The more payments an employeereceives from his or her policy, the more value they see in thepolicy. (Image: Shutterstock)

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Last year, a colleague of mine started experiencing shortness ofbreath during his regular exercise regimen. He didn't think much ofit at the time—after all, he was a relatively healthy, middle-aged adult. But, he mentioned it to hisdoctor, they performed a stress test and a few days later, he washaving triple-bypass surgery to remove an 80 percentblockage in his “widowmaker” artery.

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Why do I share this story? Because one of the biggest challengeswe face in health insurance is that consumers have long held an“it won't happen to me” or “I won't ever use it”attitude that consistently turns people away from purchasinginsurance. These people end up viewing health insurance policies as“wasted money” since there's often no tangible payoff if they'renot sick or didn't have an accident.

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Related: Behavioral enrollment, part 1

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In my colleague's case, that certainly wasn't true. He was fullyaware of the risks and acutely aware of heart conditions like theone he experienced. However, my colleague's story is a notable onebecause it reinforces just how scary these kinds of situations canbe, and how good insurance products can help defray costs andprotect your family.

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But, when it comes to the future of health insurance, educatingemployees is only one piece of the puzzle for HR teams andcarriers. Another piece that's just as important: developing andimplementing innovative plan features that provide more ways to paypolicyholders. The idea? Employees will get more value from theirpolicies while still getting the important protection theyneed.

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How might they go about doing this? Below are just five ideasthat I've heard come up in conversations with my colleagues, withcustomers, and at industry events in the last few months. I believeit's reflective of where the health insurance industry isheading:

  • Better alignment with current medicalpractices. Carriers should ensure that employees get thepayment they need more often by aligning with modern medicalpractices. If a policy was created 10 years ago, the medical worldmay no longer match the way the policy looks at a condition,leading to claim denials. For example, some policies may require anenzyme test to pay a benefit for a heart attack, but doctors don'talways perform these tests if they already know the patient has hada heart attack. With advances in the medical field occurring at anincreasingly rapid rate, it's critical your policies align withwhat's happening in the doctor's office.
  • Better account for stages of illnesses andinjuries. Help make sure employees get the benefits theyneed by taking into account the stages or severity of particularconditions. For instance, perhaps an employee didn't have a heartattack, but they might still require treatment. Perhaps an employeedidn't break a bone, but they have a severe sprain. Policies can bedesigned to find more options for payment even if the conditionwouldn't traditionally be covered.
  • More coverage for routine test and procedures.Insurance is often associated with protection for when “somethingbad happens.” But, more plans are starting to provide benefits forstandard tests and routine procedures.

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  • Reward “good behavior” more often. In the autoindustry, this is fairly common. Keep a clean driving record for ayear, and get cash back or a discounted premium. In the future,you'll probably see health insurers follow this trend. You'll seemore plans offering a discount or returning premium to employeeswho haven't used their policy. This is a great way to make sureemployees get something out of the policy even when they believe it“won't happen to them.”
  • Offer quicker payments. Expediting the claimsprocess can go a long way toward making employees happier withtheir health insurance. When an employee files a claim, it can beincredibly frustrating waiting for that claim to go through. Thesooner it goes through, the sooner the employee gets paid. It maynot mean paying more, but it certainly negates a sense that thecarrier doesn't want to pay the policyholder.

Bottom line: The more payments an employee receives from his orher policy, the more value they see in the policy. And, the greaterthe value, the more likely an employee is to purchase the product.It's a win for everyone involved and it's the reason that thefuture of insurance is in finding more ways to paypolicyholders.


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Pam Handmaker is thesenior director of product and innovation for Trustmark's disability income products. She isresponsible for researching marketplace trends and assessing thevoice of the customer in order to create new product solutions. Pamhas 15 years of product development experience, including work inthe financial industry at Northern Trust and JPMorgan Chase, andthen at Hewitt Associates earlier in her career, managing a varietyof client benefit implementations.

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