Making Employee Health Benefits an Advantage
For Your Benefits
For Your Benefits
Making Employee Health Benefits an Advantage, Not Just Another Expense
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Making Employee Health Benefits an Advantage, Not Just Another Expense

As healthcare costs continue to rise, benefit advisors and employers face major challenges when it comes to providing high-quality, affordable employee health benefits. In this episode of For Your Benefits, we chat with Nancy Giacolone, founder of Olympic Crest Insurance, about how benefits advisors can help employers understand where their healthcare related money is going and strategies they can use to save.

We discuss:

  • Questions employers should be asking their benefits advisor to make sure they get the best value from their benefits
  • What benefits advisors should know about their clients to help them make the best decisions
  • Why being transparent with your clients is important to you and your clients
  • Key strategies benefit advisors can use to help their clients save on healthcare costs

According to a recent survey, close to 60% of U.S. employers believe that their employee healthcare spending has reached unsustainable levels. Check out this recent blog, 5 Ways to Help Self-Insured Clients Reduce Medication Costs to discover key strategies that employee benefits advisors can utilize to help their self-insured clients manage rising drug costs.

In This Podcast

Nancy Giacolone, RHU

Nancy Giacolone is the founder of Olympic Crest Insurance, a boutique benefits consulting agency. She also is the host of the popular podcast “Recipe for Success.” Giacolone was named a 2020 Top Woman in Benefit Advising and as the “Most Creative Social Strategist” at the You Powered Symposium. Her mission is to leave a legacy in not only the industry but to provide employers with the tools to create a dynamic and inclusive culture making them an “Employer of Choice.”

Meghan Henry:
Hey, everyone. And welcome back. Thanks for joining this episode of For Your Benefits, the podcast where we talk with benefits advisors, HR leaders, and others about what’s happening in the world of employee benefits health, company culture, and engagement. I’m your host, Meghan Henry, Director of Marketing with SentryHealth, a clinical-first care navigation company that combines data science, technology, and an experienced care team to match people with the right healthcare.

In today’s episode, we are so excited to be chatting with seasoned employee benefits expert, Nancy Giacolone. Nancy is the founder of Olympic Crest Insurance and in 2020 was named one of the Top 20 Women in Benefits Advising by Benefit Advisor Magazine. Congratulations Nancy, and thanks for joining us today.

Nancy Giacolone:
Thank you for having me, Meghan. It’s a pleasure.

Meghan Henry:
Absolutely. So before we get started, let me hear just a little bit about you so our listeners know who we’re talking to today.

Nancy Giacolone:
Again, my name is Nancy Giacolone. I own a boutique employee benefits agency located in lovely Gig Harbor, Washington, a town I’m sure none of you are familiar with, but it is about 40 minutes southwest of Seattle. I love working in the benefits space. I work primarily with smaller to midsize employers because that is the bulk of employers in my neck of the woods.

Challenges with Health Benefits

Meghan Henry:
Well, let’s get started. Nancy, I know that you are passionate about helping colleagues in the benefits industry improve the healthcare experience for their clients. So today’s conversation is going to be about the challenges that they face when it comes to providing healthcare benefits. And then I want to shift over and talk about some strategies they can use to make health insurance a benefit and not just another expense. So let’s start off with the challenges. Nancy, what are some of the major challenges benefits advisors and their clients are facing when it comes to health benefits?

Nancy Giacolone:
I’m going to address specifically the under 200 markets, so employers with 200 or fewer employees.

Meghan Henry:
Sure.

Nancy Giacolone:
The biggest challenges that they’re facing are solutions really. Because in the under 50 space, the primary set of solutions that are available are fully insured products, which means that neither the employer nor the advisor has a lot of options as far as creativity. Sure, they might have a portfolio of products to choose from, but it’s just simply trading dollars. If you want to push premiums down, you’re taking something away on the benefit side. So that is the number one challenge.

Depending on the market that you’re in, and where in the United States you’re in, you may or may not have the access to things like medical cost-sharing programs, or self-funding in those spaces might be limited. And you can do it for one year, but if somebody sneezes and has a bad cold, it’s going to blow the experience up because there’s just not enough claims fund built in there.

Meghan Henry:
Sure.

Nancy Giacolone:
So really the very biggest challenge is the lack of solutions and affordability.

Health Benefits: Not Just an Expense

Meghan Henry:
So how can advisors help their clients understand that health insurance is a benefit and not just another expense? I know that when you’re talking about these smaller groups, money matters. It’s super important. I suspect there may be a tendency to say, “Meh, we can kind of cut corners here and there,” But what are you saying to those clients who say that?

Nancy Giacolone:
We’re still in a war on talent. It doesn’t matter what size you are as an employer.

Meghan Henry:
Right.

Nancy Giacolone:
Benefits are one of the first things that employees look at, so they want to know how much it’s going to cost and what the benefits are. And that’s one of the things that they’re evaluating when they decide either whether they’re going to stay with you or they’re going to accept a job with you. So it is truly part of your entire offer. And if it’s not attractive, you’re not going to get the people you want.

Meghan Henry:
Sure. And I know when everybody’s competing against each other, it could be back in 20 years ago, whatever, it was, “How much money can you pay me?” and “That sounds good to me.” And now there’s so much remote work. There’s benefits. There’s all these other things that new hires, new perspective hires are looking at that I can imagine that the competition must be so fierce now.

Nancy Giacolone:
It is. It is ridiculously fierce. Employers in the past that were primarily concerned about the price tag are now primarily concerned about the benefit structure. What does this benefit plan actually look like and how is it going to help you retain and attract employees?

Meghan Henry:
Yeah. And then when you’re looking at younger employees, they’re looking for those things. They’re not necessarily looking for the top salary. They’re looking for a work-life balance. How can I have a life outside of work? And what is my employer going to do to make sure that happens?

Nancy Giacolone:
And they’re looking for things like, what are the mental health benefits.

Meghan Henry:
Yeah.

Nancy Giacolone:
“How can I access that? How is my emotional wellbeing supported? Is there something in the program that addresses that? Do you have telehealth benefits? Because I don’t want to go into the doctor’s office because my phone is already surgically attached to my hands. So I may as well use that to have a visit with the doctor.” So, all of those little nuances, you have to think about the generational perspectives because what somebody who’s in their 20s finds important is going to be very different than what somebody in their 50s finds important. And your workforce encompasses all of those people so you have to be thinking about what’s important to everybody.

Meghan Henry:
Are those things available to the small and mid-market employers? I mean, they are?

Nancy Giacolone:
Oh, absolutely. Absolutely. And whether it’s baked into a plan or you’ve bolted on through another service, those are available to groups of any size. It helps not only provide those first dollar benefits, so in other words, not having to meet a deductible, not having to make a copay which is huge, but it also improves healthcare literacy. It helps members become better consumers of healthcare.

Being Transparent with Your Clients About Health Benefits

Meghan Henry:
Nancy, you’re a big fan of being transparent with your clients. I know that you write about that a lot. Why is this important? And do you think that most benefit advisors are transparent?

Nancy Giacolone:
No, I don’t. I think they’re being required to be more so than they have been in the past-

Meghan Henry:
Sure. Yeah.

Nancy Giacolone:
Because of the compensation disclosure rules. But the reason that I feel that being transparent is so important, is because, really it speaks to one of my core values, which is simply being honest. I think that the way our industry has been structured for so many years, the way the carriers courted agencies on “If you sell this, you’re going to get this huge bonus. You’re going to win this cruise. You’re going to do those sort of things,” I think it wasn’t necessarily always intentional for advisors but they were in the back of their mind thinking, “Oh, I’m just going to place this one last case with XYZ company, because then I’m going to get that cruise.”

Meghan Henry:
Right.

Nancy Giacolone:
I think that is the wrong thing to do. Because as soon as you plant the idea in your mind, subconsciously you’re going to remember it. I used to drive my carrier reps crazy for years because they would come in and want to tell me about their bonus programs and I would say, “I don’t want to hear about it.” Now, if at the end of the year I accidentally get a bonus, I’ll take it.

Meghan Henry:
Sure.

Nancy Giacolone:
But I’m not going to give it back to you, but I don’t want to even know what the program is.

Meghan Henry:
Decisions aren’t being made based on those things.

Nancy Giacolone:
Right. I don’t want any part of my subconscious to be saying, “Ooh, I’ll get X number of dollars more if I place a piece of business here.”

Meghan Henry:
Right. Right.

Nancy Giacolone:
I believe that if you do the right thing, the money follows. And so that’s part of my push for transparency. I think we need to be transparent about how we’re compensated. I think we need to be transparent about when we make mistakes. I think we need to be transparent about the size of our agencies.

For a long time, there was a lot of shame around being a small agency. You couldn’t compete, you couldn’t do as good of a job. That’s just not true. And so I will gladly tell people the size of my agency. I will tell them how much money I make on their account. Because quite frankly, I probably don’t make enough money on some of these accounts because of all the work we do. But I always show them, this is how much I’m paid, these are the services that you’re receiving in return. And if you are not comfortable with that, okay, that’s fine, but I need to make money just the same way you need to make money in your business. Nobody works for free.

Meghan Henry:
Well, and I would guess that the folks that they could be working with that aren’t being transparent are probably making just as much, or if not, more.

Nancy Giacolone:
100%.

Meghan Henry:
And so, I think this certainly would build trust. I mean, if I were a prospective client, that sounds sensible to me knowing all of those things. Do you think that the regs that they’ve just released, is that enough?

Nancy Giacolone:
No.

Meghan Henry:
No?

Nancy Giacolone:
People will find a way around them. Like I say, it’s a good start. Their intentions are good, which I applaud. So if it helps 10% of people be better, then that’s 10% more that are doing a better job.

What Questions Should Employers Ask Benefit Advisors?

Meghan Henry:
Sure, sure. I want to talk about health benefits just a second. What are some of the questions that employers should be asking their benefits advisor to make sure they get the best value from their benefits? I know that you have a document about sort of what are the things that you should be asking an advisor. What are some of those things? Because I think at times employers aren’t really sure what they should be asking, what they should be looking for, and maybe not often advocating for themselves.

Nancy Giacolone:
Well, I think the biggest thing is, honestly, that conversation should be flipped. Because if an employer reaches out to an advisor, the first thing that they need to come to an understanding about is, what are the employer’s goals. What are they trying to achieve with that money that they’re spending? What are their business objectives? How could things be different if they either saved X number of dollars or spent X number of dollars to do Y?

So it really needs to be a two-way conversation about why are you spending this money, and what do you want to do. Because if it’s just, “Well, I have to,” okay, you have to, but again, let’s talk about it because you want to maximize the value that you’re spending. If you’re just doing it because you have to, you’re actually not really getting any value.

Meghan Henry:
You need to go beyond checking that box.

Nancy Giacolone:
You need to go beyond.

Meghan Henry:
Health benefits, check.

Nancy Giacolone:
Exactly. The other thing that they need to be asking is, “How are you compensated? What services am I going to receive in addition to my annual Blue Cross renewal? Are you going to do other things for me? Are you current on compliance? Can you assist me with compliance? Do you have HR resources that you can share with me? How are you going to educate my employees regarding the benefits that we offer? Do you have assistance and claims resolution? If somebody gets in a pickle, what are your advocacy benefits?” Those are the type of things that employers should really be thinking about and asking their advisor, either their current advisor or anybody else that they’re talking to. The last thing they need to be concerned about is, “Are you going to take me golfing?”

Meghan Henry:
Right. Right.

Nancy Giacolone:
And unfortunately, that’s how still a lot of those decisions are made.

What Should Benefit Advisors Ask Employers?

Meghan Henry:
Yeah. So if we flip it, what should benefits advisors be asking their clients or prospective clients?

Nancy Giacolone:
Number one is, “With this dollar figure that you spend annually, what do you hope to achieve with it? What are your business goals and how does this support your business goals?” Because if we don’t understand what a business is trying to do, how can we really properly support them? We should be talking to them about, “What payroll system do you use? How can the benefits support the payroll system? Who’s going to enter in the deductions? Are there integrations that can happen?” We should be asking them, “What are your growth plans? What do your employees want? What’s the biggest pain point you currently have?”

Meghan Henry:
And if your advisor’s not asking you those questions, is that a red flag?

Nancy Giacolone:
It’s a red flag for me.

Meghan Henry:
Because they don’t understand you. They don’t know what you’re trying to do. And perhaps all you are trying to do is check that box and they’ve got to.

Nancy Giacolone:
Well, yeah. If you’re not asking those questions, you’re just a commodity. You’re just selling a commodity.

Meghan Henry:
Right.

Nancy Giacolone:
And in this industry, we need to be more than a commodity. We need to be advisors. We need to be consultants. We need to be business partners with our clients.

Meghan Henry:
Would you say that small, mid-market businesses benefit from having a good benefits advisor relationship with the clients? Probably it seems to me like it would be almost even more important for that size client than it would be for an Apple or an Amazon or something like that.

Nancy Giacolone:
It is 100%. Because quite frankly, most smaller businesses, don’t have an HR person. They don’t have somebody leading them. The HR person is sometimes the owner, the payroll person, the controller, and the janitor all wrapped up into one. So they’re stretched so thin anyway that when they know that they can rely on a trusted advisor to make sure they’re staying compliant, that they’re doing things the right way, that their employees have the coverage that they’ve been promised, that they can be assisted with, “Oh, hey, do you have a handbook builder? How can you help me in that way? Can you show me a resource or connect me with somebody?” That’s when you have a true business partnership with your clients. The insurance products are nothing more than tools in our toolkit to help the employers. They’re not our sole reason for being.

Key Strategies for Advisors to Help Clients Save on Health Benefits Costs

Meghan Henry:
Sure. Nancy. I know it’s important to most employers to provide the best benefits for their employees. I say most. I think some it’s just like you said, checking off the box. But a lot of them are trying to give the best benefits to their employees without leaving any money on the table. What are some key strategies that advisors can use to help their clients save on healthcare costs?

Nancy Giacolone:
Well, one of the things is to look at concierge services where they’re connecting with a nurse navigator and talking about what their need is and evaluating who can truly provide the highest value of care. So in other words, the highest quality at the best price, that’s where the best in value is. It’s not the least expensive. It’s not the most expensive. It’s really who has the best outcomes, who does it consistently. Generally, the providers with the highest outcomes and the most number of procedures tend to have lower prices because they know what they’re doing.

Meghan Henry:
And that goes against what most people think. They think, “Oh man, Dr. so-and-so is a bajillion dollars. He must be the best one around then.”

Nancy Giacolone:
Right. Right now most consumers do not have the tools to vet physicians or providers adequately. I mean, you can go on Google and look at a recommendation and the recommendation might be, “His bedside manner was fantastic. He was so nice. He had a great nurse.” His quality score could be in the toilet.

Meghan Henry:
Right.

Nancy Giacolone:
But they don’t know because that’s not the information that they’re getting. So number one, to have some sort of advocacy service as part of your plan is the number one best investment you can make. They can start looking at direct primary care as alternatives. How can you implement that? How can that be worked into your program? Direct contracting. So that you can go to a particular place for a… You essentially give avenues of care. So you give the employee the choice. “You can go to this facility for your knee or your hip replacement. We’re going to wave your deductible and your co-insurance because we know they’re a high quality, highly rated facility, and they’re going to do it for a fair price.”

Meghan Henry:
Right.

Nancy Giacolone:
“Or you can go over here to whomever it is that you want whose quality rating is might not be as good.” You have that choice, but then you’re going to have to pay the deductible, the co-insurance up to your maximum out of pocket. So really trying to engage members in the healthcare plan that’s built is going to have the biggest impact.

Meghan Henry:
And these are all available to small and mid-market businesses.

Nancy Giacolone:
Yeah. That’s right.

Meghan Henry:
I mean, I would guess that a lot of them probably think, “Oh, that’s for the big guys. That’s not for us.” But they are available. And perhaps even more important to some of those size groups, because again, they don’t have extra money floating around.

Nancy Giacolone:
Yeah. I was talking to one of my clients last week. I think they have 20 employees. They have a traditional PPO plan, but we are actually going to layer in an advocacy program over the top of it because that’s what we were talking about. Most of their employees are young males. They don’t know where to go if they need to go to the doctor.

Meghan Henry:
Right.

Nancy Giacolone:
And this builds it all into an app so it’s all great for them because they can do pretty much everything from the phone. That’s going to make that plan so much more valuable to those members, and as a result, increase the perceived value to the employer. So it’s a win-win for everybody.

Reinvest Healthcare Cost Savings

Meghan Henry:
Yep, agreed. Nancy, I know you work with your clients. You’re working for them to save the money, but I think the goal is for them to not just save the money, but reinvest it, redirect the cost savings, do things with it. What have some of your clients done with that money that you’ve saved them?

Nancy Giacolone:
I would love to tell you that they have been so benevolent.

Meghan Henry:
Donations and such.

Nancy Giacolone:
No. I mean honestly, usually, it’s just trying to improve the benefits.

Meghan Henry:
Sure.

Nancy Giacolone:
Trying to really bring the accessibility point down to the members. Instead of looking at programs that have $5,000 or $6,000 deductibles, how do we bring that down so that our members aren’t functionally uninsured? Things like, again, we were able to save money with this client I was talking about and so we took that savings and reinvested it in advocacy. So again, how do we make it a better benefit with the same dollars?

Meghan Henry:
So they’re not spending anymore, but they’re getting more.

Nancy Giacolone:
Right. Right. I mean, I have a large client, we’ve saved them hundreds and hundreds of thousands of dollars. And they’ve reinvested it back in their business into growth and to opportunities. So generally, if it’s good for the business, it’s good for the employee. I can’t say that that’s always true. But most of the employers I work with really align with my values so I see them doing good things with the money they save.

How to Get the Best Value Out of Health Benefits

Meghan Henry:
That’s great. Well, before we wrap up, Nancy, I know you’ve got lots of years of experience. You’ve probably seen a lot of changes in the industry. You’ve faced a lot of challenges. What advice would you give other benefits advisors in regards to getting more value out of their health benefits?

Nancy Giacolone:
I think the one thing that we actually need to do as an industry is we need to get back to the conversation and differentiating between healthcare and health insurance. They are not the same thing. As somebody who has been in the industry as long as I have, insurance is where we started and insurance is simply a funding vehicle.

We need to make sure that people understand that, and it’s not the healthcare delivery system. There are two parts. So if we can help people understand the difference between the two, I think we get more value, we get more understanding and appreciation, and we’re able to do things a little bit better. But when we muddy the waters between the two, I think there’s a lot of confusion and frustration and finger pointing.

Meghan Henry:
Right. And that requires education.

Nancy Giacolone:
Education is an absolute requirement. I will say, again, I’ve been in this business for 35 plus years. There is not one that day goes by that I don’t learn something new. And if I wasn’t learning something new, then I shouldn’t be in this business because there is innovation happening all the time. There are new laws coming out. There are new products. There are new approaches. And it requires a lot of work to stay on top of that. And also, to be open-minded. To know that just because that’s the way you did it five years ago may not be… Well, not, may not be. More than likely, it’s not the same way you’re doing it today.

Meghan Henry:
Well, and I think you speak of innovation, I’ve heard different benefits advisors say things such as, “I’m not interested in the next new thing. I’m not interested in the latest and greatest.” I suspect there is probably some burnout on you guys’ as part. There’s new stuff coming out all the time. You got to try and keep up on that. And I think some probably have decided “I’m not interested in even attempting that anymore.” Do you think it’s important to… I’m not necessarily saying look at every single thing that ever comes out, but it sounds to me like you’re saying it is important to keep on top of those things and at least be aware of the innovations.

Nancy Giacolone:
It is important. I think it’s important also to invest in yourself and your profession. This is the profession that we have chosen. And so we do need to further our knowledge and education constantly. We should be attending at least one industry event a year so that we’re outside of our own little cocoon and we get exposed to things that other people are doing in other parts of the country. The opportunities for that are greater than they’ve ever been, particularly in this world of virtual conferences.

Meghan Henry:
Sure.

Nancy Giacolone:
Get yourself out there. Subscribe to industry newsletters. Read one or two things a day if that’s all you can manage. But absolutely, we need to be open. Because if we’re not open to change and growth, then we’re dying. I mean we’re going backwards.

Meghan Henry:
Yep. Yep. Nancy, thank you for joining us today. This has been such a great conversation. I know that with the experience that you’ve shared with us, folks are really going to go away with some great information. If people want to reach out to you, what is the best way that they can get in contact with you?

Nancy Giacolone:
I’m very active on LinkedIn. You can find me under my name, Nancy Giacolone, although it does start with G-I-A. You can also email me at [email protected] I’m always open to having a conversation with anyone, even colleagues in the industry. I’m always happy to share and support anybody in this industry.

Meghan Henry:
Fantastic. Thank you for joining us. We really appreciate it.

Nancy Giacolone:
Thank you. It was a lot of fun.

Meghan Henry:
This is great information. Well, that does it for today’s episode of For Your Benefits. Thanks to everyone for joining us. If you like what you heard today, please don’t forget to subscribe to our podcast. If you’d like to learn more about SentryHealth, visit our website at sentryhealth.com. Thanks and have a great day.

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