[Podcast] The Importance of Value and Experience - Health Insurance Simplified
In This Episode
In this episode of Health Insurance Simplified, a business client gives perspective about the value they receive and the experience with their insurance provider of choice.
Alan Helgeson (Host): When a business considers the value it is getting from their health insurance company, it's helpful to think beyond dollars and cents. A health insurance provider should serve as more than an organization that sells insurance plans and processes employees claims. They should be an advocate for the business, its employees and a vital link in the continuum of health your employees receive.
I'm Alan Helgeson, and this is Health Insurance Simplified. Today, we're visiting with Pam Schut at the Summit League, a business client of Sanford Health Plan, and her agent, Jay, to talk about the value they receive and why Sanford Health Plan is their insurance provider of choice. Pam, let's learn about the Summit League. Tell us about your business.
Pam Schut: The Summit League is a division one athletic conference, and we are comprised of 10 institutions. We have approximately 3,200 student athletes that compete in 19 championship sports. People around here recognize the Summit League, mostly for our men and women's basketball tournament. That's held in March. And even though that's one of our biggest events, we have 17 other championship sports within the league. The office here, we have nine employees. My job involves working with all of the institutions and coordinating meetings amongst the presidents and the joint council. But I also pay all the officials and take care of the invoicing, all the bills that happen within the, the conference as a whole.
Host: What does an average day look like?
Pam Schut: Anywhere from all of the correspondence, doing all of the financials, doing the bookwork. My office manager position is payroll, health insurance, making sure all the insurances, whether health insurance or general liabilities, cover all those things and then supporting all the people in the office.
Host: With your team, Pam, you mentioned you had nine employees that are part of the team. Why is it important to offer health insurance?
Pam Schut: Health insurance is probably one of the biggest benefits that an employer can offer. We all want our vacation and, and some of those things, but we do. Everyone needs insurance. In the Summit League office, we run a real diverse age group. I have single people. I have young families. I have people who are going to start families. There are some of us who are empty-nesters and therefore the insurance piece is important to all of us, no matter what stage of life we're in, and finding that perfect plan to fit all of us, even there's just with nine of us is super important.
Jay: Well, some of the things that we run into with employers, especially small employers, you have, there were a lot of different hats. From the payroll portion of it, to the onboarding of new employees. And so as the Summit League was looking to explore this, the health insurance market in South Dakota, one of their challenges when they were first in the early stage of it was their relocation from Chicago, Illinois, and making sure that they had a plan that was comparable and competitive in the sense of making sure that it provided the coverage they needed for the employees, as they were looking to bring some of those employees to Sioux Falls, South Dakota, from Illinois, but then also to use it as a tool to recruit new hires, as they knew they had a ramp up their staffing as well. So in those two ways, it was really key for them to make sure that they had the tools and the resources available to get things going from the get-go. And so with that know, Pam, I think one of the things I know when we had visited was the onboarding process to making sure employees, certain things recovered for employees and their families, as far as, you know, the pharmacy benefits or how it, a certain benefit may be, be looked at or within the Sanford Health Plan system for a certain procedure, making sure that most families during the transition were taken care of. And so I think with one of the benefits of having a Sanford Health Plan system is our coverage is having that continuity of care and the transition of knowing with them being local and regional, they're very flexible, but very accommodating. And so this was just a good fit for the Summit League during this during their stage of relocating here to Sioux Falls, South Dakota.
Host: Pam, when we think about health insurance and certainly at the top of your list, we often start in terms of dollars and cents. So let's start there. In your specific situation, what's attractive about your current plan from an economic standpoint?
Pam Schut: Okay. So the Summit League is currently on the simplicity plan and we have a high deductible with the HRA and the FSA, but this provides our employees with a minimal amount, a minimal out-of-pocket medical expenses at an affordable price. But from the big picture standpoint, this provides larger savings to the business because we do have a limited turnover.
Jay: So I think those are probably definitely two key things that a lot of our small employers that we work with run into as well outside of the medical expenses and minimizing employees cost. You know, I think now a lot of people see health insurance premiums continuing to rise, especially small employers. And it seems to be there as far as their budget goes, one of their top budget line items. And so offering some alternative solutions such as, you know, a health reimbursement account or flex span account to help those employees cover their medical expenses is very key. So really thinking outside the box outside of just your shopping, your plans and rates, I'm looking for ways to say these employers with solutions. That's where an agent's really gonna show a lot of value, their employer groups.
Host: Pam, when it came to looking at insurance, what's important to you in terms of what's included in the plan for Summit League?
Pam Schut: Having a broad network that gives our employees access to get the care they need. In particular, when they're traveling, again with the championships that we do all over the country, we need to have that employee coverage. We need to have our employees know that we've got their back if something happens while they're out there. So it's important that we have that broad network giving them all the freedom to seek the attention they need from the person that they trust and feel good. The value-added benefits are another, another important thing in our plan. We've got the 24-7 virtual care, the fitness reimbursement program. There's some of those things out there and just going to throw this out on a personal level, one of my family members has diabetes and I have personally used the Sanford Health Plan preventative diabetes course that's out there. It's a year-long course. So I know I have taken advantage of some of those opportunities, but my team has also taken care of some of the virtual cares, the online visitation-type thing and the fitness reimbursement program. So these are important for all of us.
Host: So shifting gears, you've got people traveling all over the country, doing different things. You're here at the central office managing, trying to run a business so it's hard to manage all of these things. How has working with Sanford Health Plan helped you in your day-to-day stuff?
Pam Schut: First of all, having Jay to reach out to whenever I need him during the day is great. So if there's something I need an immediate answer to, but the day-to-day things, the online resources that are available, the tools that are out there, they help me to administer all of the things that are needed to be done for my employees' health benefits. And so even if they are traveling and they reach out and something's up, I can get into the system that I need to, to help them out. But in my day-to-day things, I get constant communication from Sanford Health Plan, whether it's on education, things that I can share with them, updates that are happening. This last year, there were always COVID updates and, and changes. And those things came to me frequently. And I was able to share all of those things, including their newsletters and just even special events, opportunities, vaccinations, whatever.
Host: And again, rolling right back to taking care of your employees and feeling like they're important because they are.
Pam Schut: They are important.
Jay: So in partnering and being an agent for Sanford Health Plan, they do a great job of having a local agent within the community, really service the employer groups which I, which Pam touched on here earlier. You know, she definitely, we work well as a team. And so with Sanford, you know, and their partnership with us for us as an agent, they do a great job of keeping us abreast on up-to-date things as well. So as our employers are getting these notifications, us agents as well are getting that same communication so that we can make sure that we're on top of things for them. Because in this past year, you know, I, with all of us, there was constant changes. And I think with new laws and regulations making sure that the age and the care both on the same page so that we can continue to serve as our employer groups. One thing that we see with Sanford Health Plan is, you know, they provide great exceptional customer service. I think you've seen that just in the constant communications that they keep with their employers but also with their agent.
Host: Pam, you talked about it earlier, but there's some benefits and some of the value is preventive care or the fitness benefits. Talk a little bit about how that benefits your employees.
Pam Schut: Obviously staying active and having routine checkups and staying healthy are good for an employee's health and wellbeing.
Jay: I think we just, within the Summit League itself, obviously they work with a lot of athletes. And so just with the people that they correspond with, you know, it's in constant on the forefront of their minds. And so I think here within the Summit League too, they have that with not just as a value benefit within the health plan, I think they literally live that out within their families as far as being active and using the preventative services as far as like your annual physicals, which are free to members on the small group or the individual health insurance plans with Sanford Health. They also offer, you know, pediatric, dental and vision benefits, which are great value ads. That's just part of the health insurance. So there's no additional cost to those services for members to use. And so the fitness reimbursement program that Sanford offers, you know, it's really provides a kind of a checks and balance in the sense of if they go so many times throughout a month, they'll get a check for the times that they've gone in a certain up to a certain dollar amount — obviously it's capped. So that's one way outside of the preventative services. There's a lot of online tools and resources for employees to use through their online portal for those consumers. And then members can also look at, you know, well, their last annual preventative checkup was obviously sometimes we forget throughout the year, I think just in the day-to-day scheme of life. So I think those are just a number of things that they provide that really show the value in the coverage outside of just your bottom dollar for the health insurance piece of things.
Host: Jay, when you're talking to your employer groups, talk about the value that Sanford Health Plan has as part of a trusted, integrated healthcare system.
Jay: With Sanford, the, they offer different wellness and lifestyle services. As far as, you know, nurse case management to a nutrition consultant to tobacco cessation programs. So we see a lot of employers wanting to get their employees on these programs because, obviously, they know that an employee overall wellbeing not only helps their employee as a person, but also productivity, which also helps the business from a, from a bigger picture perspective.
Host: Pam, through your experiences with Sanford Health Plan, you've done a lot of the hard work here and you've had the benefit of working with Jay, but there are a lot of people that are just starting out. What is some of that insight you can offer to other small businesses as they consider shopping for health insurance?
Pam Schut: Well, whether you're an established organization or you're looking to switch your health insurance plans, maybe you're a new entrepreneur in search of the ideal health plan, it's important to choose your health care carefully. When selecting insurance, health insurance, be mindful of whom your employees are, because if your workforce is made up of mostly young and healthy adults, you may want to choose a plan with a low, monthly premium and a higher deductible. As these individuals are less likely to use their insurance on a regular basis, but there's a number of other key things to consider when you're looking for your health plan or to research. And number one would be the network again, see what the providers are where the facilities are, see how they benefit your situation, prescription coverage. That's another big one. Again, I'd mentioned earlier, the high deductible health plan versus a traditional copay plan, you got to figure out what works best for your situation, your clientele. And obviously we get back down to the budget. You've got to know what your budget is for health insurance, figure out how much your business is willing to put into it, but also you need to consider what your employees will be contributing, because again, that's part of their package, but it's part of their salary too. So, but anyway, with ongoing changes in the health insurance, I'd recommend businesses work with a local agent like I have Jay to assist going through the whole process of shopping and implementing the health insurance for our businesses.
Host: Pam and Jay, I want to say thank you to you for taking the time to talk about value when it comes to choosing the right plans for your employees. To learn more about the options through Sanford Health Plan, visit SanfordHealthPlan.com/employers. You can call (877) 305-5463, Monday through Friday 8:00 AM to 5:00 PM central time. This info is also in the show notes for this episode. For Health Insurance Simplified, I'm Alan Helgeson.