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Have you ever wondered whether there was a recipe for a successful implementation? What is it that makes the experience pleasant for all involved? 

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Many brokers are trying to figure it out was well. More and more brokers are calling themselves "consultants" as their role is evolving. Previously, they shopped benefits for employers then passed along spreadsheets of prices. Now they see their role as advising on what is best for a particular employer group. At the same time, HR administrators are looking to brokers to help them lighten their benefits expertise load. 

A broker stands to make the greatest impact when onboarding a case with a new carrier. Set-up can go from smooth to chaotic over seemingly small details. Here is a list of things to pay attention to that helps ensure a seamless implementation: 

  • Plan design communication Non-standard carrier provisions that brokers negotiate on behalf of their clients take more time to set up. Time is needed for vetting, approvals and potential re-pricing. Refiling contracts with states may even be required, so be sure to communicate to carriers early about additional benefit features. 
  • True open enrollment When an employer group is taken over from another carrier, brokers often assume that the takeover includes an opportunity for new elections and/or enrollees. They will offer an open enrollment period to the employer and not always communicate this to the carrier. Often though, the takeover is only designed to grandfather employees previously enrolled in the coverage. If brokers initiate a true open enrollment period during a takeover, it's critical to negotiate with the new carrier, as it may affect timing and rates. 
  • New carrier administrative info requirements The devil lies in the details here. Administrative contacts, eligibility definitions, salary definitions, taxation, the list goes on and on.  Accurate information is important to the broker, their client and the insurance carrier.  Example: If a salary definition is multi-faceted (includes bonus, commission, etc.), be sure that the salary information reported by the HR administrator to the insurance carrier properly aligns, as the claim payment will be based on the salary information provided.  Carriers need to make sure that they are collecting appropriate amounts of premium to cover potential claims. Why? In the worst case of a misalignment, the employee's claim would get underpaid. 
  • Owners/Partners of S-Corps and LLCs Identifying the owners and partners of S-Corps and LLCs ensures that they will get the tax-free benefit to which they are entitled.  
  • Provide complete prior carrier billing statements It is very helpful when the broker can provide the previous carrier's bill, which includes benefit volumes, before the switch to a new carrier. This ensures grandfathering of employee benefit plan provisions, application of pre-ex provisions and accurately calculating dental benefit waiting periods. 
  • Advise clients on important steps to take if employees are not active at work when switching carriers When an employer group switches carriers while some employees are not "active at work," employers might need to be educated about options available to these employees. You cannot assume that these employees will be taken on by the new carrier.  Review the existing carrier's continuation provisions to make sure that no one slips through the cracks — only to find out too late they don't have coverage.  

Teresa Wheelock is a manager, group services at Mutual of Omaha Insurance Company. She can be reached at [email protected].

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