We know health care and health insurance are jargon-packed industries. Both include terms and definitions not always well understood by customers – and sometimes by others in our industry.
You can help clients have a better understanding of health care – and build loyalty at the same time – by adopting these proven strategies.
How Insurance Education Builds Client Loyalty That Lasts
1: Use plain language. Avoid technical terms or abbreviations without clear explanations. Don’t say, “Your health plan includes an HSA.” Consider “Your High-Deductible Health Plan (HDHP) features a Health Savings Account (HSA). An HSA will allow you to put away funds on a pre-tax basis to pay eligible expenses. You can use HSA funds to pay your deductible, medical copayments, and other qualified expenses.”
Keep in mind these are among the least understood and most confusing health care terms:
- Deductible: This is the amount the insured must pay for covered health services before the health insurance plan begins to pay.
- Copayment/copay: A fixed amount ($20, for example) paid when visiting a health care provider for a covered service. If a plan allows $100 for a doctor’s office visit, the office visit copay may be $20. This is due at the time of service if the deductible is already paid. If the deductible has not yet been met, the insured pays the full $100 office visit charge.
- Coinsurance: The insured’s share of contracted costs, if any, for covered health care services. It is usually a percentage (for example, 20%) of the allowable amount for the covered service. The insured must pay this amount plus the plan deductible (if not already satisfied). Copayments may vary for different services. Prescription drugs, lab tests, and specialist referrals copays will likely differ.
- Exchange: This is shorthand for the Health Insurance Marketplace created by the Affordable Care Act (ACA). In California, the state exchange for small business is Covered California for Small Business. In Nevada, the state exchange is Nevada Health Link.
- Out-of-pocket maximum: This is the most the insured will have to pay for covered services in a plan year. After reaching this amount for in-network care and services, the health plan pays 100% of the costs for covered services.
- Provider network: A group of doctors, hospitals, and other providers contracted for medical services at pre-negotiated rates.
- In-network vs. out-of-network: Health care providers can be in network or out of network. in-network providers accept contracted rates for services. This helps reduce costs for plan members. Out-of-network providers may charge higher rates or may not offer services at all except in case of emergency.
- Covered services: This includes health care procedures, treatments, or items eligible for reimbursement or payment by an insurance plan or company. Covered services can include doctor visits, hospital stays, surgeries, and medications.
- Allowed amount: This is the maximum amount a plan will pay for a covered health care service. It may also be called an “eligible expense,” “negotiated rate,” or “payment allowance.”
- Explanation of Benefits (EOB): An EOB is a summary provided by the insurance company. It provides details concerning the costs of medical services – and how they will be shared. An EOB is not a bill. It is an explanation of the claim, the total charges, what the insurer paid, and the amount due from the policyowner.
- Underwriting: The insurance company process for evaluating the risks and setting rates.
- Qualified Health Plan (QHP): A QHP provides Essential Health Benefits (defined below). It must follow limits on cost-sharing and meet other ACA requirements.
- Essential Health Benefits (EHBs): This refers to a set of 10 categories of services that health plans must cover under the ACA. These include doctors’ services, inpatient and outpatient hospital care, pregnancy, childbirth, mental health, and more. Some plans may include other services as mandated by state requirements. For details, refer to the HealthCare.gov web page.
- Advanced Premium Tax Credit (APTC): A federal subsidy that helps eligible individuals purchase coverage. Eligibility depends on an individual’s or family’s modified adjusted gross income.
2: Embrace the use of visual aids, infographics, videos, and charts. Integrating visuals into your sales presentations and client discussions is essential. Visuals can make abstract or complex ideas seem simple. They can help you build client trust and nurture a stronger connection with customers and prospects alike.
3: Provide glossaries and other resources to clients. These can be extremely helpful to prospects and clients. Word & Brown offers a wealth of provider and Rx resources online.
Also available are links for Summary of Benefits & Coverage (SBC) and the Department of Labor’s Uniform Glossary of Health Coverage and Medical Terms. Two other online glossaries are one developed by HealthCare.gov and our own site, HeyHealthInsurance.com.
4: Provide excellent customer service and personalized experiences. It’s often said that people will forget what you say – and what you do – but they will not forget how you made them feel. Commit to providing excellent customer service and frequent communication with clients. It can be by phone, email, or through your Customer Relationship Management (CRM) platform. (You made the decision to invest in CRM, now use it.) Checking in proves your interest in your clients and their needs. Reaching out only in connection with a renewal is not the way to nurture a strong client connection.
Of course, you can better serve your clients by staying up to date. You want to know what’s happening in our industry, regulatory changes made or considered, and how new products could help clients. Having this information makes you a better resource.
For other ideas on nurturing client relationships, read our other broker blogs. Be sure to come back often. We post monthly.
