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

1. How (much) do you get paid? Traditionally, it has been a combination of commission and bonus. Under this model, we made more as rates went up, which showed a failure to manage costs, and reduced incentive to utilize cost containment strategies. At our agency, we offer a shared savings model, in which the more we reduce costs, the more we get paid. In this scenario, a real win-win is presented to the client, and any thoughts of impropriety should be resolved. As risky as this model sounds, it can also bring the biggest rewards.

2. How does our plan compare and what can be done to control costs? We are starting to benchmark more than just deductible, co-pay, and out of pocket. Plan costs can be far more telling and impactful. Insurance costs are driven by medical costs, and for a long time, wellness programs were seen as the panacea to this problem. But since more than 70 percent of businesses have a wellness program, and most are not happy with the results, other strategies need to be brought to bear. At our agency, this means some powerful new cost and quality transparency tools, enhanced pharmacy management and deeper employee education and decision support