BIP Summer 2024

“The Middle Man ”

The CEO had to take a leap of faith and trust us as a new broker. We said, “You’re paying $50,000 out of pocket now. On the high-deductible plan, your max out-of-pocket for your daughter will be $10,000.” The Magic Middle I changed plan designs and saved the employer money that was then used to fund HSAs for the employees. The employer technically didn’t spend, the employee technically saved, and everybody’s getting almost $1,000 into their HSA every year from the employer. Although we kept the low deductible, high-cost plan as an option, the CEO did choose the high-deductible health plan (HDHP). He’s already told employees, ‘You need to look at this [plan], see if it makes sense for you.’ An HDHP doesn’t work for everybody every time, but offering this solution made us proud. That’s the goal, and we’ve got to continue to push for it. “ ” Insurance isn’t for the good days. It’s so that when the worst day happens, you’ll be covered.

M Michael Hart, benefits consultant at Dillingham Insurance in Enid, Oklahoma, doesn’t let his inter mediary role in the health system go to waste. For every client, he leverages his position to deliver exceptional service. Here, Hart shares just one example among many of how he consistently demonstrates that the middle is a powerful place to be. The Employer I took over a 150-life group where the CEO’s daughter has an autoimmune disease. Some of her drugs were out of network, and they cost around $50,000 a year out of pocket. We noticed this company had a lot of health plan choices, but they didn’t have great navigation. They kept this low deductible, high-cost plan simply because the CEO thought, ‘Well, this is the only plan that’s going to cover my daughter.’ HR and the CFO want to appease the CEO, but they don’t always know the right questions to ask. We wanted the CEO involved because if we were going to keep this high-cost plan, we want to know it’s being utilized the right way. Historically, employees were not thoroughly educated about the plans. Once they got into a plan, they just stayed there. When we took over, we used interactive videos highlighting the differences between the plans

Michael Hart

bridges the gap to better benefits

and when it might make sense to be on a particular plan. The Carrier On the carrier side, we worked our relationship to go to a second tier formulary. In Oklahoma, you can have some customized formularies. If you have a customized fully insured plan, they have two different tiers. They don’t like to promote the second tier because it covers drugs that the other one doesn’t. But we were able to use the clout we had with the carrier to get that secondary formulary, which covered drugs some employees were taking.

TIP: ”We wanted the CEO involved because if we were going to keep this high-cost plan, we want to know it’s being utilized the right way.”

52 bip magazine Summer 2024