Didn’t get to attend the PIMA Winter Insights Conference this year? Or maybe you did go but your team couldn’t attend all the sessions? Never fear, Point Health is here! We rounded up some of the biggest and most important topics covered at PIMA and compiled them in this blog so you can easily catch up. Let’s get started:‍

State insurance department scrutiny is on the rise.‍

Associations are under increasing scrutiny by different states’ departments of insurance. This is bad news because it could potentially limit members’ ability to get valuable benefits; i.e, different DOIs have different and evolving opinions about what constitutes a “group” and what can be offered by different associations and affinity plans. This scrutiny also creates a regulatory patchwork that is difficult for everyone involved to navigate. Steve Leverone of Chubb Services Corporation, worded it this way: ‍

“You’re not offering benefits in one country, you are offering them in 50 different countries.” ‍

Each “country”, in this sense, is a state in the U.S.. So, what can associations and their partners do? First of all, help your fellow PIMA members out by sharing information about emerging shifts in regulatory approaches in different states. Further, it is worth exploring collective action on helping regulators understand the value that member receive and what those constituents would lose if changes were made. Finally, it might be to take an even more focused approach to communicating and making recommendations to the DOIs as an organization. ‍

Benefit add-ons need to be clear and simple.‍

We all know that association and affinity staffs have limited time and resources. Honestly, almost every staff at every kind benefit-providing  entity has limited resources. For those who are pitching benefits and add-ons for associations and affinity groups to include in their plans, you have to focus on more than a great product and service. You also need to focus on clear, simple execution. If it takes months and tons of manpower to get your add-ons to a usable state for members in an association or affinity group, you’re missing out on making a crucial step of the consumer journey exceptional. To make a new benefit offering work for all the value - including the added value - it has to be clear and simple to execute for the staff of the association or affinity group. Look to partner with other PIMA members to bring a complete, turn-key offering to the table.‍

It’s imperative to choose benefits that meet three top criteria.‍

What are those top three criteria? Member value, member loyalty, and cost savings. When offering a benefit to members, the hope is always that it will lead to retention, renewal, referrals, and greater growth. But how do you make sure the benefit you choose to add to your offerings is really going to do those things? An excellent strategy to achieve those criteria is to offer a benefit that simply adds value to an already existing benefit. For example, something that increases the value of a benefit that is already being offered like a limited benefit plan. 

We’ve seen this with many of our clients when we help their members shop for the highest value care to maximize the benefit of the funds they receive. You can see how we helped one limited  benefit plan member, Christian, who needed a rotator cuff surgery. His plan had a $3K max for the surgery and he was quoted $68K by his local hospital. Our health navigators found and guided him to a nearby Ambulatory Surgical Center, saving him $60K. Had he taken the first price - as most health consumers do -  his benefit would have been 4.4%. Not very satisfying, likely not increasing his loyalty. With the help of savvy healthcare navigation, his benefit ended up being 37.5%, and he had full knowledge of how bad it could have been. Better loyalty situation? Definitely.

Moving forward.‍

The great news is that having a community of actively engaged B2B2C-serving ecosystem members helps address all of the challenges mentioned above, and PIMA is at the forefront of making sure these organizations are thriving and collaborating. We look to supporting these goals as an actively-engaged PIMA member.