One of the most difficult challenges for a broker is walking through plan design changes. While increasing costs are forcing changes, employers want to still offer a competitive plan. Often brokers are asked, “What is everyone else doing in this area?” If you are working with larger groups across many regions, it makes trying to determine appropriate plan design and levels of coverage even more difficult.

Changing plan design is a common prospect pain point as well. A number of years ago I was going for a broker of record from an 800-employee manufacturer in Wisconsin. I uncovered that they hated making plan design changes—they said it was done in a vacuum and just felt like cost shifting. Plus, they couldn’t explain to their employees the reason or whether their plan was still competitive. Because our agency provided health plan benchmarking as a key component of our renewal process, we were able to eventually win the business.

To address this challenge and help open doors, Zywave has just released the largest benefit plan benchmark report in the United States, covering nearly 70,000 plans and 50,000 employers across the nation. The benchmark info addresses seven key plan design measures:

• Plan type
• Coinsurance
• ER copay
• Individual deductible
• Individual OOP maximum
• Office visit copay
• Rx deductible

Each of these measures is further broken down by region, industry, group size and plan type, to help clients and prospects truly compare their plan to like employers. As brokers are looking for more ways to illustrate their value to the customer, being able to match their plan design to normative data will reinforce the broker’s expertise, add a new and valuable service offering, and ultimately help ensure the client is making a sound plan design decision.

At a high level, some interesting key finds in this data are:

• As a general trend, HSAs were more popular among smaller employers. Interestingly enough, at least 15 percent of plans were HSAs in all regions except the North East, where only 8 percent were.
• Across all regions, industries and group sizes, the two most popular coinsurance amounts by far were 80-89 percent and 100 percent.
• ER copays vary widely by region; however, smaller groups with less than 100 employees have a high prevalence of copays of $150+.
• Regarding individual deductibles, an interesting trend was that groups with less than 500 employees tended toward a higher deductible ($2,500+) while larger employers favored deductibles between $0 and $750.
• The two most popular Rx deductible amounts overall were $0-$49 and $250+, representing opposite ends of the spectrum. Interestingly, this suggests a pretty sharp contrast in how employers are viewing this plan design measure.

Additional information is being compiled and Zywave will release another year of data in 2013 in order to enable multi-year comparisons. This will prove to be an invaluable tool for clients and prospects looking to analyze trends, evaluate their offerings and determine the appropriate course of action. The report can be found in Broker Briefcase^®.