I’m sure you’ve put together numerous jigsaw puzzles over the years ever since you were a little child. I remember when I was very young that the early puzzles had pre-shaped pieces that fit in predetermined places, making it very easy to put the puzzle together. As I got older there were other puzzles that might have been a couple or several hundred pieces. It required turning all the pieces over and putting the right pieces in the right places so that they all fit together to finish the puzzle.
Health insurance and your health plan is very much like putting together a puzzle – you have to have all the right pieces in place in order for the plan to be successful. One of the questions I ask is “who is putting the puzzle together for you, and is it one of those puzzles that has pre-shaped pieces to go in a predetermined place, or is it one that has numerous pieces that make a better puzzle?”
It’s very important to have the right person helping you put the puzzle together because it depends upon what kind of puzzle they’re bringing to the table. If you happen to be fully insured with BUCA (Blue Cross, United, Cigna, Aetna), I would suggest that you have a very simple puzzle. If your plan is partially self-funded but bundled with BUCA you’re puzzle has a few more pieces. If your plan is partially self-funded with Best In Class independent vendors, then you have the most beautiful puzzle you can put together.
There are brokers, consultants, and advisors that like to put the simple puzzle together because it’s very easy for them, and they get paid handsomely by BUCA to do so. They rely on BUCA to do any heavy lifting and all the pieces are predetermined. It’s just a matter of which BUCA puzzle they bring to the table.
On the other hand there are brokers, consultants, and advisors that are well informed about innovations in the marketplace that compete with BUCA and bring real solutions to an employer. Some of these programs are quite sophisticated, while others simply require to have the right puzzle piece in the right place. It could be a matter of which Claims Administrator, Stop Loss, Pharmacy Benefit Manager, Network, etc. to put the right Healthplan together. Many of these vendors have different services, programs, and capabilities as well as prices. As I have said before, you can negotiate price you cannot negotiate capabilities.
If you would like to know more about the magnificent ‘puzzles’ that we’ve put together for our clients, I’m happy to share my knowledge. You can reach me at 970-349-7707 or email me at [email protected]
