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Choosing the right employee health insurance broker or consultant: a checklist

A person in a white collared shirt looks thoughtfully at a tablet held by another person while discussing something in a bright office.

It’s not hard to find a health insurance broker or consultant. Most of the time, they’re coming to you looking for business. The right broker or consultant will be someone who understands and aligns with your employee benefits strategy and business goals.

There are certain non-negotiables that you should expect. Your broker or consultant should:

  • Help navigate a complex marketplace, identifying cost containment opportunities.
  • Offer insights that add value to employee satisfaction and whole-person health.
  • Serve as a strategic advisor, sharing new trends and emerging solutions.

They should save you time, money, and aggravation — especially when rolling out new health benefits plans to your employees. The following checklist can help you evaluate each broker and consultant against the same high standards.

Employee health insurance broker / consultant checklist

There are 10 key attributes of exceptional benefits partners. Here’s what to look for when choosing an employee health benefits broker or consultant:

1. Understands your industry and workforce

Recognizes the specific challenges, regulations, and coverage needs relevant to your industry, employee groups, and company size.

2. Has experience with integrated health plans

Knows how to help employers transition to or manage integrated benefit plans that emphasize preventive care and cost savings.

3. Can analyze and explain claims and benefits utilization data

Studies existing health plan data to identify trends, outliers, and opportunities for greater value and lower cost.

4. Uses benchmarking tools and cost-modeling software

Compares plans against industry best practices and uses forecasting tools for data-driven decision-making.

5. Offers expertise in pharmacy benefits

Explores alternative strategies beyond carve-out solutions for a cost-effective integrated pharmacy approach.

5. Offers expertise in pharmacy benefits

Explores alternative strategies beyond carve-out solutions for a cost-effective integrated pharmacy approach.

6. Has knowledge of compliance and regulatory requirements

Provides peace of mind regarding legislative changes, state mandates, and health data privacy laws.

7. Uses a proven onboarding strategy

Offers a structured, transparent approach to health plan benefits management with minimal disruption to employees.

8. Shares references and success stories

Offers testimonials and metrics that demonstrate improved plan performance with lower costs and higher employee engagement.

9. Offers employee engagement techniques and communications materials

Provides or arranges training support for internal teams, along with access to comprehensive benefits communication materials.

10. Provides year-round support

Serves as a true partner, offering proactive updates on market trends, new program options, and current health plan performance.

Questions for a group health insurance broker or consultant

There are questions that should get answered while marking off the checklist and choosing your best-fit benefits planning partner. Some of these questions include:

  • Do you specialize in employee benefits for small, medium, and/or large companies? How well do you understand our business and employee population?
  • How do you define success when tracking outcomes against claims reduction, utilization improvements, and/or reduced absenteeism?
  • How do you help clients manage and plan ahead for rising premium costs, especially pharmacy benefits?
  • How do you stay up to date with group health insurance industry changes and trends? Do you meet with payers, attend conferences, and remain professionally active?
  • How often do you offer plan reviews, provide industry alerts, and suggest new opportunities? How do you learn about new plan options?
  • What’s your process for reviewing our annual plan performance? What metrics do you use?
  • Which insurance payers and plans do you work with most frequently and why?

Listen for answers that align with your goals for cost management, valued-added features, and improved employee health. The right broker or consultant partner will add simplicity to a complicated process.

They understand that their clients have decision fatigue in dealing with an ever-changing selection of employee health plans. It’s their role as an intermediary to narrow down the right choices for your employees and their unique health needs. But that doesn’t come without a proper conversation first. 

Also see Working with a Broker article for additional insights and information.

All references to “Highmark” in this communication are references to Highmark Inc., an independent licensee of the Blue Cross Blue Shield Association, and/or to one or more of its affiliated Blue companies.

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Talk to your client manager today and we’ll help you find the right health plan for your company.