We believe the modern brokerage will invest in capabilities that empower their advisers and service teams to deliver a great member experience for all clients. Before we get into the how, let's discuss the what. There are three elements to what we'd consider a great member experience: 

1. Precision enrollment decision guidance
An open enrollment where every employee has access to concierge level-support: employees can get basic questions like "what's the difference between my PPO and HDHP" or "What's an FSA?" answered immediately. They can have a private conversation with an expert about what benefits they should choose based on their family's needs. They exit enrollment feeling educated and confident in their benefits decisions.

2. Day-to-day benefits support, delivered year round  
Answers to important and time-sensitive questions are a simple text away: when employees lose an ID card or can't remember their insurance plan details, they've got a single place to go for answers. They also can contact you if they can't figure out which doctors are in-network and are, say, trying to find a pediatrician for their daughter. Good answers feel easy to get and the results are saved so they never lose context. 

3. Support in the big moments, insurance navigation and advocacy
It's clear where to go for help when a confusing bill arrives or they're stuck in an insurance issue: if they get a medical bill that they don't understand or it seems far more expensive than it should be, they can quickly get guidance. They can also count on an expert to reach out to the carrier and advocate on their behalf if needed. They feel taken care of in their deepest moments of vulnerability.  

Sounds too good to be true? We assure you it's not; it's coming to a brokerage near you. And if you're energized by this prospect, there are things you can do today to pull that future forward. If you lead a brokerage, make the decision that you're ready to commit the resources and step into this role. Start with a client listening tour and learn how they're dealing with this problem today in order to help guide your approach to building out the capability.

If you're a producer or service professional, raise your voice. Make it clear to leadership that member experience is important to your clients. And, that it's important to you being at the firm. Your clients are voting with their feet and you can do so, too. Or, you can take matters into your own hands by recommending off-the-shelf, third-party navigation point solutions to your clients. Examples of tools that are worth considering are those from companies such as Rightway, Amino Health and Healthie. While they can't offer the same level of member support you can, they're a step in the right direction.

We're going to see a new paradigm of modern firms taking the lead here by bringing this new capability to the market. Why? Because clients have spoken and this is a pressing, unsolved problem. Whether you're a producer, service professional or brokerage leader, the time for status-quo thinking is behind us. It's time to fix the member experience.