What Are Personalized Health Insurance Plans and Why Do They Matter?
“Customized coverage” and “personalized health care” are terms being thrown around more frequently. But what do they mean? How can you embrace these concepts to better serve the needs of your clients and their employees?
The key to personalized health insurance plans is tailoring coverage to include benefits and services that meet employees’ needs. Being able to control expenses is essential as is selecting the right vendors with whom to partner. Health care costs continue to rise – and experts are forecasting a 9% increase in insurance premiums in 2026. You need a plan that helps your clients manage costs without making compromises on care or access.
Flexibility in Modern Benefits Programs
A one-size-fits-all benefits program won’t work in today’s talent marketplace. Employers and employees expect more flexibility through personalized health insurance plans. That means having access to a broad range of Medical, Dental, Vision, and other benefits. Employees also expect to be able to access a diverse roster of health care professionals. Workforce demographics may also play a role. It might require you to offer multiple plan types or provider networks. That way employees are more likely to have access to their preferred doctors, specialists, and hospitals.
Choice in Health Plans and Pharmacy Benefit Managers
Did you know that different health plans utilize different pharmacy benefit managers (PBMs)? These organizations work on behalf of health insurers to manage their prescription drug benefits. They negotiate with manufacturers, create pharmacy networks, process claims, manage utilization review, and provide drug safety and education services. PBMs also play a crucial role in controlling prescription drug costs and ensuring patient access to medications. Some of the country’s most well-known PBMs in the U.S. are CVS Caremark, Express Scripts, OptumRx, and Carelon Rx. Aetna is owned by CVS Health and uses CVS Caremark as its PBM. Cigna uses Express Script. UnitedHealthcare uses OptumRx. Anthem Blue Cross uses Carelon. Blue Shield of California uses multiple PBMs. Depending on the health plan’s agreement with its PBM, it can reduce prescription drug costs by up to half without limiting access.
Self-Funding for More Personalized Coverage
Employers that choose self-funding pay for employees’ health claims directly. They do not have a fixed premium for employees’ health coverage.
Businesses have greater financial control and can enjoy potential savings when claims are lower than expected. They can also make their own vendor choices like a PBM to manage their Rx program.
How Word & Brown Supports Personalized Plans
Whatever coverage your clients are seeking, we have the carrier roster to address those needs. That includes HMOs, PPOs, EPOs, and Health Savings Account-qualified plans. Plus, we offer ancillary products. Dental, Vision, Life, Disability, Accident, Hospital Indemnity, Critical Illness, and more.
Contact your Word & Brown representative to get started, or email me to discuss how our Broker Development team can help you every step of the way. We offer personalized sales support, quick and easy quotes, enrollment assistance, compliance guidance, and strong back-office support. Word & Brown is more than just a GA; we’re your growth partner. Connect with us now.
