5 ways to increase the value of a health insurance policy


Last year, a colleague of mine started experiencing shortness of breath during his regular exercise regimen. He didn’t think much of it at the time—after all, he was a relatively healthy, middle-aged adult. But, he mentioned it to his doctor, they performed a stress test and a few days later, he was having triple-bypass surgery to remove an 80 percent blockage in his “widowmaker” artery.

Why do I share this story? Because one of the biggest challenges we face in health insurance is that consumers have long held an “it won’t happen to me” or “I won’t ever use it” attitude that consistently turns people away from purchasing insurance. These people end up viewing health insurance policies as “wasted money” since there’s often no tangible payoff if they’re not sick or didn’t have an accident.

In my colleague’s case, that certainly wasn’t true. He was fully aware of the risks and acutely aware of heart conditions like the one he experienced. However, my colleague’s story is a notable one because it reinforces just how scary these kinds of situations can be, and how good insurance products can help defray costs and protect your family.

But, when it comes to the future of health insurance, educating employees is only one piece of the puzzle for HR teams and carriers. Another piece that’s just as important: developing and implementing innovative plan features that provide more ways to pay policyholders. The idea? Employees will get more value from their policies while still getting the important protection they need.

How might they go about doing this? Below are just five ideas that I’ve heard come up in conversations with my colleagues, with customers, and at industry events in the last few months. I believe it’s reflective of where the health insurance industry is heading:

  • Better alignment with current medical practices. Carriers should ensure that employees get the payment they need more often by aligning with modern medical practices. If a policy was created 10 years ago, the medical world may no longer match the way the policy looks at a condition, leading to claim denials. For example, some policies may require an enzyme test to pay a benefit for a heart attack, but doctors don’t always perform these tests if they already know the patient has had a heart attack. With advances in the medical field occurring at an increasingly rapid rate, it’s critical your policies align with what’s happening in the doctor’s office.
  • Better account for stages of illnesses and injuries. Help make sure employees get the benefits they need by taking into account the stages or severity of particular conditions. For instance, perhaps an employee didn’t have a heart attack, but they might still require treatment. Perhaps an employee didn’t break a bone, but they have a severe sprain. Policies can be designed to find more options for payment even if the condition wouldn’t traditionally be covered.
  • More coverage for routine test and procedures. Insurance is often associated with protection for when “something bad happens.” But, more plans are starting to provide benefits for standard tests and routine procedures.

  • Reward “good behavior” more often. In the auto industry, this is fairly common. Keep a clean driving record for a year, and get cash back or a discounted premium. In the future, you’ll probably see health insurers follow this trend. You’ll see more plans offering a discount or returning premium to employees who haven’t used their policy. This is a great way to make sure employees get something out of the policy even when they believe it “won’t happen to them.”
  • Offer quicker payments. Expediting the claims process can go a long way toward making employees happier with their health insurance. When an employee files a claim, it can be incredibly frustrating waiting for that claim to go through. The sooner it goes through, the sooner the employee gets paid. It may not mean paying more, but it certainly negates a sense that the carrier doesn’t want to pay the policyholder.

Bottom line: The more payments an employee receives from his or her policy, the more value they see in the policy. And, the greater the value, the more likely an employee is to purchase the product. It’s a win for everyone involved and it’s the reason that the future of insurance is in finding more ways to pay policyholders.

Posted 9:00 AM

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