PAINS

   Low enrollment
   Broker management issues
   Low customer retention
   Inaccurate reporting
   Quoting and underwriting delays
   Marketing campaign issues
   Competitor tracking
   Low productivity
   Increasing claims costs
   Increased expenses
   Billing issues
   Profit losses
   Merger difficulties
   Multiple offices and branches
   Internal communications
   Excessive paperwork
   Decrease in service quality
   Other

PAIN DESCRIPTION:

As you know, a broker is a salesperson who has obtained a state license to sell and service contracts of multiple health plans or insurers, and who is ordinarily considered to be an agent of the buyer. Health Plans are interested in keeping relationships with brokers warm since profits of both depend on a strong partnership.

Many insurers find it challenging to maintain strong relationships with independent brokers and agents. The following problems might arise when dealing with brokers:

1. Slow response with rates, quotes, and renewals.
2. Channel conflicts.
3. Management of broker commissions.
4. Knowledge of what other HMOs your broker works with.
5. Management of multiple broker licenses.
6. Complicated broker appointment process.
7. Confusing hierarchy and relationships between general agencies, agencies, and brokers.
8. Waste of rating time when multiple brokers request quotes for the same company.
9. Waste of quoting time when brokers always use you as a third runner up.
10. Management of marketing materials; library for brokers.
11. Weak campaigns to selected brokers; not rewarding top producing brokers.
12. Insufficient knowledge about brokers' interests and preferences.
13. Insufficient reports on broker's performance.
14. Errors and omissions coverage.
15. Fraud control and prevention.
    

PAIN ANALYSIS:

A good broker will form a partnership with you in the delivery of solutions for your risk management concerns. Brokerages can perform many support functions to augment your staffing and internal procedures.

In return, you can help brokers with:

• Quotes and Proposals
• Establishing the Sales Process
• Sales tools such as Benefits Summaries
• Product information
• Representation on sales calls
• Marketing materials

Slow response with rates and quotes may prevent your HMO from being in the top three choices a broker will present to his client; delays with renewals will irritate broker's clients, and a broker may recommend they switch to another insurer. You can speed up the quoting process by having an automated system that will instantly submit required information to the underwriting and notify you when the results become available.

Managing multiple broker licenses might be a challenge if you do not have an easy and accessible view of the broker's profile. Would it be useful if you could see a list of brokers with a certain license type, or what licenses brokers have in certain counties/states, or keep track of licensing history for each broker? The answer is "yes". Do you have a complicated broker appointment process? Do your brokers have to fill out numerous forms, profiles, and questionnaires? Do your regional directors respond promptly to brokers' applications and process them quickly? To optimize your communication with brokers, you need additional brain power to ensure efficiency and zero delays. Why not let a system supervise these processes?

If you have a direct sales team, there is a great possibility that your sales reps might compete with your brokers for certain prospects. If your goal is to eat a meal, why do you allow your hands to fight for the spoon? If you are deciding between in-house reps and brokers, the trend is toward the use of brokers, especially for smaller, non-national accounts, and away from in-house sales staff, says Terry Cooney, managing director of brand protection and financial services for the Blue Cross Blue Shield Assn. But if you have both channels, how do you resolve conflicts between them? Health Plan managers can benefit from having a single profile for a prospect that is available to all designated reps, and track all activities for this account, control sales processes, and thus, prevent channel conflicts.

With a variety of brokers working with your insurance company, you need to know if all of them are doing honest business with you. Often, brokers might use you as a "third runner up", i.e. always suggesting your plans to their clients as a third choice: you never win their clients and burn your time and money on useless quoting. It is rare today that a quote costs you less than $67; multiply this amount by the number of lost quotes, and you will get a clear picture of why you want greater control over brokers' activities, patterns, and engagements.

Many brokers work with several HMOs/PPOs, most of which are your competitors. Tracking their interactions can provide you with knowledge of how committed and faithful your brokers are.

Your brokers will sell your plans more efficiently if they have enough tools to convince their clients that your HMO/PPO is the best choice. Providing them with such tools will not cost you much if you have a centralized library of marketing materials that can be easily managed by a designated specialist and easily accessed by regional directors involved with brokers. Sometimes it takes a few glossy brochures to win a client.

Keeping your brokers satisfied with their commissions is another significant task you have to perform. Whether you reward brokers with commission per contract or use a percentage of the premium, it is important for your reputation to make fewer mistakes calculating commissions and to do it on time. Tracking commissions efficiently also can help you to use them as a sales controller. A common tactic is to change broker commissions to emphasize one product over another. For example, Blue Shield of California has adjusted its broker payment schedule to reduce commissions paid on sales to the smallest groups. The system you are using to manage commissions should be smart enough to handle assigning commissions to both an agency and an individual broker.

A key concern for many HMOs/PPOs is to automatically monitor a broker's performance. Knowing who is your top producing broker is a key to more sales. Recognizing their achievements will motivate your best agents to be more loyal to you and help you increase your membership. At Blue Cross Blue Shield of North Carolina, top agents are rewarded through a different, higher commission schedule, says spokesperson Michelle Vanstory. Many HMOs reward their top brokers by inviting them to the special events. This is when campaign functionality, sophisticated record filtering, and powerful reports become very handy for your management.

ADVICE:

There are not that many systems out there that can help HMOs and PPOs optimize their relationships with brokers and agencies. You need one solution that includes record tracking, campaign management, reporting, record associations and filtering, built-in libraries, commission tracking, license management, account hierarchy, integration with rating systems, activities and history, and instant synchronization. All of these features and many more made HMOZ a leader in HMO-Broker communications.

One Demo is better than a thousand words, and one Solution Audit is better than a thousand demos. We encourage you to follow our CRM proverb and take advantage of this opportunity.

Click on one of the three links below to continue your HMOZ research.