Assuring Affordable Healthcare through Insurance

Jim Foley, Vice President, Product & Underwriting at Wellfleet, has been associated with the company since 2018. His responsibilities include leading the product development and underwriting teams. Foley has assisted Wellfleet in diversifying its product portfolio and expanding its market reach, with a background in underwriting, product, and market development. 

What are the latest trends in the supplemental health insurance market?

The pandemic has increased the number of eople being diagnosed with mental health issues. In addition to increasing obesity among Americans, the pandemic has made the population more vulnerable to different diseases.

Many companies have started providing employee health insurance benefits as a measure to counter the increasing medical debt among their workforce. The government has also introduced many benefits, like the Affordable Care Act. These measures are particularly helpful to people who are self-employed and in need of a solution from the health insurance marketplace.

In the current scenario, there are evolving trends in the market, and Wellfleet tries to combine supplemental healthcare products with those trends. The company provides payment incentives for diagnostic tests or health screening benefits as payments that fall under an employer's health insurance plan. Wellfleet also looks at creative ways to align major medical plans to help cover auto-pocket costs. In the supplemental space, it is important to know the risk exposure that needs to be taken into consideration.

The trends are also happening on the executive side, as many technology providers are looking for ways to execute plans, such as benefit administration solutions, enrollment solutions, and the like.

In your opinion, what are some ways to achieve excellence in underwriting? 

The first step to achieving excellence in underwriting is to understand your customer. As a carrier in the employee benefits space, the most important process is to understand the unique needs of employees and employers. An underwriter must first understand who their customer is. They must be aware of their customer’s needs to provide them with the service they require. It is imperative to recognize what they are attempting to protect in terms of risk exposure. As soon as you understand the customer and their needs, a writer should try to determine where the risk exposure lies within their profile. Ultimately, they should be able to provide the right solution at an affordable rate with an offer that is suitable for the customer.

What innovations are being implemented in the healthcare insurance industry to increase the accessibility of healthcare for consumers?

After COVID, the crucial steps taken to check customers’ debt burden is by providing incentives. There are a lot of health screening benefits being given to encourage people to get the vaccination and get regular checkups for diseases like cancer.

A lot of discussions are also happening on ways to make health insurance more affordable. Many employers provide an accurate plan for their employees that covers their healthcare needs. But employees can also go to a health insurance exchange to pick a plan which will be later paid for by their employer. For instance, the Tennessee state healthcare exchange enables employees to choose a health insurance plan that best fits their needs. These exchanges allow the employee to select a plan, and the employer can either fund part of the premium, or the entire premium, depending on the funding. As a result, the employee has a choice that also helps the employer plan their budget more effectively.

What is your vision for the future in terms of disruptions and transformations?

The same cookie-cutter approach doesn’t suit anymore; the insurance plans need to be customized according to the needs. Insurance companies should also make an effort to educate their customers about the types of insurance they should purchase and the illnesses that those policies cover. Customers who involve the insurance provider at the start of the claims process have a better chance of streamlining the procedure. This enables insurers to locate market solutions, such as possible partners.

What advice would you like to share with your peers in the industry?

For any insurance provider, understanding the customer's needs and risk exposure is crucial to providing a customized insurance coverage plan. The focus should be on filling the gaps in the distribution ecosystem by bringing in innovative measures. Innovation and change are two crucial elements to bring into the healthcare insurance sector.