Here are four questions and answers that can mean the differencebetween won business and lost business.

1. How (much) do you get paid?

Traditionally, it has been a combination of commission and bonus. Underthis model, we made more as rates went up, which showed a failureto manage costs, and reduced incentive to utilize cost containmentstrategies. At our agency, we offer a shared savings model, inwhich the more we reduce costs, the more we get paid. In thisscenario, a real win-win is presented to the client, and anythoughts of impropriety should be resolved. As risky as this modelsounds, it can also bring the biggest rewards.

2. How does our plan compare and what can be done to controlcosts?

We are starting to benchmark more than just deductible, co-pay,and out of pocket. Plan costs can be far more telling andimpactful. Insurance costs are driven by medical costs, and for along time, wellness programs wereseen as the panacea to this problem. But since more than 70 percentof businesses have a wellness program, and most are not happy withthe results, other strategies need to be brought to bear. At ouragency, this means some powerful new cost and quality transparencytools, enhanced pharmacy management and deeper employee educationand decision support

3. What kind of online tools and HR technology do you provide orsupport?

Supporting in-house personnel is becoming inherent. Approachesvary, but they all serve one common result: solving real HRproblems and supporting education and decision making. We investedtremendous resources into the software we provide, and our in-housepersonnel allows for four-hour turnaround times on open enrollmentand site setup. While agencies offering such systems are becomingless unique, the differentiator is becoming how well you cansupport the setup and ongoing management. Are you familiar enoughwith the systems you use to be put to the test by a moresophisticated employer?

4. Are we meeting our fiduciary responsibility toparticipants?

While these changes may create additional responsibilities,let's not lose sight of the fact that most employers were notmeeting their responsibilities even prior to this change. Mostthink managing ERISA responsibility involves distributing updateddocuments and filing a 5500 when required, but that alone is notsatisfying an employer's fiduciary responsibility. The primaryeffort must be protecting plan assets and making sure all decisionsare for the benefit of the participants. The same rules thatrequire 401(k)s to review investments, charges and suitability,apply to the health plan. So are all claims being audited to ensurethere are no fraudulent charges, charges for services not renderedor not needed, and that a reasonable price has been paid for thelegitimate ones? I argue that practically every plan overpays forservices every day.