Health Insurance

Buyers Are Looking Around

Health insurance buyers talk to several carriers, but don’t switch.

Buyers went into risk-avoidance mode as COVID-19 ramped-up, but they are now evaluating their current carriers with a tougher eye.

To explore this trend, Alexander Group recently surveyed cross-industry health insurance buyers. The results were clear―health insurance customers want more value, including:

  1. New work-from-home solutions and help communicating them
  2. Broader case management assistance
  3. Self-insurance navigation: given a potential claims rebound
  4. Help make wellness more compelling for employees
  5. More cutting-edge, value-added features

Alexander Group discussed these findings in a recent roundtable with 20+ health insurance leaders. The carriers shared some candid thoughts on how they are approaching these challenges.

Priority 1: New Work-From-Home Solutions

It’s obvious that telehealth usage has gone through the roof. Employees love it and want more tele-options. Carriers are responding accordingly, but employers also want more of all the other services that enable a healthy, productive at-home workforce. This includes more mental health support, case management, at-home diagnostic kits for different conditions, wellness programs for fitness and work-force connectivity, mail-managed prescriptions, remote metric/symptom tracking and rapid at-home COVID-19 tests, among others. Roundtable participants noted that this creates clear implications for carrier solution bundles, sales process, segmentation and account management.

Moreover, with a pandemic comes panic, so employers looked to minimize the impact on employee morale and focus. In addition to more at-home program elements, buyers also want help in communicating these elements to employees. Buyers complained that many employees (and even HR) don’t understand how to leverage the programs they pay for currently. It’s understandable, as carriers rapidly deployed solutions to millions and may have lacked enough account-level explanation and usage enhancement. Getting it right will help carriers get closer to customers and build loyalty. Getting it wrong will encourage employers to continue seeking out new approaches from other insurance providers. Roundtable participants noted that account management needs to play a richer role in this situation.

Priority 2: Broader Case Management Assistance

Within the new work-from-home carrier service bundles that are becoming more crucial, health insurance buyers highlighted their need for more/better case management support. They are acutely conscious that many employees’ chronic conditions might spin out of control in a work from home environment. Specifically, without direct provider and peer contact, conditions can quickly worsen and symptom blow-ups become likely. Some buyers also felt that carriers’ case management resources were not always available or ready during COVID-19, creating a delayed, more serious employee focus impact in 2021. Roundtable participants noted that sales-to-buyer dialog, subject matter expert involvement and target offerings are crucial here.

Priority 3: Self-Insurance Navigation

As many procedures were delayed due to the virus and many chronic conditions may have missed sufficient case management, employers (and carriers) began to worry about 2021 claims management and network capacity. Carriers acknowledged that providing superior customer service becomes key as they cope with an expected 2021 claims upsurge.
But equally important to many self-insured buyers is that they may bear the impact of a claims upsurge across many employees―even with a stop-loss program. As a result, employers are seeking advice from carriers to determine whether to go or stay self-insured. Per the roundtable participants, there are clear sales implications for carriers in terms of where to push/offer self-insured coverage, the right sales process, talking points and incentives.

Priority 4: Help Make Wellness More Compelling to Employees

Buyers are concerned about rising claims/costs from chronic conditions as employees stay home/inside. They also worry about isolation driving binge eating/drinking and mental health issues. While health insurance buyers acknowledge that wellness programs are no longer the “shiny new objects,” they are right for the moment―especially given some new tech features. As one health insurance buyer said, “Peloton’s success shows that people are hungry for ‘fun’ exercise and for community.” Assuming that employees can easily dial up/down their participation metrics, wellness helps them feel included and helps them manage both their physical and mental health. So employers are looking for wellness, but with an exciting new high-tech gloss on it.

Priority 5: More Cutting-Edge, Value-Added Features

Health insurance buyers want to increase their employee satisfaction while increasing efficiency and lowering their costs. As such, they report looking for carriers to “wow” them with new features that will impress employees. Some mentioned new information tracking capabilities, fitness and other wearables, seamless “plug-and-play” digital solutions, and new Alexa type services (like Anthem’s) that give employees updates or plan status, shipping times or background on drugs. Because most employees are now home, they are eager to leverage this intersection of health maintenance technology and tele-support.


Employers are struggling to manage employee focus and productivity in the COVID-19 period and are looking to carriers to help. If successful, carriers create a stronger connection that sustains price evolution. On the other hand, buyers reported that if carriers are unresponsive because switching seems too disruptive, they will quickly do more than just talk to other carriers. Moreover, in these confusing times, buyers clearly want guidance along with accessible services/platforms as they help their employees. Carriers should therefore double-down on clarifying the sales and AM processes, hand-offs, incentives and talking points for their work-from-home buyer priorities above.

A full briefing on both this carrier roundtable and the health insurance buyer survey findings is available. Please contact an Alexander Group Health Insurance practice lead to learn more.

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