BIP Summer 2024

SUMMER 2024

Official magazine of NABIP + AI’S GROWING — AND YOUR JOB + NABIP STANDS FIRM ON AGENT RECOGNITION

INFLUENCE ON HEALTHCARE, EMPLOYEE BENEFITS

AMID MEDICARE RULE CHANGES FUTURE FORWARD Years of dedicated leadership in her community and the industry, along with her strong family values, have primed Alycia Riedl’s path to President. Where will she take NABIP next?

SUMMER 2024

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Official magazine of NABIP

NABIP Shaping the future of healthcare

Volume 71 No.1

EDITOR-IN-CHIEF Elizabeth Galentine elizabeth.galentine@contentovation.com

ADVERTISING SALES MCI (410) 584-1900 Danielle.lucifero@wearemci.com

PRINTER Walsworth (573) 442 8714 www.walsworth.com

focus

REPRINTS MCI USA (410) 584-1900 Danielle.lucifero@wearemci.com

20 The Power of Presence Alycia Riedl draws upon a lifetime of committed service as she steps into the NABIP presidency. 28 From Data to Decisions With artificial intelligence permeating everything from benefits design to patient care, brokers face a pivotal moment. Embracing AI holds the potential for tailored solutions and enhanced outcomes, but ethical considerations and privacy concerns still loom in this transformative era. 34 The Medicare Rule Ripple Effect Amid sweeping updates to Medicare rules, NABIP’s advocacy underscores the indispensable roles that agents and FMOs play in ensuring effective Medicare delivery, pushing for policies that acknowledge their vital contributions to the healthcare system.

MAILING ADDRESS 999 E Street NW, Suite 400 Washington, D.C. 20004

EDITORIAL & DESIGN ContentOvation with Therium Studio

www.ContentOvation.com jamie.green@contentovation.com

www.theriumstudio.com melissa@theriumstudio.com

The opinions expressed in this magazine are not necessarily endorsed by NABIP nor does the magazine assume responsibility for statements made in advertisements or published articles. Send editorial submissions to: BIP Editor, 999 E Street NW, Suite 400, Washington, D.C. 20004. BIP (ISSN 2475-5826, publication no. 238660), 2023, volume 71, number 1 Published 4 times per year (Spring, Summer, Fall, Winter) by the National Association of Benefits and Insurance Professionals, 999 E Street NW, Suite 400, Washington, D.C. 20004. $25 annual subscription price is included in NABIP member dues. Periodical postage paid at Washington, D.C. and additional mailing offices.

On the cover: photography by Cary Rothschild

“ ”

inspiration

02 LETTER FROM THE CEO

Our members can be at the forefront of ensuring AI is where compassion meets innovation. — NABIP CEO Jessica Brooks-Woods

From impactful to indispensable

6

04 LETTER FROM THE PRESIDENT Operational excel lence and unified strategic planning 06 NABIP IN ACTION Free cybersecurity

14 PROFESSIONAL DEVELOPMENT ERISA fiduciary duties and client centric insurance emphasize acting in participants’ best interests and building client relationships 18 VOICES

training; CMS collaboration; a Healthcare Bill of Rights to improve care

10 INDUSTRY

INNOVATION CMS addresses

The value of M&A advisors; how to help clients navigate complex benefit trends; the consum er protection focus in recent CMS rule

20

unauthorized plan switches; economic and workforce trends shape benefit strategies

action 44 HEALTHCARE IS LOCAL

50 THE MIDDLE MAN Michael Hart

NABIP Maryland’s advocacy efforts; direct contracting lowers client costs EDUCATION Consultant pursues REBC certification to stay current Joining NABIP to connect insurance with advocacy and growth; Where in the World is NABIP?

optimizes benefit plans, negotiates better formularies, and educates employees

46 ONGOING

50

48 ENGAGEMENT

34

Letter from the CEO

From impactful to indispensable

We are essential. Do you feel the weight of that responsibility? Our mission to shape the future of healthcare demands that NABIP and our members evolve from being impactful to becoming indispens able to the healthcare ecosystem. This transforma tion is crucial for our sustainability and longevity. The redesign and rebranding of our magazine mark a vital step. BIP showcases NABIP members at the forefront of insurance and healthcare innovation, highlighting our essential role in the ecosystem. Living up to the call of essentialism requires not tolerating anything that hinders it. Recently, unau thorized plan-switching on HealthCare.gov and the Centers for Medicare & Medicaid Services response have reflected poorly on our industry. Agents and brokers place 78% of coverage through HealthCare. gov; plan switching results in stolen clients. The nar rative put out by CMS casting agents and brokers in

the ACA Marketplace in an unfavorable and misleading light overlooks the likelihood that automated systems, not unethical practices, cause many unauthorized switches. NABIP has presented evidence of systems switching thousands of consumers within mere minutes — a task impos sible for humans. This clearly indicates a need for enhanced security protocols. CMS’s Dean Mohs discusses the topic further in “CMS ad dresses unauthorized Marketplace activity,” p.10. Our role spans from kitchen tables to boardrooms, guiding health care access decisions that impact countless families. This central position allows us to influence quality, access, delivery, and affordability. The NABIP Healthcare Bill of Rights was designed with this unique respon sibility in mind. Learn the significance behind its formation in “Health care Bill of Rights heralds a new era for NABIP,” p.8. Its principles will guide us in aligning our decisions with the needs of those we serve. A final note as we head into open enrollment season. This period is intense, as our members care for many people every day, making impor tant decisions that impact numerous lives. The dedication required can lead to burnout. I encourage you to recognize when you need support, prioritize your mental health, and remember that your well-being is as important as those you help. Please rely on your peers and our asso ciation for support during this demanding time, as you’re supporting everyone else — NABIP supports you!

I encourage you to recognize when you need support ... and remember that your well-being is as important as those you help.

“

Living up to the call of essentialism requires not tolerating anything that hinders it.

”

Jessica Brooks-Woods CEO, NABIP

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Letter from the President

A unified vision for NABIP

As I enter my term as NABIP President, I reflect on our recent CEO search process and how it filled me with renewed optimism and purpose for our association. Throughout the candidate interviews, we encountered a broad spectrum of potential leaders. On one end were traditional, experienced nonprofit executives well-versed in established association management. On the other were charismatic figures who excelled in the spotlight, bringing attention and allure to the association. What became apparent was our need for a

visionary leader — someone who could manage effectively and elevate the NABIP brand as they articulated a compelling plan for the future. In other words, we needed someone who could help us sparkle but also really think strategically about where we’re going and who we want to be and then figure out a way to get us there. Jessica Brooks-Woods stood out because she embodies both opera tional excellence and strategic foresight. She is unafraid to boldly declare who we are and where we’re headed. Her vision aligns with NABIP’s ambition to be seen as essential and innovative. Already, we’re enhanc ing the value of being a NABIP member in terms of the increasingly sophisticated technology, resources, and credentialing we offer. I look forward to working closely with Jessica and the NABIP staff to continue elevating NABIP’s presence and utility in the broader healthcare and insurance communities. Over my years on the NABIP Board of Trustees, I’ve witnessed a shift toward a more cohesive, collaborative management style and away from islands of leadership. We are a collective group of leaders with very different experiences. Whether it’s your religion, your color, your age, your industry, or where you live in the country, we need to value each of those individual experiences, strengths, and points of view and find a way to harness them so that we are more powerful as a group than we are individually and separately. Today, we prioritize teamwork, respect, and unified strategic planning. We’re committed to ensuring that our leadership transitions are seamless and our strategic goals are consistently pursued so that we foster a powerful, united front. Together, we are stronger, more innovative, and better positioned to achieve NABIP’s objectives.

We’re committed to ensuring that our leadership transitions are seamless and our strategic goals are consistently pursued.

” “

I look forward to working closely with Jessica ... to continue elevating NABIP’s presense.

Alycia Riedl Incoming President, NABIP

photo by Cary Rothschild

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NABIP in Action

Improve your cybersecurity safeguards New NABIP partnership offers free cybersecurity training for members and their clients. by Katie Butler

Last year, three in four U.S. businesses were at risk of a

material cyberattack, according to chief information security officers. And it’s not just a worry for big business. A whopping 41% of small businesses experienced a cyberattack in 2023, according to insurer Hiscox — almost double the number in 2021. To help members and their customers combat this evolving threat, NABIP is partnering with the U.S. Help Desk Academy to offer an apprenticeship-based cybersecurity training program with 100% of the cost — typi cally from $5,000 to $8,000 — paid through Department of Labor grants. The goal is to equip more companies with the necessary skills to protect their assets, ensure the safety of healthcare data, and, by exten sion, safeguard healthcare con sumers’ privacy and well-being. “I’m excited to share this opportunity where organizations large, small, and in between can benefit from the know-how of agencies at the highest clearance

level possible,” says Gavin Walker, director and recruiter at the United States Help Desk Academy. “All of us in the industry — members of NABIP, their employees and customers — can benefit from this training at no cost.” Businesses that host a cybersecurity apprentice will receive: • a one-year complimentary bonus incentive • access to live support seven days a week • cybersecurity training for all new and existing employees

• waived fees for cybersecurity certification exams • tax credits in applicable states Added value for NABIP members and clients The program is a natural extension of NABIP’s Healthcare Bill of Rights, which emphasizes the industry’s commitment to the privacy and confidentiality of patient medical information. “As insurance professionals, we store and maintain a lot of sensitive information about our clients,” Walker says. “We all have the potential of being subject to a cyber breach, and

To sign up, visit USHD Academy.com or call (888) 598-7432.

Kosamtu / iStock

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41% of small businesses

Affecting change from the inside For years, Joshua Brooker has been meeting with The Centers for Medicare & Medicaid Services’ (CMS) Center for Consumer Information and Insurance Oversight (CCIIO), which oversees the HealthCare.gov marketplaces, to discuss the role of agents and brokers on the platform and advocate for security enhancements in particular. Now a Market Research Data Analyst at NABIP, Brooker put his long-term relationship with CMS to quick use when news broke this spring about privacy concerns within the HealthCare.gov marketplaces enrollment system due to unauthorized plan switching [see ‘CMS addresses unauthorized Marketplace activity,’ p.10 for more on the CMS response]. Within a couple of hours of the release of an article by NPR, CMS reached out to Brooker directly to confirm the feasibility of Social Security Number access. “Throughout that day and into the next, I was at the forefront of ensuring the security updates published by CMS were verified. This wasn’t just about addressing a vulnerability but about demonstrating the utmost responsibility that comes with access to sensitive information. As a licensed broker, this is part of our role, but the ethical handling and swift action in the face of vulnerabilities truly define us,” Brooker says. He adds that NABIP’s relationship with CMS is part of an ongoing omnichannel approach to working directly with regulators, policymakers, and legislators. That way, when one avenue is slow — such as Congress during an election year — NABIP can continue its advocacy efforts within other channels. “We’re directly engaging with CMS around the individual market. We’re talking to the Department of Labor for feedback on ERISA issues. We’re providing information to sculpt where brokers’ livelihoods will be for years to come,” Brooker says.

experienced a cyber attack in 2023. Source: Hiscox

we want to do what we can to prevent that. This type of training is very expensive if you have to pay a consulting firm. That’s why being a NABIP member is so valuable — you can benefit from a program you might not normally know about at no cost.” Cally Ideus, owner of the Ideus Agency in Filley, Nebraska, says the program is ideal because the academy will “hold your hand through it, as long as you are willing to put in the work,” she says. “There are not too many organizations out there that will do that. It strategically aligns

with our philosophical vision for supporting our members and their customers.” While businesses in the healthcare space have been in the spotlight for cyber breaches and need to double down on protective actions, there is also a client opportunity. “I think NABIP members would be remiss not to offer this program to their customers — to use it as a reason to reach out and say, ‘my professional organization is giving us an opportunity to help my clients,” Walker says. “It creates retention and loyalty in their own book of business.”

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NABIP in Action

Healthcare Bill of Rights heralds a new era for NABIP Initiative provides a framework to improve the U.S. healthcare delivery system.

patient privacy protection, health equity, and emergency care for all. Kohlsdorf says NABIP is perfectly positioned to lead this initiative because members see healthcare holistically. “Providers and hospitals see it from their perspective, doctors see it from theirs, and insurers see the risk basis,” he says. “We see it from all those angles and the most important perspective: people who use the healthcare system.” Kohlsdorf tapped longtime NABIP member Mark Gaunya, principal of Borislow Insurance in Boston, Massachusetts, to lead the new national committee. Gaunya then selected a team of people with a range of expertise and geographic reach to lead the new national committee, the Delta Force. Gaunya says the Bill of Rights purposefully excludes insurance, regulation, and legislation. “It’s about our fundamental rights as healthcare consumers in the private market,” he says. It is a proactive step forward for NABIP to advance the healthcare discussion. “We’ve created a brand-new foundation for a private healthcare system that serves the consumer,” Gaunya says. For complete details, visit nabip.org/who-we-are/nabip healthcare-bill-of-rights

THE HEALTHCARE BILL OF RIGHTS Article I: Right to Access Affordable Healthcare Article II: Right to Quality Care Article III: Right to Privacy and Confidentiality Article IV: Right to Individual Autonomy Article V: Right to Health Equity Article VI: Right to Health Education Article VII: Right to Affordable Medications Article VIII: Right to Emergency Care Article IX: Right to Healthcare Advocacy Article X: States Rights

THE TASK FORCE

The NABIP Healthcare Consumer Bill of Rights debuted this spring with one person in mind: the American healthcare consumer. “It addresses a new direction for our healthcare system by including the consumer as the priority and not ‘the system.’ With a new focus, our members will have a great opportunity to impact this change,” says Eric Kohlsdorf, president of Prisma Strategies in Des Moines, Iowa, and NABIP president. “It’s a Bill of Rights to improve healthcare for all of America. And we’re helping our members help Americans by using it.” Tenets of the Healthcare Bill of Rights include affordable access, quality care standards,

Andrew Biernat

Brian Butler Mark Gaunya Dede Kennedy Simington Eric Kohlsdorf Dawn McFarland Sheila Prior Alycia Riedl Greg Stancil Michael Smith Michael Wojcik

Jacob Wackerhausen / iStock

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Industry Innovation

CMS addresses unauthorized Marketplace activity By Dean Mohs

The Centers for Medicare & Medicaid Services (CMS) is concerned about activity by some agents and brokers who assist consumers in the Marketplaces that use HealthCare.gov related to unauthorized plan switches and unauthorized enrollments. Health insurance agents and brokers have also reported to CMS that their national producer number (NPN) is being updated without consent. This is done to take the agents’ or brokers’ commissions. These actions disrupt consumers’ access to care and impact the livelihoods of agents and brokers complying with CMS rules. CMS is acting swiftly to protect consumers and root out bad actors. Agents and brokers have always been required to obtain consumer consent before submitting a Marketplace eligibility application or updating a client’s coverage. In 2023, CMS finalized regulations requiring agents and brokers to document consumer consent and application accuracy before assisting a consumer with enrollment or applying for insurance affordability programs through the Marketplaces. The consent documentation requirements must be satisfied before an agent or broker can search for a consumer’s eligibility application, update information,

or submit an enrollment with a plan selection or change on behalf of a consumer. As a reminder, agents and brokers must be prepared to submit documentation to CMS on request or risk having their Marketplace privileges suspended

or revoked and may be subject to additional compliance actions. CMS is working closely with Marketplace issuers, State Departments of Insurance, and law enforcement so that those who violate CMS rules face consequences. CMS also

CMS is evaluating all regulatory, operational, and technological options to prevent unauthorized activity. CMS’



technical teams are working to implement additional system

controls to block

unauthorized or fraudulent Marketplace activity.

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CMS welcomes your feedback and engagement and encourages agents and brokers to continue raising issues. “ ”

continues to improve existing information-sharing processes with issuers and encourage them to terminate contractual agreements with bad actors. In addition, CMS is updating automated information sharing with State Departments of Insurance so that states can more easily revoke licenses and identify problematic actors. CMS appreciates the discussions we’ve had with NABIP regarding unauthorized activities and welcomes your continued feedback and engagement. CMS looks forward to our continued partnership with NABIP. CMS is evaluating all regulatory, operational, and technological options to prevent unauthorized activity. CMS’ technical teams are working to implement additional system controls to block unauthorized or fraudulent Marketplace activity. Many are anticipated to go into effect prior to open enrollment. What can agents and brokers do to help? Agents and brokers should call the Marketplace Call Center at 1 (800) 318-2596 [TTY: 1 (855) 889-4325] to report unauthorized activity. CMS continues to ensure that affected consumers receive assistance to minimize the impact of unau thorized activities. This includes retroactively restoring or can celing coverage and updating tax forms.

You can help protect your clients. Misleading and deceptive marketing practices, such as promising cash, gift cards, or other incentives, as well as non-compliance with CMS rules on documenting consent and application review, are behind many of these unauthorized activities. Marketplace agents and brokers are required to provide accurate information to con purchasing sales leads from marketing firms, lead gen eration companies, and other third-party entities that use misleading tactics to acquire consumer information. Any third parties you contract with must adhere to requirements related to the pri vacy and security of personally identifiable information (PII). Unauthorized activity in the Marketplaces is unaccept able. CMS encourages agents and brokers to use NABIP and regular Marketplace feedback channels to continue raising any issues you see. Working together with NABIP and other industry partners, CMS is committed to rooting out bad actors from the Health Care.gov Marketplaces. Dean Mohs is director of the Division of Strategic Stakeholder Engagement & Operations (DSSEO) at the Centers for Medicare & Medicaid Services (CMS). sumers and refrain from misleading conduct or

dane mark / iStock

dane mark / iStock

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Industry Innovation

Ongoing national trends impact benefit strategy By Perry Braun

As we enter the second half of the year, there’s a sense of déjà vu. Policies that address voters’ financial position, feeling of security, basic living expenses, and education will be central. Still, dramatic change is doubt ful, given the fractured state of politics. We’ll need to wait at least a year or two for real action, and what happens will depend on the political configuration of the government. More immediately, the following issues are likely to impact NABIP members. While the economy will continue to expand, monetary and fiscal policies will work against each other. Businesses hope that interest rates will move downward to lower the cost of borrowing capital. At the same time, they will find it challenging to retain labor as other compa nies pay more to recruit workers. This upward pressure on wages will put pressure on inflation, and the cycle will continue. Employers will balance cost savings against too many adjustments that could lead to an exodus of talent. Two-thirds of American workers believe their pay is inadequate to cover the rising cost of inflation, ac cording to Bank of America. Many are making spending decisions based on short-term needs rather than long-term consequences, such as forgoing prescription drugs.

Understanding the implications of these trends is crucial for us as advisors. It allows us to provide the best possible advice and make necessary adjustments to benefit plans, ensuring our NABIP members and clients are well-prepared for the future.

Shifting workforce dynamics

Expect inclusion, diversity, and social and environmental causes to progress at different speeds based on the business’s leader ship and region of the country. Employees increasingly want a voice and a seat at the decision making table. Company reactions to these conversations will be scrutinized against employee retention, productivity, and what other local businesses are doing. Employers will move cautious ly and be more data-dependent in decision-making to stay with other employers in their space. Correspondingly, we see a lot of discussion about the impact of AI and its role in workplace strategy. Perry Braun is president & CEO of the Benefit Advisors Network (BAN), an exclusive network of progressive and independent employee benefit brokerage and consulting companies in the U.S. and Canada.

dane mark / iStock

Professional Development

The health plan fiduciary blind spot By Jennifer Spiegel Berman

employees? Not exactly. When making decisions in establishing a plan, called “settlor” functions, it’s OK for an employer to act on its behalf. But, once an employer turns to administering the plan, it starts to act as a fiduciary, and that’s when it has to act on behalf of the plan participant. Once the employer is acting on behalf of the participants, it has to be able to make good decisions and demonstrate that it has made those good decisions. Many retirement plan sponsors are already doing this. They have committees that meet quarterly with their investment advisors to ensure that the vendors servicing their plan provide good service, appropriate fees, investment objectives are being met, etc. So, what is fundamentally different about health and welfare benefit plans? Nothing. A real-world example A lawsuit against Johnson & Johnson, filed on Feb. 5, 2024, alleged breaches of fiduciary duty concerning the management of the company’s prescription drug benefits. The lawsuit claims that Johnson & Johnson and its benefits committee failed to act prudently — especially with the selection and lack of oversight of their PBM. Strikingly, committee members were named personally. More striking is that Johnson & Johnson had a health and wel fare benefits committee that met

Plan sponsors should consider creating a fidu ciary committee to make critical decisions on behalf of the plan participants. “ ”

It’s impossible to walk a benefits trade show floor without hearing the term “fiduciary duty,” but there remains a critical gap in many organizations’ understanding of the formal fiduciary structures and controls ERISA requires. The rules surrounding fiduciary duties apply beyond retirement benefits. ERISA requires plan fiduciaries to act exclusively in the best interests of plan participants and beneficiaries. Does this mean that employers are always required to act only in the best interests of their

Once the employer is acting on behalf of the participants, it has to be able to make good decisions and demonstrate that it has made those good decisions.

sorbetto / iStock

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Professional Development

The magic of client-centric insurance

regularly to evaluate and make decisions related to its plan. The majority of plans I work with do not, making them substantially more vulnerable to legal attack. Plan sponsors cannot transfer their responsibility as fiduciaries to outsiders — whether advisors, TPAs, or other solution providers. The responsibility is theirs alone. Thus, to meet those obligations, plan sponsors should consider creating a fiduciary committee to make critical decisions on behalf of the plan participants. This committee should operate under a formal corporate charter and meet regularly. Those meetings should be well documented so that if the decision-making process is ever questioned, the plan sponsor can defend it. A document repository should also be created. This ensures easy organization of plan documents, committee charters, committee meeting schedules, compliance calendars, proposed agenda items, and executive meeting summaries and transcriptions. One final and important point: Fiduciary duty applies to all plan sponsors, regardless of the plan’s size or funding status. While a small, fully insured plan’s only fiduciary decision might be selecting a fully insured carrier, the sponsor of a sizeable self funded plan might make hun dreds of large and small decisions in a given year. Either way, it is time for plans and their fiducia ries to leave the blind spot. Jennifer Spiegel Berman, JD, MBA, is a leading employee benefits attorney and compli ance consultant and CEO and co-founder of MZQ Consulting, LLC, a benefits compliance and ACA reporting firm.

When Erin Issac opened her agency about 18 months ago, the president of Joy Benefits in Frisco, Texas, was prepared to wear many hats — owner, salesperson, janitor. But what really invigorated her was the freedom of owning her own business, which allowed her to innovate like never before. During a recent BenefitsPro Broker Expo panel, she asked, “If you don’t have a sales goal and are not considering your commission, what would you do for your client if money didn’t matter?” “There are things I put in place that don’t make me money because it’s about the bigger picture of taking care of clients, building the relationship, doing something that matters to them at that moment, and the rest of it will come,” Issac said. Decades of focusing on the bigger picture has played a part in long-term client loyalty for Issac’s fellow co-panelist Nancy Giacolone, president of Olympic Crest Insurance in Gig Harbor, Washington. She’s had some clients for 35 years through two separate agencies and multiple generations. Key to maintaining those relationships is creating value that is not product-based and meeting each unique need as clients evolve. “I have worked with grandparents, parents, kids, and it’s because I didn’t treat the next generation the same way,” she said. “I listen to them and focus on their needs, priorities, and concerns. I don’t cling to what worked in the past for prior leadership.”

Nancy Giacolone,

left, and Erin Issac, center, with fellow co-panelists at their BenefitsPro Broker Expo session, Iron Sharpens Iron, where the group of experienced brokers shared tricks of the trade.

TIP: Plan sponsors cannot transfer their responsibility as fiduciaries to outsiders. The responsibility is theirs alone.

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Voices

Thinking of selling your business? 4 ways an advisor can sweeten the deal. By Brett Rosen

For many years, I sat on the buy side of the table as my organization acquired small companies in employee benefits, insurance, retirement, and HR. We recruited seller-owners directly, and I did all I could to help sellers. But, owners working directly with a buyer “don’t know what they don’t know.” For starters, some sellers left money on the table. Some could have earned up to 25% more with a broader perspective and help negotiating. Unrepresented sellers can fail to grasp fully how the change in ownership would affect them, their employees, and customers. When a buyer’s M&A team is rolling out the red carpet, it can be hard to remember t hat they have a duty to serve their investors by presenting the most favorable terms for their firm, not to act as the seller’s fiduciary. Experiencing first-hand the value of a seller having a fiduciary, confidant, and negotiator is why I am now an advisor to business owners. In the insurance markets I know best, only about 50% of small business owners get help from an M&A advisor. Why don’t more? Sellers may not know the service is available, or balk at fees, which amount to 2-5% of the selling price, and not see the ROI. Buyers also may claim third party consultants interfere

fail to fully understand what they will be expected to do post-sale. Some sellers exit the business altogether. But those moving to the acquiring firm can avoid unpleasant surprises with an advisor’s help. 3 Values alignment and legacy. For many entrepreneurs, their business is their baby. They care about their employees, their customers, and their services. An advisor can ensure that agency owners who are looking to sell their business get full value for what they’ve built and don’t sell to a company that isn’t aligned with their deepest values and the legacy they want to leave. 4 Velocity that’s right for you. Owners often get caught up in the momentum. They may be recruited by a big player moving fast. However, getting the best deal typically requires patience, thoroughness, and perspective. Advisors can help you proceed at the speed that’s right for you. When clients come to me with an offer in hand, they rarely end up sticking with that deal. Having an advisor who can provide a broad perspective and negotiate on your behalf is crucial to make the most of a one-time opportunity to sell your business.

TIP: NABIP’s Mergers & Acquisitions resources offer invaluable insights of webinars. These tools are designed to equip members with the knowledge and skills necessary to navigate and succeed in the complex world of mergers and acquisitions. through a collection

with personal connections required for a successful deal. However, the best advisors facilitate those relationships, ensuring the sale is not purely transactional. Here are four benefits of working with an advisor. 1 Valuation that’s fair. Most small business owners who hear from buyers what their company is worth are likely getting incomplete information. Advisors can help sellers get a sense of their company’s actual market value and negotiate accordingly. 2 Visibility into your future role. Many owners firm that represents owners in the sale of their businesses. He previously spent 17 years at OneDigital Health and Benefits, most recently as executive vice president of corporate development. Brett Rosen is principal of Rosen Advisory, a leading advisory

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Beware of the dark side of trendy benefits Help employees become true consumers of healthcare. By Eric Silverman

We play a crucial role in shaping employers’ benefit packages. While more comprehensive and customizable offerings seem beneficial, it’s essential to consider the potential challenges and unintended consequences. One issue is the financial burden associated with expanding ancillary benefits. While attractive on paper, these benefits can strain a company’s finances. It’s our responsibility to help clients understand the long term financial implications. As advisors, we should en courage employers to consider a more tailored benefits strategy that aligns with the diverse needs of their workforce. One way is to assist employers in customizing their benefits through an em ployer-funded “shopping spree,” a defined contribution model. Each employee receives a fixed monthly amount to spend on any non-medical benefit they choose. Employees must under stand that these funds are “use it or lose it” and that they do not have the option to convert unused amounts into paycheck increases. Any excess spending results in a payroll deduction, while unused funds do not in crease their paycheck. The flexibility offered by enhanced benefits, also known as voluntary benefits, is appealing, but it comes with its own set

critical in today’s workforce, focusing too heavily on them can unintentionally sideline other vital areas, such as professional development and mental health support. This oversight might alienate employees who do not directly benefit from such initiatives. Additionally, diversity, equity, and inclusion (DEI) initiatives are vital, but there’s a risk they could be treated as superficial additions to benefits packages. We must encourage clients to implement meaningful, substantive DEI practices rather than cosmetic ones. This helps ensure these initiatives genuinely improve workplace culture.

of challenges, notably decision fatigue. The array of options can be overwhelming, leading to underutilization or suboptimal choices. We must assist employers in structuring these programs to simplify decisions and maximize employee engagement and satisfaction. Moreover, the employee funded nature of these programs can lead to disparities in who can afford to opt in, potentially creating inequities within the workplace. We must guide our clients in exploring ways to make enhanced benefits more accessible to all employees. For instance, while family-friendly benefits are Eric Silverman owns Voluntary Disruption, a non-medical employee benefits technology, communications, and engagement firm with in-house distribution and enrollment capabilities. The firm serves advisors, brokers, and consultants.

“ ”

Our role is to help clients critically assess their benefits strategies to avoid potential pitfalls and truly meet the needs of their employees.

The shift toward more comprehensive and flexible benefits packages is generally positive, but it comes with challenges that require careful navigation. Our role is to help clients critically assess these trends and tailor their benefits strategies to truly meet the needs of their employees.

Summer 2024 bip magazine 19

Voices

CMS Medicare final rule shows serving consumers matters most Four changes that are likely to affect industry stakeholders and consumers. By Dan Mangus

The intent of CMS’s Contract Year 2025 Medicare Advantage and Part D Final Rule is clear: Serving consumers matters most. Our industry has the same goal: to protect Medicare beneficiaries from adverse selection and to enhance access to care. Still, it’s crucial to understand how the rule could impact your business with changes to Part D, contract terms, compensation rates, star ratings, admin payments, ancillary benefits, and more.

This will help protect consumers while ensuring that responsible organizations can compliantly serve beneficiaries. 3 Putting consumers in the right plan. It’s apparent that CMS also wants to help ensure unbiased guidance. Due to the focus on ensuring consumers are in the right plan for them, the rule manages contract terms between MA organiza tions and agents, brokers, or other TPMOs that CMS believes may interfere with the ability to objec tively recommend plans. This means technology, com parison platforms, and evaluation solutions matter even more to ensure that agents can provide the right recommendations. 4 Providing more with ancillary benefits. The rule addresses how the value and relevance of ancillary benefits are determined. It also requires plans to notify mid-year enrollees of available supplemental benefits. This is intended to help ensure that Medicare beneficiaries fully utilize their plan benefits. By stipulating changes that put consumers at the center, the Medicare Advantage and Part D Final Rule is certain to impact core aspects of the marketplace.

Dan Mangus is VP of growth and

development with Senior Marketing Specialists, an

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Integrity company. He helps build businesses and guides them through mergers and acquisitions. Mangus started his first insurance agency at 18. By age 21, he was president of his local Association of Life Underwriters and later served

Technology, comparison platforms, and evaluation solutions matter even more to ensure that agents

as area chairman of the Life Underwriter Training Council. He is now on the NABIP FMO Council.

can provide the right recommendations.

The following are four initial thoughts about changes and what they might mean for industry stakeholders and consumers: 1 Agent support. The rule calls for a $100 increase in the fair market value (FMV) used for com missions to agents. Commissions do not come from the medical loss ratio (MLR) requirement of 85%. Instead, they come out of the 15% for carrier administrative

purposes. This makes items either fully commissionable or non-commissionable — there is no middle ground. 2 Consumer data focus. To protect against the misuse of personal data, third-party market ing organizations (TPMOs) are prohibited from selling data to other TPMOs unless the beneficiary gives prior express written consent.

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A CARRIER YOU KEEP

If your clients want a Medicare supplement carrier with extensive experience, outstanding service and diverse coverage choices, look no further than Mutual of Omaha . With more than 55 years in the market and over 1.3 million policies in force, Mutual of Omaha offers the staying power and stability your Medicare-aged clients value. We also offer competitive rates, a household discount up to 12%, dedicated sales support for you and automated underwriting (most applications auto decision within two minutes). As a leading Medicare supplement provider — and a Fortune 500 company — Mutual of Omaha is clearly a carrier you keep.

Questions? Contact your marketer today for more information or visit mutualofomaha.com/ sales-professionals.

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For producer use only. Not for use with the general public.

xxxx photo credit here

22 bip magazine Summer 2024

presence The power of Alycia Riedl draws upon a lifetime of committed service as she

steps into the NABIP presidency.

By Elizabeth Galentine

Photographs by Cary Rothschild

xxxx photo credit here

Summer 2024 bip magazine 23

W When Minnesota’s chapter president had to step down early, Riedl stepped in, serving nearly double the typical term. She did it again just a few years later with the Region IV vice presidency. Riedl consistently shows up in every facet of her life. She became a Red Cross instructor after

“What does it mean to be a leader? It’s about showing up,” says incoming NABIP President Alycia Riedl . And she would know.

accomplishments will be, but it'll be more than we could ever expect. We will have been moving at a steady pace every day from the day she takes over ‘till the day she finishes.” Family and service first Benefits and insurance are in Riedl’s blood, having spent much of her childhood with her family’s agency, EMEX Benefit Systems, in the home’s basement. Her father, David Wiest, was highly involved in the Minnesota Association of Health Underwriters (MAHU), as it was known then, and remained a mentor and industry confidant

her father’s heart attack, testified about the essential role of agents and brokers as Minnesota formed its state exchange, acted as a guardian ad litem for children in the juvenile court system, and served on a task force to develop a long-term strategic plan for NABIP. After nine years on the

until his death in 2018. “That became a thing for us where we could communicate about the insurance and healthcare world,” says Riedl. Family continues to be the foundation of everything Riedl does. Although she is not directly involved with EMEX, her brother and sister-in-law Cory and Courtney Wiest run it now, Riedl has framed who she is around setting a strong example for her children, son Dylan Lindgren, daughter Aryanna Riedl, and bonus children Noah and Zoe Rothschild with her husband, Cary Rothschild. Family is about more than blood, she says, “It is where you choose to spend your time, where you choose to give your energy, where you choose to be your best self. That is the most fundamental aspect of my life.”

NABIP Board of Trustees, the principal at Mercer and resident of Maple Grove, Minnesota, begins her term as president with an extensive track record of professional, community, and familial service. You may not know Riedl as well as other NABIP leaders — “I’m not a super ‘sit at the bar and talk to people kind of person,’” she quips — but you will feel her impact, says Jen Berman, incoming legislative chair at NABIP. “She's not one of those outgoing, loud leaders. She's very focused on everything that she does, and she knows her stuff. She's a quiet force,” says Berman, CEO of MZQ Consulting. “I don’t know exactly what her

KEY POINTS

▶ Alycia Riedl has a strong family foundation, emphasizing the importance of setting an example for her children.

▶ During her term as president, Riedl aims to enhance NABIP's

collaboration with other organizations and provide valuable resources for agents and brokers. ▶ Her leadership approach includes fostering transparency within NABIP and using the Healthcare Bill of Rights to guide NABIP's future direction.

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Before and during her years studying at the University of Minnesota, Riedl volunteered with kids with disabilities, thinking she’d ultimately become a social worker. Instead, she landed her first job at integrated health system HealthPartners after a stint working for her father. “Even though I truly believe the work that we do in our industry is service, people need us, and the work we do is really meaningful, I really missed giving back to the community,” Riedl says. Throughout the years, “Any time organizations that I worked for would want to do volunteer events or put together employee resource groups, I would try to get involved in those things as well,” she adds. “It's always been a really big part of who I am, being able to find other ways to continue to help the community.” A place at the table Riedl first became involved with MAHU thanks to her role in broker sales for insurance company Medica, where she worked after leaving HealthPartners. “MAHU was where brokers got their education, where they networked, where carriers interacted with the broker world,” she says. Within six months, Riedl found herself on MAHU’s Board of Directors, where she met her now-husband, although they did not marry until years later. At the time, Minnesota was beginning to build its state-based exchange, MNsure. Shawnee Christenson, Region IV vice president for NABIP, says Riedl ensured MAHU had a place at the table. “She was a big advocate of us attending those meetings so that we could help make sure all the decisions that were being made had agents’ insights in mind,” says Christenson, CEO of Crosstown Insurance. It was also when Riedl realized the strength of NABIP’s national presence. “It became really clear, really fast, that this was much bigger than Minnesota,” Riedl says. “I made a connection with our previous CEO, Janet Trautwein, who helped me consider what we needed to bring to the table to ensure the role of the broker.”

Alycia and her late father Dave Wiest at the 2018 Gordon Memorial Dinner, NABIP Annual Conference

Alycia and her mother,

Ginny Wiest,

enjoying a favorite holiday activity, baking

Alycia and her husband Cary's 2016 wedding. From left to right, Dylan Lindgren, Aryanna Riedl, Alycia Riedl, Cary Rothschild, Zoe Rothschild and Noah Rothschild

Summer 2024 bip magazine 25

“ All of the work that I've done within MAHU,

NABIP, it has formed me into the leader I am today.

David C. Smith, NABIP treasurer, has known Riedl for nearly a decade. “I've always particularly been impressed by her mindset. She always knew the right kind of questions to ask but also was unwilling to accept that's the way we've always done it,” says Smith, senior vice president at eBen. “She is really committed to the idea that what we ought to be as an association is more than we are. She’s really pushed the opportunity for us to think about things in a totally different way.” Susan Rider, NABIP vice president, agrees. “One of the things that stands out to me about Alycia, she's very good at asking questions of curiosity,” says Rider, director of compliance and HR consulting at Human Capital Concepts. Proactive and collaborative shift Along with the strategic plan, Riedl credits the NABIP Healthcare Bill of Rights [see, "Healthcare Bill of Rights heralds a new era for NABIP," p.8] with putting NABIP in a forward-facing position. “We are no longer reacting to the world. We're actually forging the future,” she says. The Healthcare Bill of Rights framework sets the tone for what the organization stands for and where it will focus its time, adds Riedl. “The things we're talking about at NABIP now really boil down to people being able to have a respected and high-quality interaction with the healthcare system,” she says. So what will the future look like? Riedl has two immediate goals in mind. Leveling the playing field with the big guys and boosting collaboration

Then, when the Region IV vice president also took another job outside the industry, Riedl finished out his term, followed by two of her own. Professionally, she’d moved on to Towers Watson and then Willis, where she gained experience in retail, hourly workers, and unions with clients like supermarket chain Meijer. Following her move to Mercer, where Riedl now specializes in overall client relationship management, she was elected to NABIP secretary in July 2020. At that time, she’d already been working with then-NAHU President Pat Griffey on the Futures Advisory Group Task Force. Looking at the economic landscape and industry influencers, the task force created a five-year strategic plan, including “a level of transparency about what we're doing as an association, where there's gaps that we need to fill, and what could rally us around the future,” says Riedl.

"She is really committed to the idea

that what we ought

to be as an association is more than we are." — David C. Smith, NABIP treasurer

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