Top challenges facing health insurance professionals

The last few years have been particularly challenging for healthcare professionals, including those in the insurance industry. Even post-pandemic, insurance leaders are still feeling the effects of the public health emergency.

Health insurance providers face major challenges in 2024. As you look toward the future of the healthcare industry, staying ahead of these obstacles will give you a competitive advantage in the market.

In this article, we'll look at five common insurance industry challenges brokers, agents, and claims specialists face today. We'll also outline how you can overcome them and better serve your clients as they navigate the ever-evolving healthcare benefits space.

Takeaways from this blog post:

• Rising healthcare costs make it difficult to find affordable plans for clients. Health reimbursement arrangements (HRAs) are cost-effective alternatives to traditional group health insurance.
• Health insurance professionals must have a greater focus on customers, who have high expectations for personalized service and human interaction.
• The digital transformation requires insurance professionals to adapt to new technologies and tools to stay competitive. However, health insurance professionals must protect client health information due to the increasing risk of data breaches.
  

1. The rising cost of healthcare

One of the biggest challenges for insurance professionals is the ever-increasing cost of healthcare. Health insurance professionals have come to expect premium prices to go up once renewal season comes around. The higher price tag makes it increasingly difficult to help small businesses find an affordable plan that meets their budget. For many, it's an expensive investment.

A recent eHealth survey¹ found that if group health insurance rates increased by 15%, 47% of respondents wouldn’t be able to afford to offer coverage.

Inflation isn't just impacting organizations looking to offer benefits to their employees. Rising cost-of-living expenses could have some people stretching their budgets thin to the point where they delay their routine or preventative care to make ends meet. According to KFF², one in four people say they've missed or delayed necessary healthcare within the last year due to cost concerns.

How to overcome this challenge

Traditional group health insurance plans aren't the only options brokers and insurance agents have to offer their clients. Offering a health reimbursement arrangement (HRA), especially to small and medium-sized organizations with limited budgets, can be a far more affordable and flexible alternative.

Through an HRA, employers offer their employees a tax-free monthly allowance of their choosing. Their employees can pick their own individual health insurance and the medical care they receive. Then, they submit those expenses to their employer and receive tax-free reimbursement for their qualifying medical expenses.

There are several types of HRAs available, and each one offers tax benefits. Here are three popular options:

• Qualified small employer HRA (QSEHRA): The federal government created the QSEHRA for employers with fewer than 50 full-time equivalent employees (FTEs) looking for simple, easy-to-manage health benefits. A QSEHRA allows your clients to reimburse their employees for health insurance premiums and out-of-pocket expenses. Employees can have their own policy or be on a parent’s or spouse’s plan as long as it has minimum essential coverage (MEC).
• Individual coverage HRA (ICHRA): An ICHRA is a way for employers of all sizes to reimburse employees for individual health insurance premiums and qualifying out-of-pocket costs. For organizations with 50 or FTEs, offering an affordable ICHRA allowance can help them satisfy the Affordable Care Act’s employer mandate.
• Group coverage HRA (GCHRA): A GCHRA allows employers to supplement their existing group health insurance, such as a high deductible health plan (HDHP). Your clients can use a GCHRA to offset high out-of-pocket expenses by reimbursing employees for their deductibles, copayments, and coinsurance.

An HRA is an excellent alternative for your clients who see a large rate increase, can't afford group coverage, or don't meet minimum participation requirements. So, how can you help your clients offer an HRA? PeopleKeep offers innovative HRA solutions for small and mid-sized organizations. By partnering with PeopleKeep, you'll earn commissions for any clients who sign up with us. Plus, your clients will have their $150 sign-up fee waived.

2. High customer expectations

We get it; the insurance business is tough. You have sales goals to meet and policies to sell. But if you want to find success in 2024, you need to humanize the insurance customer experience.

Your customers expect a high level of service that's as personal as it is professional. A PwC study³ on customer experience found that one in three consumers will walk away from a trusted brand after a single bad experience. Data from the survey found that 82% of U.S. consumers want more human interaction as well.

Healthcare consumers expect their brokers and agents to act as trusted advisors they can count on to help them make informed decisions about their health plans. Your clients want to know they're seen, heard, and cared for. When you take the time to educate them and listen to their needs, they're more likely to trust your professional opinion.

How to overcome this challenge

A good tactic to overcome the pressure to sell while also building rapport is to work sales and meaningful connections into your business goals. While you undoubtedly already have short-term sales and production goals in place, consider setting long-term goals that focus on building up your clientele and improving your client relationships. You can check in more often and offer important updates whenever possible to enhance customer engagement and satisfaction.

3. The digital transformation

Another challenge for insurance organizations and insurance professionals is adjusting to technological advancements. Optimizing operations using digital technologies is the name of the game for 2024.

With everything being instant these days, it's become an expectation for your clients. Much of the world digests information in quick bits on the internet, social media, and other digital platforms. You’ll get left behind if you're not embracing digital resources and technology in the insurance sector.

Plus, mobile apps and other platforms can make your life easier.

How to overcome this challenge

Don't be the last insurance broker to hop on the bandwagon. Reassess your business model and learn how to leverage technology platforms. Several health insurance companies have already adopted cloud computing and artificial intelligence to improve their processes.

In addition to educating your clients in the traditional ways, try giving them a positive digital experience. You can share videos, guides, and infographics to help make the health insurance world less intimidating. Plus, this goes hand-in-hand with providing exceptional customer service that builds trust and rapport with your clients.

4. Protecting health information

Another challenge for those in the insurance industry is keeping their client's personally identifiable information (PII) and protected health information (PHI) safe. The healthcare space is loaded with private, confidential data. These days, everything from health records, prescription information, and medical histories all exist in some electronic format.

According to the HIPAA Journal⁴, there were 725 data breaches reported to the Department of Health and Human Services (HHS) Office for Civil Rights in 2023. Those data breaches exposed more than 133 million records. As someone who handles health information, you collect all kinds of potentially sensitive information, making you even more vulnerable to cyber-attacks and data breaches.

How to overcome this challenge

If your clients ever share personal health information with you, it's your responsibility to make sure it's kept safe. Implementing best privacy practices like encrypting sensitive files, staying up-to-date on PHI privacy rule procedures, using anti-virus and firewall software, and using a secure password manager to keep everything straight will help you keep your clients' information protected.

5. Ongoing industry changes

From the rise of telemedicine and telehealth to unique guidelines for those impacted by COVID-19, health insurance professionals have to continually stay informed about relevant industry news, regulations, and insights as they happen.

How to overcome this challenge

Since there's no stopping the consistent series of transformations, health insurance professionals must keep a close eye on the news and follow trustworthy industry experts to stay in the know. Whether it's signing up for a weekly email newsletter, following official social media accounts, or checking in with blogs and sites from industry experts, keeping up with news as it happens is the best way to ensure you're never caught off guard.

Conclusion

From inflation to data breaches, 2024 comes with its share of critical challenges for health insurance professionals. But being aware makes you better prepared. People are looking to you for answers, guidance, and reliable information. When you remember to put your customers first, you can reach your business goals while cultivating meaningful relationships.

This article was originally published on April 16, 2014. It was last updated on March 12, 2024.

1. https://www.benefitspro.com/2024/02/19/health-benefits-help-smbs-hire-and-retain-workers-despite-ongoing-challenges/?kw=Health%20benefits%20help%20SMBs%20hire%20and%20retain%20workers%20despite%20ongoing%20challenges&utm_position=3&utm_source=email&utm_medium=enl&utm_campaign=bprodailynews&utm_content=20240220&utm_term=bpro&oly_enc_id=5656A6968923B8Y
2. https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/
3. https://www.pwc.com/us/en/advisory-services/publications/consumer-intelligence-series/pwc-consumer-intelligence-series-customer-experience.pdf
4. https://www.hipaajournal.com/healthcare-data-breach-statistics/