Achieving a Balanced Perspective in Stop Loss

In the insurance industry, there’s a well-known “healthy tension" between Sales and Underwriting. That push and pull of what could be viewed as contrasting objectives. I came to know it well over many years as a marketing underwriter, working at the intersection of responsibilities and gaining the perspective of “the in-between.”

That role taught me the importance of taking in a range of views that included input from our nurses, pharmacists, and actuaries too. When you consider different frames of reference and work to find common ground, you can better maintain the right balance in the business.

The navigation of diverse perspectives also extends beyond our own intentions as a carrier to encompass the factors being weighed by our broker partners and our mutual self-funded clients. After all, how can any of us feel confident in the coverage provided without considering what everyone involved is aiming to achieve?

Our Sales team is driven by the desire to meet customer needs and build lasting relationships. We focus on growing and maintaining business while fueling our broker partners’ ability to deliver coverage that their employer groups can rely on.

Our Underwriters, alongside our Clinical and Actuarial experts, work to provide protection for self-funded groups while also guarding our own financial health. They carefully assess risk and work to ensure that the coverage we offer is sustainable and priced appropriately. They also look at the long-term picture to help protect both our policyholders and our own organization from unforeseen liabilities, so we can deliver on our promises.

Our Broker Partners are the vital link to the employer groups. As trusted advisors, they work to understand their clients’ unique challenges and requirements. It’s their goal to deliver reliable and competitive offers for coverage that they can confidently present, knowing that what’s on the table should reflect the best interest of each client.

Employer Groups want to know that they are protected from the financial impact of unforeseen catastrophic claim costs that could potentially devastate their self-funded health plans. They seek stability, predictability, and coverage that protects their bottom line. They have chosen to self-fund to gain more control over plan options and costs, so they want to know that the details and price of their coverage make sense.

Finding the right balance can feel challenging at times, but it’s essential. It’s far more than simply a policy sold – it’s the ability to deliver the right coverage at the right price for all involved.

To accomplish this, Sales must approach each opportunity with a holistic view – understanding risks and collaborating closely with the underwriters to create smart solutions. The underwriters, clinical experts, and actuaries must recognize that behind every set of numbers is an employer group with unique circumstances and a need for protection that considers their different attributes. When evaluating each case, they have to find creative ways to mitigate risk and provide effective coverage.

And to help our broker partners understand and find value in our approach, we must empower them with transparent information, responsive support, and solutions that demonstrate that we have the best interest of their clients in mind. They should come to understand, through what they experience first-hand when working with us, that what we say we will provide and what we ultimately do are one in the same. Consistency matters.

In an unpredictable market, our predictable approach can provide a sense of stability that enables our brokers to deliver our coverage with confidence. Ultimately, the most important thing for employer groups is to know that their claims will be paid.

Some may simply consider a closed deal a win, but true success is built on trust. When every perspective is considered and solutions are developed collaboratively, we strengthen partnerships and deliver better outcomes for all.