Benefits brokers have been on the receiving end of backlash from employers and employees alike due to the perceived lack of transparency in their dealings between companies and insurance carriers. But one brokerage is set on changing this narrative.
This month, Nava Benefits is releasing a
"We sold employers these plans and we recommended these vendors," says Donald DeSantis, co-founder and chief product officer at Nava. "If you're having an issue, we shouldn't leave you hanging and potentially on the hook to fight a bill because you tried to use your insurance benefits."
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Surprise medical bills aren't out of the norm, regardless of the insurance carrier or health plan. One in five U.S. adults has been billed an unexpected balance after receiving care, with 22% of those respondents being overcharged $1,000 or more, according to a 2022 survey from the Morning Consult, a business intelligence company.
DeSantis recalls an employee who was charged $20,000 after the hospital claimed their procedure wasn't covered. Nava was able to get the claim reprocessed and reduce the bill to $0. Nava hopes this app makes it easier for employees to reach out and resolve the problem.
"The person probably would first reach out to the insurance carrier, run into a wall and then escalate it to HR — then HR comes to us," says DeSantis. "There's so much friction there. How many people got a big bill and were never able to reach us? We are talking about a bill that could be the difference between bankruptcy or not for a lot of people."
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In fact, despite just 8.6% of the U.S. population being uninsured, an estimated 41% of Americans currently have medical debt, ranging from $500 to $10,000 or more, according to Kaiser Family Foundation. In other words, insurance doesn't necessarily protect its members from medical debt. But DeSantis believes benefit brokers are in the position to do just that.
"We work with HR professionals to design an optimal benefit strategy and negotiate the best possible rates that we can with all insurance carriers," he says. "So we should also help employees get the most from those benefits. This shouldn't be unique to Nava. Every broker should be doing these things."
And since Nava mainly works with small to mid-sized employers who have between 25 to 1,000 employees, DeSantis is confident that Nava's app can make
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"We don't charge anything additional for the [app]," says DeSantis. "We just believe it's super important and everyone needs it."
Nava already provides 100% fee transparency to their clients; if the employer doesn't save, then Nava doesn't charge for its services. Notably, benefits brokers did not have to disclose their fees, bonuses or commissions until the Consolidated Appropriations Act of 2021. Even then, brokers are notorious for being unwilling to share how they make money due to unfavorable dealings that put the carrier first rather than the employer.
Still, DeSantis is optimistic about the future of brokers and hopes Nava can inspire brokers to hold themselves more accountable — something that proves difficult if brokers aren't honest with their clients.
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"Transparency isn't necessarily good for transparency's sake," he says. "Transparency is good because it drives accountability."
In the meantime, DeSantis predicts the app will lead to higher utilization of benefits while empowering employees to maximize what they get out of those offerings. In a
"This might be hard. This might be a lot of work for us," says DeSantis. "But I would love it if more brokerages did what Nava is doing here. It's better for everyone."
