The health care and health insurance systems have been a predominant issue in the media lately. There is no doubt that the insurance system needs to be revamped, but does it need to be completely scrapped and rebuilt?
The politicians would have us believe that our system, built on the capitalistic principals that the rest of our nation is built on, is inferior to the socialistic insurance systems found in many European countries. They would have us believe that it will be better if our healthcare is provided by the government, but of course, we have choice … to take the expensive private plan or the inexpensive government sponsored plan.
When the masses opt for the "free" plan provided by the government, be prepared for the private insurance carriers to leave the marketplace. A play-or-pay alternative for employers is also being considered a viable alternative. The already overburdened small-business owner should be prepared to be taxed to help support the "free" government-sponsored plan.
If a government-sponsored system is in place, who will help business owners navigate and understand the process and options? Many of the proposals currently being drafted have no role for the professional insurance agent. In fact, this role is strictly prohibited in most scenarios and is replaced by a government bureaucrat, someone to pick up the phone and find an answer from a manual.
The insurance agent plays a valuable role in the insurance industry, both at the group and individual level. The insurance agent is an educator. We educate our clients and their employees on how their plan works and make sure they understand what is and is not covered. We are available to explain the difference between a deductible and co-payment. We explain why a "routine" test may not be coded and processed as a routine claim … which translates to more out of pocket costs for the employee. We explain the importance of using network providers whenever possible. We educate our clients on the laws they must abide by regarding COBRA/Continuation, SCHIP, HIPPA and how these relate to their specific employee benefit situations.
The agent is a facilitator between the employee and the insurance carrier. Sometimes claims don’t get processed correctly. We are the intermediary who puts the pieces of the puzzle together and helps the convoluted claim get sorted out and processed properly. We help connect employees with care management coordinators they didn’t know they could utilize.
The agent is the human resource department for the small-business owner who already is the accounting department, sales department, foreman and president of the company. We help encourage employees to live healthy lifestyles. This in turn will help reduce their medical expenses which translate to lower insurance premiums.
An agent does all of these things for 3 to 5 percent of the premium paid to the insurance carriers. This piece of the pie is small in comparison to the benefits and services provided. Could a government employee provide the same services for the same cost? The state projected that Healthy Wisconsin would cost 15 to 20 percent of payroll for businesses. Small business owners could hardly afford that type of an increase.
The insurance professional has an important role to play in the purchase or procurement of insurance. The agent is a trained professional who is required to undergo continuing education and product certification in order to maintain their state appointed license.
Changing our nation’s, or state’s, insurance system so drastically and prohibiting the agents from being involved in this process would be a disservice to employees and employers alike. The cost in time, effort and frustration, not to mention dollars, would be greater without out us than with us.
It is important that you contact your state and federal politician and tell them how much you value the role of your insurance agent. Make sure they understand exactly what your agent does for you and how important they are to your business.
Laura Bagin is an insurance agent at Cyganiak Planning Inc. in Brookfield.
