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Better Business for Small Business Leaders
Better Business for Small Business is the go-to podcast for entrepreneurs looking to get 1% better in their business every day. Hosted by Chrissy Myers, CEO of AUI and Clarity HR, each episode dives into real-world stories and expert insights from resilient small business owners who blend passion, purpose, and philanthropy to drive success.
Better Business for Small Business Leaders
Broker or Broken? Finding the Right Health Insurance Partner with Alice Rhodes
Do you know what your health insurance broker actually does? Most small business owners assume their broker simply shops for the cheapest rates, but that's just skimming the surface of what a true strategic benefits advisor should provide.
Alice Rhodes from AUI breaks down this misunderstood role, revealing that for businesses with fewer than 50 employees, benefits aren't just about price—they're about protection, retention, and compliance. A great broker doesn't just deliver quotes; they develop game plans tailored to your specific business needs, navigating the complex world of insurance options to find solutions that are relevant, cost-effective, and actually work.
Northeast Ohio businesses have a distinct advantage with nine carriers offering various products including MIWAs (Multiple Employer Welfare Arrangements), level-funded plans, self-funded options, and captives. This competitive landscape creates opportunities that aren't available in many other regions, but it also requires knowledgeable guidance to navigate effectively. What separates good brokers from great ones? Great brokers take time to understand your business structure, employee needs, and ask critical questions that others might miss—like whether common ownership across multiple businesses could allow you to combine entities for better purchasing power.
The "set it and forget it" approach to insurance is dangerous. Benefits aren't static—legislative changes occur, workforce demographics shift, and compliance issues arise throughout the year. If you only speak with your broker during renewal season, you're missing crucial support. True broker partners check in regularly, assist with claims issues, help with new hires, and educate your team about effectively using their benefits. This education piece is vital, as employees who understand how to be smart healthcare consumers (like knowing when to use independent labs instead of hospitals for testing) can save hundreds of dollars while helping keep overall plan costs down.
Ready to evaluate your current broker relationship? Ask yourself: When was the last time you saw them? Have they helped with claim problems? Do they educate your team? Do you even know their name? The best business leaders don't just react—they plan proactively. Reach out to us at AUI to discover what a true strategic benefits partnership looks like.
🎙️ Connect with Chrissy Myers and discover how resilience, expertise, and community can transform your world:
🔗 Follow Chrissy on LinkedIn for behind-the-scenes insights, leadership tips, and updates on her journey as the CEO of two thriving businesses.
📘 Grab your copy of 'Reluctantly Resilient' to learn how Chrissy turned challenges into opportunities and how you can do the same in your life and business.
🤝 Explore Clarity HR and discover how Chrissy’s team simplifies HR for small businesses, giving you peace of mind to focus on what matters most.
💼 Visit AUI to see how Chrissy's employee benefits expertise can help you build a healthier, happier workforce.
We've been doing this a long time. We don't just want to bring you a quote, we want to come with a game plan. So, for businesses that have less than 50 employees, there is a myth that benefits are only about price, but really it's about protection, retention and compliance.
Speaker 2:If you've ever wondered what your health insurance broker actually does, today I'm going to talk with Alice Rhodes from AUI about what that actually is. So, alice, thank you for being on the podcast today. Thanks for having me. So, before we get into the heavy stuff about what exactly a health insurance broker does, what lights you up about working with small businesses in the insurance space?
Speaker 1:We are a small business and we need to find partners that understand us and what we go through, so I love that and being able to get in and talk to people and understand them.
Speaker 2:Nice, All right. So we're going to go to the burning question. Of course, let's clear these things up because you know, the word broker has some baggage. So just a little, a little bit. What is an agent? What is a broker? So we're going to talk about those things. So what is the role of a broker? What do small businesses get wrong about it? So what do we actually do as health insurance brokers? What's the secret?
Speaker 1:So, yeah, definitely baggage. So most people think all we do is shop rates. So, but we are a strategic advisor. We've been doing this a long time. We don't just want to bring you a quote, we want to come with a game plan. So for businesses that have less than 50 employees, there is a myth that benefits are only about price, but really it's about protection, retention and compliance. Our job is to sift through the noise and bring back only what matters, that's relevant, cost-effective and it actually works. A lot of our quotes come in. They've got 80 pages. If I just sent them to people, they'd be like what the heck did you send me? And their head pops off.
Speaker 2:So I know I had a conversation yesterday with someone in the financial services sector and so he works with a brokerage outside. They're in Ohio but they're in Cincinnati and he had a question for me. He's like you know, it seems like the landscape in Northeast Ohio is different than even like Cincinnati or like West Virginia. Can you speak to that a little bit? I know we know about competition, but just to kind of give our listeners an understanding of really the role of a broker in especially Northeast Ohio and kind of how we can help.
Speaker 1:We're very fortunate in Northeast Ohio is it is a very competitive market. We have like nine carriers with a whole plethora of options. They've got MIWAs, they've got level funded, they've got full-blown self-funded, we've got captives, we've got all sorts of different options that aren't available even in other parts of the state. We are also very fortunate. We have three great hospital systems that aren't always necessarily in different networks and if you're not in the area you don't know what that means.
Speaker 2:Yeah, so when we're talking about competitive, we have competition on price, but we also have competition based on product, type of network, strength of type of plan and things that you know. In most places they have what? Two, three different options and we have nine times all of the different products and different types of funding sources. So I mean we're in a special spot.
Speaker 1:I even get calls from brokers in other states, like about Miwa's. They don't understand them, they don't know what to do.
Speaker 2:And I'm like hey, dude. Yes, For those of our listeners that don't understand what MiWA is, it's multiple employer welfare arrangements. So it's a way to medically underwrite small group insurance so that they can get better rates and avoid some of the cost drivers from the Affordable Care Act. That doesn't necessarily make insurance super affordable, right? So let's talk. We've talked a little bit about what separates a broker, what a broker kind of does helping navigate the insurance, what separates a good broker or an okay broker from a great one.
Speaker 1:A good broker just quotes your business, sends you options back. A great broker learns your business and how it works and what you need for you and your employees.
Speaker 2:So tell me when you go into an organization and being a great broker like, give me some examples of what that can look like sometimes for clients.
Speaker 1:I like to sit down and get to know the owner, the decision maker, figure out what their employees need. Do they have somebody that's currently in treatment that needs to make sure, or they just had a preemie with a very high claim number and you know how can they navigate that? Yeah, Just getting to know them Exactly.
Speaker 2:Another thing I thought was interesting because you've kind of come up with it in the last in a client that we're working on right now is kind of those uncomfortable questions that brokers don't know to ask, like how's your entity structured?
Speaker 1:You want to talk about common ownership, oh, yeah, yeah. So sometimes there's a rule that if you have more than 50% common ownership, you can combine your businesses.
Speaker 2:So if I own four or five different businesses, we could all have the same insurance plan under one plan, correct?
Speaker 1:Simplifies things for you, especially if you're trying to administrate all of them, or sometimes then you get the purchasing power of more employees?
Speaker 2:Okay, so can. Sometimes, because people don't understand common ownership, can it sit them in the wrong funding model, the wrong type of insurance?
Speaker 1:Oh yeah, they could be looking at. You know, five groups with five people. If we look at that, a plan that's self-funded probably isn't the best option for them. But if we can combine them and get a group with 25 employees, it gives us more options. We can look at some level funding that type of thing, Even as they're adding.
Speaker 2:They go from 20 to 50, 50 to 100,. Does that help with rates? Potentially too.
Speaker 1:Potentially yeah, depending on the risk of the group.
Speaker 2:All right. So tell us about a time, since asking the right questions is really important. Can you tell us about a time, kind of, when asking the right question made a major impact? I'm thinking like whether it's entity structure, plan design, dealing with you know, family members and understanding the group itself.
Speaker 1:Yeah, so we've got a small employer. Right now, one of the employees is undergoing treatment in multiple hospital systems oh, wow, okay and has a child that's not in the area Okay, so we need to make sure that the child who's away at school can has coverage and that the person in treatment can go to where she needs to go.
Speaker 2:Okay. So yeah, I think oftentimes employers forget that dependents, so AKA college students or young adults, can stay on a plan until they're 26. Yes, so being able to navigate the right type of plan structure for your employees can be important Nice.
Speaker 2:All right. So what's the danger? I know the danger. You know the danger of having that like well, I bought my insurance, I transferred carriers, the broker got me where I needed to go. It was painful. I really don't want to talk to them again. I really don't want to do anything like that Set it and forget it, where they never check back in, they never talk to their broker. What's the danger of having a set it and forget it broker?
Speaker 1:Well, sometimes, you know, benefits aren't just static, there's lots of different things that can come into play. You know, typically at the end of the year we run into some legislative changes that could alter things that we need to stay on top of and make sure employers know about. Also workforce. So if you're a group that only has four employees, they Do something called composite rating where you pay the same rate for every single person. Well, that's an average of everybody's age. Oh, if you lost an employee that was 25 and replaced them with an employee that's 50, now your average age is increased and there's going to be a rate bump just based because your average age increased. So you got to know those little things in the group. And then also when you run into Medicare, compliance with if they're over 65 and who's primary, so you just kind of got to know your group, making sure that the employees have what they need, that their drug coverage is credible, so they don't, so the employee doesn't run into issues later.
Speaker 2:Yeah, I've always said that if you only talk to your broker at renewal, you don't have a broker, you have a spreadsheet delivery service only talk to your broker at renewal. You don't have a broker, you have a spreadsheet delivery service. So what are some of the things that you do differently as a broker and some of the things that we do differently at AUI?
Speaker 1:that kind of set us apart.
Speaker 2:Keep us engaged with our clients throughout the year.
Speaker 1:Yeah. So we check in year round. We help them if they have new hires, if they have a change in the person that's administrating the benefits, making sure that that person understands the plan and you know who's on it. Also, if an employee is stuck, I was at a group earlier this week talking about something completely different and he came in with a stack of papers like, hey, I got this in the mail, here's my claim. Yeah, yeah, I don't know what it means. Can you help? It's like hey, I got this in the mail, here's my claim. Yeah, yeah, I don't know what it means. Can you help? It's like okay, so sat down and helped him figure out. Okay, no, this is you know.
Speaker 2:Yeah, Because so much of you know being a good broker is providing good benefit. Education, Because I think oftentimes employees don't realize the benefit that they're getting on behalf of their employer, what their employer is really paying for, especially if they're cost sharing.
Speaker 2:They forget, you know, I'm paying $50 a month, but my employer may be paying $200, $400, $600 a month or more, because I mean, the average cost is what, at this point in time, when we're looking at single rate, six or $700? Six or $700 a month and it's 50% of the single premium. So the employer themselves is paying at a minimum, $300 a month for this employee.
Speaker 2:And so they see the dollars, but they don't see what their employer's paying, and so helping them understand and navigate can be so powerful. I've watched you in employee meetings on the education side in teaching the client or the employees how to use the benefits. I feel like empowered employees that know how to use their insurance are better employees. You want to talk about that a little?
Speaker 1:bit, oh yeah. And it's even down to making sure, especially if you have a high deductible. We're so used to. You go to the doctor. They give you a prescription to go get lab work done and you're like, oh you know, my doctor is attached to the hospital, I'm just going to go over there. Well, that's the most expensive place to get your lab work done. So it's going towards deductible now. So that lab work is $400. Whereas if you take that prescription and go to the local independent lab, that lab work may be $25.
Speaker 2:Wow.
Speaker 1:So, and we're fortunate now a lot of the carriers have apps where I can go in and say, okay, I need this medication, where's the best place to fill it? Or even down to, and it's not even things that will affect your as an employee, out of pocket, but the company costs as well. In your mammograms, yeah, as an employee, I don't pay anything. It's considered preventative care, but where I go could cost the insurance company more.
Speaker 2:Ah. And if it costs the insurance company more when they're looking at renewal Exactly, your ratings can go up Right. So being a good health care consumer as an employee is important also in keeping the cost down, not just to you as the employee, and your contribution, but also to the employer and good broker education around how to navigate those benefits and teaching them the right way to use them Right.
Speaker 1:And also, too, a lot of, especially in the small group market. A lot of these plans have little perks in them that like our own coverage. We've got something in there that if I go get my my annual exam and they run my cholesterol, I get points towards a $25 gift card just to make sure I'm doing what I need to do. And a lot of employees don't even know that exists because they just got their card and go to the doctor.
Speaker 2:So having that education around how to use the benefits is really important. Oh yeah, definitely Okay. So kind of talking. If someone's listening right now and they're wondering, you know I get a spreadsheet usually the week before my business is supposed to renew my health insurance. I don't really hear from my broker throughout the year. I think they're phoning it in. What should they be looking for, and how can a business owner tell if their broker is doing enough? What are some of those things you should know.
Speaker 1:So ask yourself, when was the last time you saw your broker? When was the last time they helped talk to your employees or helped you with an issue, with a claim problem? We had a death claim on somebody about six months ago. Seasonal business and employee happened to be out on leave and passed away at that time. Well, based on the terms of the contract, the claim wouldn't have paid. So I was able to step in, be a little proactive on it, got the claim paid. So doing things like that helped the group feel better for this employee or this dependent of this employee that you know was in turmoil because they had an unexpected death in the family, and it helped the employer or the employee realize, or the dependent realize like, oh you know, they helped me.
Speaker 2:I like that. I know that one of my red flags whenever I talk to people is like who's your broker? And if they're like I don't know, yeah, you don't know their name that's a big red flag. It should be your first If you don't know your broker's name or why you're in the plan that you're in like. Why do you have Medical Mutual? Why do you?
Speaker 1:have Anthem, why do?
Speaker 2:you have Simicare. I don't know. I think that was the cheapest and that's what we picked. Well, does it cover the things that you need? I mean, how many times have you seen that?
Speaker 1:Oh geez, more than you can count. Oh yeah, yeah, okay At, I would think so. Get a call from somebody. Hey, I don't know what I have.
Speaker 2:Yeah, and I would think, too, asking yourself like when's the last time your broker educated your team, like have they come in? Have they explained the benefits? I know that benefit meetings are a large component of what you do because you love employee education. I'm a nerd, yeah. So if the answer is I haven't seen them, I haven't talked about it.
Speaker 2:We haven't had any types of claims issues that we've worked through. They haven't helped us. If it's never, then I think that we should absolutely talk to us. Oh yeah, One of the other things that I think sets us apart a little bit is that education piece and compliance, oh yeah. As business owners you're kind of wandering through.
Speaker 2:You're focusing on the things that you're good at. You're kind of wandering through like you're focusing on the things that you're good at. You're focusing on your business and growing it You're not focusing on. There's been a major change in insurance law. There's been a change in how plans are delivered, and I think that's something that you like to do, and kind of be proactive from a client perspective.
Speaker 1:Oh, yeah, well, and it happens all the time, even with something that everybody thinks they've heard of Cobra. Yeah, because it's been around forever. Nobody understands it.
Speaker 2:It's not a snake.
Speaker 1:No, and they don't know that they only have five employees. Cobra doesn't matter, so it doesn't apply to them, but there's different things that could.
Speaker 2:All right. So someone's driving to work right now, they're listening to our podcast and they're starting to think OK, I need to do something about figuring out what I can do and fixing some of my benefits, or understanding if my broker's doing anything. What would step one be in kind of determining, like, do I know what I'm doing with my benefits and do I have a broker who knows what they're doing?
Speaker 1:Pull out your summary. Does it make sense to you? Do you understand it? Do you know why you have it?
Speaker 2:Do you even know where your insurance plan is? Yeah, do you know what carrier you have?
Speaker 1:Okay, no, yeah, that happens a lot. We hear from our employers that, hey, I know you sent this to me, but I don't know where I put it. So it's okay, it happens all. Yeah, it happens. Here you go. But honestly, just call us, we'll help you figure it out. We'll do the audit of the benefits, we'll help. Best case you're in great shape, you don't need to do anything. Worst case hopefully we can find a way to save you money and get your employees in a better situation.
Speaker 2:Yeah, we talk about this more, I think, on the HR side of the house and talking about like, where are we in mapping and benchmarking HR side of the house and talking about like, where are we in mapping and benchmarking? And that's something I know that you help with a lot with the Clarity clients and even our AUI clients and understanding where are your benefits in comparison to who your competition is?
Speaker 2:and even what the market is and I think oftentimes especially if they've had the set it and forget it brokers their benefits may be way off base from what the standard is, whether it's they've got really, really rich benefits and they're paying a significant premium for those benefits, or they have a low-level benefit and they're realizing that they're not keeping or retaining or attracting people because they can't get people on the door because of the insurance product they have.
Speaker 1:Right, and I've even seen that down to a waiting period where, oh, my employees have to wait 90 days to get benefits. I need to change something, because I'm losing people because of it.
Speaker 2:What do you see as the standard best practice now for waiting period? We're going to talk about that. I think that's a great takeaway.
Speaker 1:Yeah, depends on you, know your industry. I like to see first a month, because then it's easy for billing purposes after 30 or 60 days.
Speaker 2:Okay, what do you absolutely hate? What makes you cringe from a benefits perspective?
Speaker 1:Honestly, it's data hire. Yeah, and you hate to say it, but you know you get new hires and we all hope they they work out. Usually, though, if they're not going to you, you figure it out pretty quick and it's usually within that first 30, 60 days used to kind of joke. It was about three weeks. You figured out, you know where their bad habits were and, um, if you don't have to get them on benefits, get them off, especially if now you're in a COBRA situation where they could stay on your benefits. So if you can not even put them on the plan before you realize, it can help out a lot, and I would say even on the administrative side for an organization, I mean first, data hire is really difficult because you're dealing with that paperwork.
Speaker 2:The employee has to make those decisions fairly quickly. If they don't work or they self-select out, you're dealing with that turnover of paperwork again. So it's almost like if you don't have a full-time HR person, data hire is a difficult onboarding, especially if you have a lot of turnover.
Speaker 1:Yes, then you got to remember to take them off.
Speaker 2:Yes, and that happens oftentimes. You forget to turn someone off the benefits. You've turned them from the organization but you forget and they've been on the benefits for six months, and it can be a challenge to get that premium back? Yeah. So, as we're getting ready to close, we always ask the 1% question like how can business leaders get 1% better in their business today? How does that relate from a broker perspective? So, because you know big changes come from small shifts, what's your 1%?
Speaker 1:better tip. Be proactive. The best leaders don't react, they plan. I like that.
Speaker 2:Alice, thank you for your time today. Thanks for having me Talking about being a broker and how to be a great broker, and so if you want to talk to Alice, her email is aalice. So aalice R-H-O-D-E-S at auinfocom. Auinfocom is our website and you can always find us on LinkedIn and all the other socials. Thanks a lot, thanks.