May 2023
Voluntary Benefits Voice M A G A Z I N E
The Great Debate Long Term Care Insurance vs Disability Insurance
Part III: The Current State of Claims The Next Generation of Claims
Disability Insurance Marketplace Update
Editorial Board
Mark Rosenthal PwC
Seif Saghri BenefitHub
Jessica DePhillips Mercer
Michael Naumann Reliance Matrix
Jack Holder EBIS
Jennifer Daniel Michael Stachowiak Colonial Life Aflac
Key Contributors
Steve Clabaugh CLU, ChFC
Editorial Staff Co-Editors Trevor Garbers Trevor@voluntary-advantage.com Heather Garbers Heather@voluntary-advantage.com For Media and Marketing Requests contact: Heather@voluntary-advantage.com and Trevor@voluntary-advantage.com
2023
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FEATURED ARTICLES 01 Market Update: Disability Insurance
Leaders in Disability insurance share current trends and predictions
02 Part III: The Current State of Claims Conclusion of our 3-part series on the claims process today
03
The Great Debate: Long Term Care Insurance vs Disability Insurance
04
Opportunity Ahead: Worksite Disability Income Impact of Economic Factors on Disability Insurance
05 Championship Team Behavior Working Together as Colleagues
Voluntary Disability Insurance
Looking to Attract & Retain Younger Workers?
Plan your work. Work your plan. And most importantly, plan for adjustments along the way. Greetings and happy Spring from Colorado. If you know anything about our great state of Colorado, I need to be very careful when using the term Spring, as by the time I complete this piece we could very likely have 4-5 inches of snow on the ground. In fact, we recently had a wonderful Spring day where the temperature reached 81 degrees on a beautiful Tuesday. It was glorious as the sun was in full-force, people were out walking and doing yard work all while the grills were being broken out for the sunny summer days that await us all. And then, fast-forward 24 hours to Wednesday when we only reached a bone chilling high of 18 degrees. Yes, you read that correctly, we went from a temp of 81 to 18 in back-to-back days. Our great state in a nutshell. Let me be clear, Heather and I absolutely love Colorado and have lived here for the past 16 years and hopefully our careers will allow us to retire in this beautiful state if all goes as planned and we are able to execute our proposed vision as we advance in our careers. However, as we enter May which is Disability Awareness Month, we know first-hand the perfect vision, the well-drawn up game plan or fairy tale golden years of living in the mountains could change in an instant. Like many of you who subscribe to Voluntary Advantage we are all incredibly blessed to impact the lives of so many with the work we do today to protect our most valuable assets. We have brought in the best of the very best within our marketplace this month to discuss what I believe is a benefit that still today is overlooked, misunderstood, grossly misrepresented at times and, should be growing at a faster rate nationally regarding placement, participation, utilization, and overall claims experience by our valued policy holders.
By Trevor Garbers I do know one thing for sure, we have our work cut out as a marketplace in driving change as of today, at least 51 million working adults in the United States are without disability other than the basic coverage available through Social Security. Only 40% of US households have enough in liquid assets to cover three months of their existing expenses. And lastly, only three out of ten American adults indicate that they would be able to pay an unexpected $400 bill without having to carry a balance on their credit card or borrow money from friends, family, or the bank. As I bring this to a close, our challenge to our marketplace is, what can we all do to reduce these gaps in coverage and increase awareness during the month of May as we focus on a benefit that can change the lives of so many as we have a duty to be there when they need us the most. And as always, thank you for supporting our publication. Your feedback has been amazing and we are absolutely blessed to play a small role in helping shape our precious marketplace.
Market Update: Disability Insurance By Heather & Trevor Garbers May is Disability Insurance Awareness Month. To help drive awareness of this valuable benefit, we have interviewed a panel of experts to get their guidance on current trends and the future of the marketplace. Here is what Jessica Moser (JM) – VP Workplace Solutions at Aflac’s Premier Life, Absence and Disability; Brad Maddock (BM) - Regional Manager, Mutual of Omaha; Meghan Shea (MS) - VP Head of Strategy and Solutions at New York Life Group Benefit Solutions; and John Labrie (JL) - AVP Product & Market Development, Unum & Colonial Life, had to say. Some form of disability insurance has been around since the Middle Ages - what is trending in the world of disability insurance today? MS - We are seeing a few key themes impacting both employers and their people including the increasing prevalence of mental health conditions, the role of technology and the regulatory landscape related to paid leave. In terms of technology, we’re seeing a growing expectation from employers around increased visibility into their disability program, tools that make the claims experience easier for their employees and the ability to access detailed activity and status quickly and seamlessly. Finally, we know the leave landscape is becoming increasingly complex. Historically, employers needed to navigate only a handful of leave programs, but today they are navigating an ever-increasing combination of federal, state, municipal and company-specific leaves that vary from state-tostate. BM - We are seeing trends toward richer benefit programs in lieu of richer compensation pay due to the competitive job market. Many groups are looking to make employer paid benefits tax free (gross up or tax choice plans) vs. the traditional taxable benefit.
JL – We are seeing a couple of different trends, 1) creating a better digital experience for employers and employees - it is increasingly important that disability providers digitally connect with employers and employees from the time of enrollment to the time of claim. This connection is typically a win-win for all - ease of administration for employers, faster payments for claimants, and higher customer satisfaction and retention. 2) State Paid Leave programs - The increase of states adopting mandated paid leave plans presents an opportunity for disability providers. These state programs are highlighting the importance and need for disability coverage. This increased awareness will grow consumer interest nationally on the value of this coverage, and there are opportunities to provide coverage above and beyond the state mandated plans. JM – I’ll start with statutory leaves, given the increasing number of various emerging paid statutory leaves, employers are modifying their disability programs and making adjustments in their current offerings to align with what best serves their employees in various states. Next, I would say, tech, tech, tech - no surprise, the increased use and innovation with technology continues to trend. What has changed a bit, is the type of technology and why. First, there’s more of a recognized need for strategic reporting to help employers identify clients’ trends and gaps, and a growing need for true consultative reporting based on carrier analytics. The need for AI continues to grow, particularly for underwriting shops and ease of claims administration, especially in disability, due to its complexity.
Because of the complexity of leave, it can be challenging for employees to decipher disability benefits versus the different types of leave benefits. Meghan Shea (MS) - VP Head of Strategy and Solutions at New York Life Group JM - Finally, although many carriers and tech platforms have been talking about API’s for years, implementation of true APIs to drive data sharing with multiple HR and ben admin platforms still remains significant. Simplicity is also important, as consumers come to expect simple and personalized solutions, there is an increased focus on education to help empower employees to make better choices, in many cases, through digestible education and getting away from industry jargon and “insurance speak” in the communication provided in plans and policies. Comprehensive, understandable and thoughtful communications is crucial to help people navigate and make informed decisions about their care. Lastly, I would add that value adds must bring value. Insurance carriers or vendors are looking more closely at the tangential services they offer to ensure they are sensibly integrated and attractively embedded to address employer and employee needs and create differentiated solutions. For example, an EAP is critical, but in today’s world, it often falls short in terms of value as a standalone concept. Depending on the employer’s preference and culture, some may find better utilization with a telehealth provider that includes behavioral health options. Pricing is important today as we fight the effects of inflation and recession, why might cheaper not always be better when it comes to disability insurance? BM - We all like a fair price for any service, in disability insurance, it is a financial instrument where you don't appreciate the protection until you need it. With average stats of 7 out of 100 employees using STD benefits and 3 out of 1000 insured using LTD benefits, investing in these plans are key. MS - Among different disability insurance policies, there is often a wide range of what is covered under the policy and these differences may be reflected in the price employers and employees are expected to pay. A cheaper policy may offer less coverage or fewer features, and for employees utilizing this benefit, they may find that the benefit they are eligible to receive does not cover their full need. As employers think about a disability offering, it’s important to work with carriers that provide options for plans that meet the needs of the organization’s workforce with flexible funding options and varying employee/employer contributions. It’s also helpful to educate employees about the value of a buy-up plan, as employees often underestimate the likelihood of experiencing a disabling event.
What is the biggest gap that members find in their coverage at time of claim? JM - Members may lack a full understanding of what they bought, which is fairly common. Often, confusion around policy and plan provisions, and how benefits integrate and coordinate (offsets, exclusions, how disability and statutory programs can work together, and more broadly, how employer programs work with Social Security Disability Insurance or an individual disability policy) are a greater challenge. Carriers and vendors should continue to help employers better educate their HR managers (as the first point of contact for an employee) as well as employees about how their benefits work as standalone products, and how they work together. This should be done in a more impactful way than as part of an employee handbook. There is also a great opportunity for thoughtful, specific information to be delivered in a digestible way, in plain language, at the time of claim filing to help the employee get the most they can and feel confident about the benefits they are receiving. BM - Generally pre-existing condition differences and interpretations, which include prudent person language. We also see animosity amongst claimants who are partially disabled as contracts vary dramatically carrier to carrier. Progressive partial, 50% offset, and proportionate loss are three different formulas that change payment amounts to partially disabled claimants and directly affect return to work motivation. Also the difference between "Any Occupation" and "Any Gainful Occupation" which affects claimant eligibility after the general 24 month period. This can remove a claimant quickly with one carrier where, with another they would still have disability protection and receive benefit payments. MS - Because of the complexity of leave, it can be challenging for employees to decipher disability benefits versus the different types of leave benefits. Some leave is paid; some is unpaid; eligibility requirements can differ per leave; each leave can have a different duration; and finally, some of these leaves run independently and some concurrently. It is complex, so most gaps are born from a misunderstanding or confusion around what to expect.
What do integrations between disability and leave management programs mean for the client and end consumer? MS - Ultimately, integrating a disability plan with a leave management program means easier, less resource-intensive administration for employers and a simplified, better benefits experience for employees. The demand for paid and unpaid leave is rising and as states continue to launch programs, employers seek to provide consistency in benefits across their populations. As a result of increasing leave legislation and company leaves, employees may now be eligible for FMLA, state leave, and company leave – in addition to disability – and often these various leaves are running concurrently. The combination of leave types and the roles of the employer and employee can be confusing but integrating absence management with one carrier can enable employers to create a more holistic approach and seamless experience for both employers and their people.
What does the future hold for the disability marketplace? What impact will state leave programs have? JL - We will continue to see advancements in the digital experience, increased awareness of the need for disability coverage and new benefits that support behavioral health issues. The introduction of new state PFML laws will continue to impact the types of solutions we present to the customer. Many of these state programs have high income ratios for employees who earn less than ~$75,000. The impact will be a reduction in premium for some sectors of the disability industry. The good news is there will be opportunities and a need for additional disability coverage in these states with longer duration plans or income replacement above the state plan. The growing recognition of Paid Leave insurance as this new category of insurance is exciting. This helps expand the disability and leave market and recognizes the insurance needs for the modern-day employer and employee.
More specifically, since there is one carrier managing both disability and leaves, there’s no room for finger pointing should something go wrong. There is one source of truth for data, which leads to smoother customer experience when it comes to general questions as well as claims. Jessica Moser (JM) – VP Workplace Solutions at Aflac’s Premier Life, Absence and Disability JL - Coordinating disability and leave management programs has become complex for employers and employees. The future management of these programs will require a strong integrated connection from enrollment to the time a claim is filed. This integration will be enabled by the growing suite of digital solutions being adopted by many disability providers. The result of a strong digital integration experience will create simplification and improvements for employers, while providing a better claims experience for employees. JM - Bottom line, integrations allow for true coordinated leave and disability management. For both the employer and the employee, this can often mean saving time and effort, which reduces cost while increasing satisfaction. More specifically, since there is one carrier managing both disability and leaves, there’s no room for finger pointing should something go wrong. There is one source of truth for data, which leads to smoother customer experience when it comes to general questions as well as claims. Importantly, when these kinds of programs are integrated, employers can apply a holistic lens to identify trends as well as gaps that their employees may be experiencing, enabling them to provide the best and most appropriate benefits.
MS - Issues like the increasing prevalence of chronic conditions, rising healthcare costs and an aging workforce are all likely to impact the disability marketplace in the future. As more states implement paid leave programs, and more employees expect paid leave to be part of a standard benefits package, we should anticipate utilization of these benefits – and the potential burden on employers to stay up-to-date and ensure compliance – to increase. BM - I believe non-integrated disability plans that pay on top of state disability/PFML plans will get more popular over time. JM - Innovation must continue to be the future of the disability marketplace because new and creative solutions will help the industry to effectively create and price products for diverse customer needs in a consistently evolving and complex regulatory environment. An increase in remote and hybrid work environments has led to employees looking for more flexible policies that address their individual circumstances. That means that carriers must stay ahead of these trends and changes to create the right solutions. For example, studies have shown that those who work-from-home or telework often lead a more sedentary lifestyle compared to their in-office peers, which could lead to an increase on musculoskeletal conditions. As these types of trends continue to develop, carriers will need to determine how to best address them.
JM - When it comes to the impact that more widescale leave programs will have, carriers will have to figure out how to quickly enable applicable state leave programs effectively, while employers will need to be aware of the ongoing changes in order to make the most appropriate adjustments to their current disability offerings. This landscape continues to increase in complexity for employers, including compatibility or new integrations, impacts of various state paid leave laws on various demographics, and differences between mandatory and voluntary statutory paid leave programs. There are many ways carriers can continue to help with this ongoing education. Overall, the disability marketplace must continue to evolve to focus on the needs of people with disabilities. I recognize that seems like a simple idea, but with innovation as the how and consumers as the why for our north star, the future will be bright.
It is critical that consumers understand the disability provisions and exclusions at time of enrollment to reduce possible confusion at the time of a claim. This is why there is a need for strong employee education, engagement, and an easy-to-understand enrollment process at the point of purchase John Labrie, Assistant Vice President of Product & Market Development, Unum & Colonial Life As you can see, disability insurance is growing in complexity as states adapt leave programs, and carriers are already adapting to the evolving legislative landscape to fill gaps in coverage and provide value to members. It is our job to ensure that members understand these valuable benefits and purchase adequate coverage for their needs, and that our clients receive the guidance they need to administer these programs effectively for their employees. Disability insurance is for anyone who works #DIAM2023
John Labrie, Assistant Vice President of Product & Market Development, Unum & Colonial Life - John is an innovative insurance leader with expertise in product development and risk management. He has U.S. and international insurance experience in Life, Disability, Paid Leave, and Supplemental Health products.
Jessica Moser, Vice President, Workplace Solutions at Aflac’s Premier Life, Absence and Disability organization – Jessica Moser leads Workplace Solutions, with accountability for strategic creation and implementation of new Group Life and Disability solutions within Aflac. Focused on the customer, she is responsible for developing innovative strategies, driving results and expanding to new markets.
Brad Maddock, Regional Manager & National Practice Leader – Voluntary Enrollment Strategy - in his role with Mutual of Omaha, he has achieved national individual and team success that includes being a multi-year winner of Rep of the Year, Voluntary Rep of the Year, Most New Customers Award, Nationwide MVP, and Office of the Year. In Brad’s new role of “National Practice Leader – Voluntary Strategy”, he is working hard with his new STEPS team to create the largest enrollment ecosystem in the country, already servicing over 1,200 group enrollments in 2022 alone.
Meghan Shea, Vice President and Head of Strategy and Solutions at New York Life Group Benefit Solutions - Meghann oversees the Product & Experience, Marketing, Project Management, and Learning & Development teams. She is responsible for the long-term vision, short-term strategy, and timely delivery of all products and connected experiences to drive value for NYL GBS clients, customers, and brokers.
Eastbridge: Voluntary Disability Insurance As a Key Contributor to the Voluntary Benefits Voice, Eastbridge Consulting will be sharing content from our research and experience that aims to represent the perspectives and “voices” of the many different stakeholders in the voluntary market. This month we are sharing perspectives from our Brokers Back in Business SpotlightTM report
Eastbridge is the source for research, experience, and advice for companies competing in the voluntary space and for those wishing to enter. For over 25 years, they have built the industry’s leading data warehouse and industry-specific consulting practice. Today, 20 of the 25 largest voluntary/worksite carriers are both consulting and research clients of Eastbridge. Nick Rockwell President
Danielle Lehman Senior Consultant
Part III: The Current State of Claims (Conclusion)
By Heather & Trevor Garbers
XXX This is the final article in our three-part series on claims. This was an important topic for us to cover as technological advances have changed the demand for services from our consumer, and we as an industry need to evolve to meet their expectations. What do we mean by that? Today, your OnStar system knows if you have been in a car accident and can call for help. You can even submit a claim to your car insurance carrier from your smartphone within minutes. While filing out a paper claim form and mailing or faxing it to the carrier (after waiting weeks for itemized EOBs to come in or for your Physician to complete an APS), is a good fit for some individuals to file claims, it is not a fit for the changing demographics of the workforce. Should the employee benefits industry leverage technology to evolve similarly to the car insurance industry? This question is important for us to ask when it comes to engagement and persistency rates. If the claims process is difficult, the perceived value of the plans declines, and it impacts enrollment rates and the number of individuals canceling their coverage after the first claim attempt. At this point, my own 80-year-old grandmother orders from Amazon on her smartphone, uses online banking to manage her accounts and even transfers $25 into my account every October 1st. Today, we have generations in the workforce that do not know what a fax machine is, have never stepped inside a physical bank, and may not own a desktop computer or printer, and we need to meet them where they are to maintain engagement of these benefits. Our first articles in this series shared insights from the Carrier point of view and then from Brokers across different segments in the marketplace.
By Heather & Trevor Garbers
This time, we have interviewed stakeholders from an outside point of view, the vendors behind the systems that are trying to enhance the process today. Christy Traupe (CT) is SVP Claims and Absence with FINEOS and Tracy Funk (TF) is the Supplemental Benefits Practice Lead at Benefits Science Technologies, a Multiplan Company. FINEOS is a global software company providing modern customer-centric core software to the Employee Benefits and Life, Accident and Health industry. Benefit Science Technologies combines world-class technical knowledge and practical experience to harness powerful data science insights for the healthcare industry. What is the average utilization of supplemental health products today and what should it be? TF – Based on our research, the utilization of supplemental health products still remains quite low today. Our findings indicate that less than 40% of eligible claims are filed, which is a clear indication that the industry needs to work towards improving utilization. Employers who provide supplemental benefits to their employees should anticipate that their trusted advisors and supplemental carrier partners have a claims integration strategy in place to address this issue. CT - Utilization is still low, but it is increasing. According to an Aon survey in the SHRM article, “Employees Want Voluntary Benefits but Don’t Always Understand Them,” Accident Insurance (AI) and Critical Illness (CI) utilization both went up 10% from 2021 to 2022. CI went from 16% in 2021 to 27% in 2022 and AI went from 13% to 23% across that period. I don’t know if there is a specific benchmark for what utilization should be but I do think it is a measure of success if utilization continues to increase over time.
Are you seeing an increase in carriers that would like to find solutions to increase claims utilization? What is behind this? CT - Yes, more carriers are trying to find solutions to increase claim utilization and this is being driven by the increasing demand for Voluntary Benefits. People are trying to find ways to increase their financial security as they confront increased medical costs, inflation, and economic uncertainty. TF - Employers have a fiduciary responsibility to ensure that their benefit plans provide maximum value for their employees, who often pay for these plans out of their own pockets. Loss ratios have been historically low, which reinforces the need for carriers to develop effective claiming strategies. We anticipate that within the next 12 months, all of the top 20 supplemental carriers will have wellestablished claiming strategies. What does claims integration mean and how does it work? CT - Claims integration is treating a claimant’s life event that may result in multiple benefits as a single connected event . Other ways to frame it are using the data from one claim to identify other benefits the claimant might be eligible for; or allowing the claimant to file once with the carrier without having to specify which benefits they are filing a claim for. With claims integration, modern technology identifies the coverages a claimant has so that the claims managers know all the available benefits to review and approve. For example: A claimant might file a claim because they were in a car accident and had to stay in the hospital for surgery. They call the carrier to start a Short-Term Disability (STD) claim, but they also have AI and Hospital Indemnity (HI) that they may have forgotten about. As the STD claim is entered into the system, the case manager is notified that there are also AI and HI benefits available, so they can process all the claims at one time and the employee can be informed of – and receive payment for -- all benefits available to them at the same time. TF – When it comes to claims integration, obviously the medical carriers that provide both medical and supplemental products have a competitive edge in implementing advanced claiming strategies due to their access to medical claims data. Meanwhile, other supplemental carriers that compete with these medical carriers may be actively seeking ways to comply with regulations, while still enabling their clients to maximize the value of their purchased products in a similar fashion. This involves a thorough assessment of the supplemental benefit plans and matching relevant medical claims codes such as ICD10, CPT, and DRG to those benefits.
Incorrect mapping of claims data and policy provisions can result in missed or falsely identified potential claims, leading to frustration and confusion for employees. Tracy Funk, Supplemental Benefits Practice Lead at Benefits Science Technologies TF - It also involves obtaining medical claims data with appropriate agreements and authorizations, as well as integrating this data with supplemental health enrollment and individual authorizations to identify potential supplemental health claims. As claims integration is growing in importance, why isn’t it more mainstream today? What works or doesn't work when it comes to claims integration? TF - Access to medical claims data is crucial for successful claims integration, but it's not always easy to obtain. Some medical carriers may be hesitant to share data with perceived competitors, which can cause obstacles during implementation. It's also important to consider the supplemental plan provisions and how they align with medical claims codes when moving towards an auto-pay strategy. Incorrect mapping of claims data and policy provisions can result in missed or falsely identified potential claims, leading to frustration and confusion for employees. Effective communication is essential for employees to understand the benefits of claims integration. It's difficult for employees to appreciate the value of claims integration when they have to make quick benefit elections. A wellcommunicated plan, user-friendly benefit administration platform, complianceknowledgeable consultant, compliant third-party data aggregator, and a supportive supplemental carrier are all essential components of a successful claims integration program. It's vital for carriers to clearly explain their process and get stakeholder buy-in early on. CT - What works and doesn’t work both come down to data. What makes claims integration successful is having data in a single-source system and having that data well-defined. Having to pull data from multiple systems makes it more challenging because integrating across systems alone is difficult, and if those systems are older legacy systems, that will make it even harder. Getting the data translation to sync up between two systems will take a lot of planning, mapping, and testing to make sure it is consistent across systems. This isn’t impossible, but it will take time and planning.
What compliance regulations hinder additional efforts? Are there limitations to how data can be shared? TF - For claims integration to be effective, there are various compliance requirements that must be met. Foremost, members must provide authorization for their claims data to be used for the purpose of identifying or paying out supplemental claims. While this can impact utilization, it is crucial for individuals to have the right to choose whether or not their personal claims data is used for claiming on a supplemental benefit. In addition, there must be an agreement in place between the health plan and the party that receives the medical claims data. For selfinsured plans, this is typically a Business Associate Agreement (BAA). Furthermore, the supplier of the medical claims data must also have a data share agreement in place to share the medical claims data. Medical carriers are accustomed to collaborating with trusted third-party data partners to assess the appropriate protections and ensure that there is a chain of BAA custody between the relevant stakeholders. Where do you anticipate claims integration to be 2-3 years from now? CT - As with everything today, technology will be a key component. Carriers that are still using multiple systems and/or legacy systems will definitely be trailing in the market for a few reasons. Claimants should expect an easy process to file for their benefits and get paid quickly. Because claims integration helps claimants to receive the fullest benefits possible to protect their financial well-being, it will become all the more important. Every organization is trying to find ways to cut costs, increase efficiency and raise customer satisfaction. If carriers can process multiple claims with fewer case managers because of claims integration, they can significantly reduce overall costs. Claimants should expect an easy process to file for their benefits and get paid quickly. Because claims integration helps claimants to receive the fullest benefits possible to protect their financial wellbeing, it will become all the more important. Christy Traupe, SVP Claims and Absence with FINEOS TF - Within the next three years, it is anticipated that a majority of supplemental carriers will have implemented an auto-pay strategy to some degree. This may be as basic as automating wellness claims (which some carriers already do currently) or as intricate as automatically filing or paying out hospital indemnity and critical illness claims after a cancer diagnosis.
The adoption of auto-pay strategies will likely occur gradually as carriers become more comfortable with the data they use for claims integration. The level of sophistication of their integrated claims solution will determine how quickly a carrier is confident enough to move towards auto-file or auto-pay options, and most carriers will proceed cautiously. Stating that a carrier auto-pays supplemental claims is a powerful statement, and the carrier will not want to be in a position where they must revoke this due to unexpected outcomes. The most successful carriers in this area will have the capability to oversee the claims that are auto-paid and have numerous mechanisms to ensure their success, ranging from specific claims to a dollar threshold.
How can we increase utilization on these plans outside of claims integration? CT - Ongoing education is the key to increasing any type of benefits utilization. A once-a-year communication that goes out during open enrollment is not enough to expect people to remember they have benefits available. You must meet people where they are and provide them with easy access to materials however they would like to access them. Again, technology can be part of the solution. For example: campaigns through portals that popup banners to remind people of voluntary benefits that might be available, or short ondemand videos on an intranet site that can be viewed at an employee’s convenience. There are apps that can house all of your benefits information in one place, so a person can just look in the app to understand all the benefits they have signed up for when they need to file a claim. Employers can go beyond the carrier and work with all their vendors to include information in communications they are sending.
Our goal with this publication is to share information and thought leadership to drive innovation in our industry. Innovation in this context, means enhancing the member experience when it comes to claims. To get there, we need more widescale adoption of: A completely online, mobile optimized or appbased (did we mention paperless?), claims submission process. Use of integrated technologies to assist in proactively notifying members of potential claims and eliminating redundancies in processing multiple claims for the same event.
More engagement with the consumer to enhance their comprehension of the plans and proactive nudges to file claims throughout the year. We’ve seen a shift away from mailing employees a copy of their certificate of coverage after they enroll, making the 18 minutes spent enrolling in benefits each year, the only time an employee thinks about these benefits throughout the year. As these benefits are now mainstream, as clients expect to see an ROI on their benefit programs and as employees’ expect to see more value for their dollar, we need to leverage technology to enhance the employee experience if we want to appeal to the next generation of workers and increase plan adoption.
Tracy Funk, Supplemental Benefits Practice Lead at Benefits Science Technologies, a Multiplan Company – Tracy is a seasoned professional with a wealth of experience in the employee benefits industry. At BST she is responsible for cultivating and expanding partnerships with supplemental benefit providers while driving innovation in the market. Tracy lives in Roswell, GA and is passionate about helping employers and employees maximize the value of their benefit plans.
Christy Traupe, SVP Claims and Absence, FINEOS - Christy has over 20 years of experience in disability and absence management. Prior to her position at FINEOSS, she spent 11 years at Reed Group as director of operations and director of product and quality, and 4 years in the employer space at DaVita where she led the leave of absence and the health and welfare teams.
Looking to Attract & Retain Younger Workers? Offer Non-Traditional Benefits WINDSOR, Conn., May 10, 2023— New LIMRA research reveals today’s younger workers expect a broader array of benefit offerings from their employers. While a majority of younger workers consider traditional benefits (such as paid time off, medical, and retirement savings plans) very important, they also prioritize non-traditional benefits, including flexible work schedules, emergency savings benefits, tuition reimbursement, and financial, mental and health wellness programs. “While salary remains the number one consideration for many workers, the majority of workers (56%) rank something other than salary as their top priority when evaluating a new employer,” said Patrick Leary, corporate vice president and head of LIMRA’s workplace benefits research. “Employers must offer a comprehensive benefits package to attract and keep their workers. Our research suggests younger workers want greater flexibility and support to help them achieve a wellbalanced life.” In its second year, LIMRA’s 2023 BEAT Study: Benefits and Employee Attitude Tracker, provides an in-depth look at workers’ perceptions about their benefits and their employer.
“In this competitive job market, offering an attractive benefits package is only an advantage if the employees are aware and understand the benefits available to them,” noted Leary. “Our study showed just 55% of employees feel they understand their benefits very or extremely well.”
The study finds workers with more educational resources available to learn about their benefits are more likely to be knowledgeable and satisfied with their benefits package, which will position them to make better decisions. Overall workers report using online resources, in-person meetings, and printed materials the most to learn about their benefits. Millennial and Gen Z workers are more likely than older generations to rely on email, phone, and online chat to learn about benefits. External factors influencing workers’ benefits decision Generally speaking, workers make benefit selections based on their personal needs, risk factors and recent life changes. Economic uncertainty and the residual impact of COVID-19 also have influenced workers’ benefit choices. More than half of all workers said inflation and the potential for an economic downturn affected their benefits decisions. Millennials and Gen Z workers were more likely to worry about economic conditions and as a result could be more hesitant to spend additional money on benefits, opting instead to hold onto their money in case of economic hardship. Companies should communicate the risks of not having coverage and reinforce the value of workplace benefits.
In a 2020 LIMRA study, 54% of workers viewed their benefits as more valuable because of the pandemic. Today, 4 in 10 said COVID-19 continues to influence the benefits they select. Again, younger workers were more likely to say concerns about COVID-19 influenced their decisions. “Understanding workers’ mindsets — particularly those in younger generations — will enable employers and providers to better position the benefits available and communicate their value,” said Leary. “Despite emerging negative economic indicators, the job market remains strong. One way employers can edge out their competition is to offer a robust workplace benefits package and educate their workers about those benefits throughout the year.”
About LIMRA Serving the industry since 1916, LIMRA offers industry knowledge, insights, connections, and solutions to help more than 700 financial services member organizations navigate change with confidence. Visit LIMRA at www.limra.com.
The Great Debate: Long-Term Care Insurance vs. Disability Insurance By Marc Glickman, CEO and Co-Founder, BuddyIns More employers today are considering a long-term care insurance benefit for their employees. This additional benefit can help attract and retain great talent and also help employees better plan for their own futures. Since many employers already offer disability insurance (DI), there may be some confusion around the need for longterm care insurance (LTCi) and the differences between disability insurance and LTCi. With May being Disability Insurance Awareness Month, let’s take a moment to learn the differences between DI and long-term care insurance. Both benefits have a place in an employee’s overall financial plan. Long-term care insurance and disability insurance are both designed to help someone cope with a loss of function but for different purposes. However, they have some commonalities, including: Group coverage may be available with limited or no health underwriting If purchased as individual coverage with more comprehensive benefits, require health underwriting They both fit into a comprehensive financial plan Let’s look at each type of coverage. What is long-term care insurance? Where disability insurance covers a loss of income, longterm care insurance covers the cost of care for people who need assistance with activities of daily living due to chronic illness, disability, or aging. Long-term care insurance can help protect one's assets and income from being depleted by expensive bills and provide peace of mind. Reasons why someone would want to purchase long-term care insurance are: To have more choices and control over the type, quality, and location of care they receive, whether it is at home, in a facility, or in a community setting
To avoid relying on family members or friends for caregiving, which can be stressful, timeconsuming, and emotionally draining for both parties To reduce the risk of becoming impoverished or dependent on public programs such as Medicaid, which may have limited coverage and strict eligibility requirements To take advantage of tax benefits and incentives that may be available for long-term care insurance premiums and benefits To plan and ensure that they have adequate resources and support to meet their long-term care needs Liam’s LTCi Story Liam had always been a healthy and active person. Even well into his seventies, he maintained an active lifestyle. One day he started feeling tired and nauseous but thought it was just a flu bug. After several weeks, he decided to see his doctor, who ran some tests and delivered the shocking news: Liam had kidney cancer. He needed surgery to remove the tumor, followed by chemotherapy and radiation. It also meant that Liam would need long-term care. When Liam was 55 years old, he met with a long-term care insurance specialist who suggested he consider adding LTCi to his financial plan. Because Liam was in good health, he was approved for an LTCi policy. Fast forward 20 years and as Liam started chemotherapy and radiation, his LTCi policy gave him the financial means to be able to consider several options for his extended care, including home care and assisted living. He and his family decided on a local assisted living facility that provided him with meals, transportation, and social activities. He felt comfortable and supported in his new environment, and he made friends with other residents who were going through similar challenges.
Long-term care insurance gave Liam and his family peace of mind during a difficult time. It allowed him to choose his care options and maintain his dignity and independence. It also protected his financial security and legacy for the future. How do you obtain long-term care insurance? Many people obtain long-term care insurance from a private insurance company. However, more employers are offering a group plan – one of the simplest and most cost effective ways to get coverage. Often these policies are a guaranteed issue group benefit. The enrollment process can be as simple as filling out an enrollment form. Group LTCi or hybrid plans are also portable to an individual plan upon leaving the company or retirement. Offering employees a base plan allows them to then consider an individual supplemental plan that may provide even greater coverage. Getting individual coverage can be more complicated but also offers greater benefits overall. There will be an underwriting process that involves responding to health related questions. You will also have to undergo a medical exam. The insurance company will then determine your eligibility and premium based on your age, health, and the level of coverage you want. You can compare different policies and rates from different companies before you make a decision. Individual long-term care insurance can be more expensive than obtaining coverage through an employer, but it can also provide much greater protection. Life insurance with an LTCi rider are hybrid policies that provide a death benefit to beneficiaries if care is never needed. These group hybrids are more commonly offered than group standalone LTCi in the market today. What is disability insurance? Disability insurance is a type of insurance product that can protect against a loss of income if a policyholder is prevented from working due to a disability. A disability can be caused by an illness or injury that affects the ability to perform core work functions. Disability insurance can replace a portion of the policyholder's base salary, usually 40% to 70%, up to a certain limit. Reasons why someone would purchase disability insurance include: Can provide financial protection and peace of mind for people who rely on their income to support themselves and their families. The risk of becoming disabled for an extended period of time is higher than many people think. According to the Social Security Administration, more than one in four 20-year-olds will experience a disability for 90 days or more before they reach age 67.
Without disability insurance, a loss of income due to a disability can have serious consequences, such as difficulty paying bills, saving for retirement, or maintaining a standard of living. Remember that DI is to protect against loss of income. That means that when employees retire, there is no longer a need for it. Zoey’s DI Story Zoey, a software engineer at a major tech company, was driving home from work when a truck ran a red light and hit her car. She was rushed to the hospital with a broken leg and had to undergo multiple surgeries. She was unable to work for three months and faced mounting bills and living expenses. Fortunately, she had taken advantage of the disability insurance offered by her employer. It covered 60% of her income while she was recovering. The insurance company also provided her with a case manager who helped her navigate the health care system and access the resources she needed. Alice was grateful for the coverage as it protected herself and her family from financial hardship. How do you obtain disability insurance? There are two main ways to obtain disability insurance: through an employer or as individual coverage. Many employers offer short-term and/or long-term disability insurance as part of their employee benefits package. These policies are typically cheaper and easier to qualify for than individual policies, but they may have lower benefits, longer waiting periods, or stricter definitions of disability. They also may not be portable, meaning an employee could lose coverage if they change jobs. Purchasing disability insurance as an individual can be done directly from a broker. These policies are more expensive than offering it to employees as a group benefit and require medical underwriting. On the other hand, they offer more flexibility and customization. You can choose the benefit amount, duration, waiting period, and definition of disability that suit your needs and budget. You can also keep your coverage as long as you pay the premiums, regardless of your employment status.
The Bottom Line: Peace of Mind and More Options By now it’s clear that both disability insurance and long-term care insurance have a place in any employee’s financial plan. Disability insurance and long-term care insurance are two types of policies that can help protect income and assets in case of a serious illness or injury. Disability insurance provides a continuation of income if the policyholder is unable to work due to a covered condition, while long-term care insurance covers the cost of services such as nursing home care, assisted living, or home health care – very real expenses that are not covered by health insurance or disability insurance. By purchasing both types of insurance, employees can ensure that they are protected for different scenarios that might create tremendous financial hardship in the future. Marc Glickman, FSA, CLTC, is CEO and co-founder of BuddyIns, a leading long-term care insurance education, marketing, and technology company. Marc is a licensed insurance agent in all 50 states and serves on the Board of Advisors for CLTC. Marc has over 15 years of experience as an actuary including as the Chief Investment Officer and Chief Sales Officer for a major LTC insurance company. Marc earned his degree in economics from Yale University. In 2019, Marc was named one of the top 20 innovators in the insurance brokerage space.
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Opportunity Ahead: Worksite Disability Income By Bill Bade, FSA, MAAA Consultant, Sydney Consulting Group In The Open Door, Helen Keller writes “Security is mostly a superstition, it does not exist in nature, nor do [children] as a whole experience it…Avoiding danger is no safer in the long run than outright exposure…Life is either a daring adventure or nothing.” The passage itself has additional context and is worth reading, but there is plenty of meaning to be found in the above snippet. Many of us live life as an adventure, and we contribute to a simple fact: 25% of adults will become disabled before retirement age.1 Worksite disability products fulfill this need, particularly in the subset of small to mid-size employers when voluntary short-term disability income (can we all agree to call it SDI instead of STD?) is an employee’s primary access to disability coverage. As carriers broaden their portfolios beyond Accident, Critical Illness, and Hospital Indemnity, SDI is an increasingly attractive option similar to the trends in gap and worksite life. These SDI products are typically easy to understand for consumers and have expanded to include mental health and other coverage. Conventional wisdom suggests that SDI claims are influenced by economic factors, and this is particularly 2 relevant during the current inflationary period with no shortage of advisors suggesting a recession is near. Should higher claims drive away potential insurance carrier entrants to the SDI market? For the purposes of this article, we pulled experience from two large insurance carriers with products launched in the 1990s. These products covered two recessions: the Dot Com Recession of 2001 and the Great Recession of 2008/2009. Table 1 shows that both of these periods were associated with slight upward movement of the actual to expected incurred loss ratio.
1. https://www.ssa.gov/disabilityfacts/facts.html 2. https://www.businessinsider.com/recession-outlook-us-economy-downturn-fed-interest-rates-inflation-banks-2023-5
The loss ratio patterns are relatively stable despite two significant recessions. Importantly, what little to moderate fluctuation does exist can be mitigated through appropriate pricing methodology. Through this simple data pull and our experience developing product, we observe three key trends in the SDI market: 1. SDI products have historically run closer to pricing than Accident and Critical Illness products; 2. Disability sales leveled off to some extent after implementation of the Affordable Care Act, likely due to the emphasis placed on Accident and Critical Illness; and 3. There is a resurgence of disability product activity that leads to believe the product line is primed for expansion. We are grateful to Voluntary Advantage for the opportunity to participate in the Disability edition. We look forward to reading the contributions of others to the publication, and appreciate the attention generated for this important product line. We remain excited about the possibilities for growth and innovation in the SDI market.
Bill Bade, FSA, MAAA – Consultant. Bill founded Sydney Consulting Group with a strong desire to provide client-focused actuarial, compliance, and strategic support to carriers of all sizes in the supplemental benefits industry. Sydney Consulting Group’s product expertise includes, but is not limited to, Accident, Cancer, Critical Illness, Hospital Indemnity, Long / Short Term Disability, Term Life, Universal Life, and Whole Life.
Championship Team Behavior Part 1 – Working Together as Colleagues By Steve Clabaugh, CLU, ChFC Being part of a team trying to win a championship is one of the most enjoyable, and at the same time stressful, experiences you can have. Whether it’s a sports, educational, or other activity-based team event it is exciting to do your best and be measured against the best efforts of the other teams. There’s just nothing else like facing the “thrill of victory or the agony of defeat,” as they used to say during the opening of ABCs Wide World of Sports tv show. It can be equally passion inspiring to cheer for a favorite high school, college or professional team. Whether you’re a team member or an ardent fan, the one downside of all team events is the reality that once the competition is over for that season every team starts over again for the next season. While there are some teams that are consistently strong competitors, they still have to start every season with the same record as everyone else. Business teams, however, have the amazing opportunity, not only to build winning teams but to continue and enhance their success on an ongoing basis without having to start over again every season. This, to me, is one of the most exciting aspects of virtually any business.
Since we in business are able to improve and grow continually, what do those organizations who sustain and enhance their operations and profitability on a perpetual basis have in common? How do winning business teams work together to keep on winning? What are the behaviors of championship teams? There are many different definitions of Championship Team Behavior, and it can be confusing to determine which ones are the best for any given organization. A quick check on Google identified 58,400,000 results. Yes, you read that right - fifty-eight million four hundred thousand results for the query Championship Team Behavior. I had the privilege of reporting to and working with a gifted and generous individual who I consider to be the finest mentor of my entire business career. He taught and practiced Championship Team Behavior based on 6 key principles which he expected those of us, his direct reports, to live by and to teach to the teams that reported to us. Over the next few issues, I plan to share with you the principles I was taught and have used successfully working with 3 different companies I was privileged to serve. Here is the first one.
Because there is no season! Yes, I realize that we measure our results on a monthly, quarterly or annual basis. And we have contests and conference qualifying periods – mostly for sales associates. But we don’t have to start those teams from scratch as the new month, quarter or year begins. In fact, we tend to measure our success as a percentage of increase or improvement over the prior measurement period. This gives us the opportunity to invest time, energy and resources building teams in all disciplines, not just sales, that can continually improve contributing more and more benefit to the overall organization.
Championship Team Behavior #1 – We Work Together as Colleagues! This principle says that the potential contribution of each member of a project team is equally important. Team members are free to share ideas, challenge assumptions and even disagree with other members who may be of a higher rank or level of authority. The importance of the team’s mission requires the best ideas from all the members and supersedes the title of any one member. So, we commit to working together as colleagues joined together in a cause that is vital to our team and organization’s success.
Positions, titles and levels of responsibility are very important and most of us aspire to achieve increasingly higher levels of each. The desire for upward mobility is a great thing and should be encouraged. But when it comes to selecting, organizing and implementing project teams it can literally block the team’s ability to succeed. We don’t want to miss out on a game changing idea because a “junior” member of the team is intimidated or not free to share it. In fact, it has been my experience, on more than one occasion, that the team members closest to the issue at hand often have the best and most practical ideas about how to resolve that issue regardless of their title. One practical way we applied this principle was in the process of developing the annual plan and budget for a small company. Each team member represented a vital discipline of the company (we have also used this effectively at the division level in a large corporation). The first meeting of the team required each member to present to the whole team the projects and plans they wanted to focus on in the next fiscal year. Discussion and questions were centered on why they chose these plans, how they perceived their plans fit into the overall organizational goals, a high-level estimate of the budget needed and how their plans would impact company profitability. Discussions were often intense, requiring participants to be at times dedicated listeners and at other times dedicated speakers as the situation called for. This first meeting usually took a long time, often over a 2day period. After the initial meeting, team members were responsible for interacting with their counterparts in finding ways their plans could become aligned with each other and then with the whole group. After a reasonable period of time (usually 2 or 3 weeks), we reconvened the entire team to repeat the process of the first meeting.
This time, each presenter demonstrated how their plan and budget fit into the plans of the other disciplines and supported the overall goals of the organization. As we considered each area’s plans the members offered input to support, enhance and sometimes challenge the plan. While there was still work to do finalizing and rolling up the departmental plans into a consolidated presentation for board approval, we pretty much had a good picture of where we planned to go in the coming year. It is important to note here that this was not an easy or tension free exercise. Many times, the priorities of one area were almost directly contrary to the desired plans of another. A project that is considered absolutely essential to Human Resources can seem meaningless to IT, Actuarial or Sales. This tension can be compounded if there is even one new member of the team resulting in ramping up the pressure in the Storming Stage of team development (see the April edition of Voluntary Advantage for the article on Dr. Tuckman’s FSNP process of team formation and productivity). Every time you add a new member to a team the process starts over again. Conversely, the longer a team is together the better they become at mastering the process. Next month we’ll look at 2 key principles that are vital in helping manage differences among team members in a positive way. In the meantime, please feel free to reach out to me if you have questions or want to discuss how to implement Championship Team Behavior in your organization.
Together Everyone Achieves More
Steve Clabaugh, CLU, ChFC started his career in insurance as a Field Agent, moving on to a Sales Manager, General Manager, Regional Manager, Vice President, Senior Vice President, and President/CEO. A long time serious student of professional leadership, Steve created the Relational Leadership program that has been used to train home office, field sales associates, mid-level managers, and senior vice presidents. If you are interested in working with Steve on an individual or organizational basis, contact him at sjcsr2@hotmail.com.
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