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Tech company works with insurers to reinvent benefits delivery

Guardian today announced a partnership with Maxwell Health, a Boston-based technology company, that will see the insurer launch a multi-carrier, proprietary platform to provide brokers and employers with a comprehensive, end-to-end operating system for health and other insurance benefits.

Guardian BenefitsCenter, which the insurer is rolling out through select Guardian brokers on a limited basis starting in the second quarter of 2016, will streamline the administration of benefits, human resources and payroll functions for brokers and benefits decision-makers at small- to mid-size employers, according to the company. Employees on the platform will have access to all of their benefits through a mobile app that incorporates health concierge, telemedicine and ID theft protection services.

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Vinay Gidwaney, Maxwell Health’s chief product officer and co-founder, recently spoke to EBN about how the company works with brokers and its vision for a subscription-style benefits delivery model.

EBN: Tell me about your business model.
Gidwaney: We get the questions often [such as] ‘Are you a private exchange?,’ ‘Are you ben admin?,’ ‘Are you HR?,’ ‘What are you?’. We usually say, ‘We’re all of the above’ because we're bringing a completely different approach to what it means to engage in healthcare in this country.

In terms that we all understand, we are a benefits administration HR platform for small businesses. We believe we are best-in-class when it comes to any employer under 1,000 employees that needs a system to handle everything from open enrollment, to ongoing changes, to being a system of record when it comes to their census, to HR and HRIS capabilities, integrations with payroll companies, working with TPAs, and sending data to carriers. We’ve put together what we believe is a modern, fast, benefits solution.

Now, that being said, we’re not actually here to solve ben admin and HR problems alone. We're actually using that world of benefits administration as a vector to get to the consumer because our long-term vision here is a little bit different. Our long-term vision is to really reinvent the economic and engagement platform for consumers when it comes to health and financial well-being. I know you talked a little bit before in your publication about our relationship with MassMutual [Maxwell is the technology partner for MassMutual’s BeneClick! exchange platform] and we hope to announce relationship with more companies like them, where we are working with carriers to completely reinvent the idea of what it means to have insurance.

Ultimately, our vision is to build America’s first subscription plan for health and financial well-being. We believe every American family should have the opportunity to pay a few hundred dollars a month and not get health insurance or get life insurance or get wellness tools or any of those things, but actually to subscribe to the outcome of health and financial well-being. It’s happening in all other aspects of our lives. You think about entertainment. We no longer buy music by itself. We subscribe to entertainment. Many people choose not own a car because, in essence, they subscribe to transportation through Uber and other products and services like that. We want to bring that same idea, and it’s very sorely needed, to the world of healthcare and financial well-being.

Now, the problem of course is that it’s incredible complex and it’s much harder to make it happen in that world. There are many ingrained ways of doing things such as benefits and employers and insurance companies. We know that’s the area that we need to start innovating in in order to get to that long-term vision.

EBN: This idea of a subscription service for health, how would that work?
Gidwaney: It is the crux of the challenge here. That whole idea of a true subscription service, it's going to take us time to get there. When we decided to start this company, we knew that this was going to be a decade-long commitment to pull off this kind of vision. We’re just starting on getting there. By no means are we at the point where we can say, ‘Yeah, there truly is this subscription.’ It's one payment mechanism, and one insurance product, or even a collection of vendors that all look and feel the same. You know that [this] is a messy, messy world and it’s going to take a lot of time and effort to make that happen.

At the same time, though, it doesn’t mean that we shouldn’t start trying. It doesn't mean that we shouldn’t start trying to dig at very specific areas where we can really improve things. If you get a chance to look at our technology, you’ll see that from a shopping process open enrollment in the world of Maxwell Health looks very different than open enrollment on any other private exchange or ben admin platform. We focus on this idea of a bundled based approach. We focus on the idea of eliminating decision exhaustion. In many ways [we’re] re-looking at [what] decision support actually means. I think education is important, but we’re all fighting this very significant uphill battle to get people to really care about what we want to tell them. Instead what we should be doing is re-framing the conversation to say, ‘Look, this is not about choosing between a high-deductible [or] low-deductible plan. It’s about choosing about how much financial security you want as a family and what you need.’

In fact, that's what we’ve done with MassMutual, because the most interesting thing that they’re able to do is that because of the nature of their business, they have a life-long relationship with their members’ retirement and life insurance. They’re in the best position to help you save for retirement, save for the financial freedom that you want for you and your family. They have the tools to do that. The problem is that those tools don’t get used because when I’m choosing my health insurance through my employer, I’m not spending a lot of time thinking about retirement, and disability, and life insurance, and all those other things because I get preoccupied with health insurance.

We always comment that there are two things that we need to do very well in the company. One is great design. If you can’t engage consumer – and I use the word consumer every single time because this is more than just about employees – the most common denominator out of all of this is the fact that everybody is a consumer and they expect a certain experience to match what the rest of their life looks like in the world of Facebook. One thing we have to be great at is consumer experience and design.

The second thing is that we have to do amazing plumbing. There’s no way we can pull this off unless we are actually able to work with all the existing systems. Whether it’s working with payroll companies, or insurance companies, or TPAs, all that back end stuff that needs to happen, [and] we’ve gotten very good at it.

EBN: Does the model you’re envisioning depend on defined contribution?
Gidwaney: We started digging at this and it was one of those things we never really understood. Why, if I wanted to take advantage of a reasonably good shopping experience and private-exchange-like qualities, that I all of a sudden [I have to] make the economic decision to move towards defined contribution?

Think about us as an operating system. Whether you want defined contribution, or defined benefits, or you want to pay for these products as an individual with your credit card, or they’re 100% employer-paid, or some combination thereof, promo codes, whatever, and whether the products are insurance products, wellness products, whether it’s Kashable or blooom or any of those other companies that are providing really great financial products to consumers today, those are all just apps on our operating system.

EBN: More benefits education by employers doesn’t always equate to employees making better decisions, which is a challenge. How is Maxwell Health addressing that?
Gidwaney: When you come to Maxwell Health and choose your benefits, you’re not presented with ‘pick your medical products, here is a cost calculator,’ or a decision-support tool to help you look up your provider and figure out what network makes sense or what deductible makes sense. Instead, you’re presented with – and we let you know most of the information to be able to figure this out – a bundle of offerings that’s cued for your lifestyle. If you have young children, you may be presented with a 'little tots' bundle. You're not looking at just medical. You’re looking at a complete package of benefits and services that make sense for you as a young family.

[For example] I’ve got two young children. The service that I care most about when it comes to healthcare is my telemedicine provider, not my health plan. My health plan is just whatever.

It’s sometimes [about saying] I should be spending more thinking about what kind of life insurance I want because I do now have a family, as opposed to how much it would cost if I were to break my leg on this medical plan. I think that sometimes we direct people into the wrong areas. As you know, the 13 minutes that people spend a year choosing benefits, I don’t think we’re of a sudden going to double because we’ve given them better tools. I think that’s a reflection of peoples’ motivation. What we have to try to do is make sure that those 13 minutes are very well spent. Things that take more time are kind of the opposite of what we need to do there.

EBN: What’s the role of brokers in your model?
Gidwaney: Brokers are built-in distribution channels that already have the relationship with every single customer in the country. Brokers are out there fighting for business and fighting for employees and American families to have successful futures. They're out there doing that every single day. We believe wholeheartedly in empowering them to do their jobs even better and giving them the tools to go there and succeed in that mission of helping employers understand what it means to have benefits. I think people always joke that their broker is going to disappear. Is that going to change? Well, maybe. It certainly is changing. Some brokers are getting out of the business. Some are doing great.

The bottom line is, though, that no matter what model you believe is going to work, there’s one common factor. And that is that the consumer is at the center of it. That’s why when we built our technology, it was all about the consumer. Brokers, employers, insurance companies, and others are just stakeholders along the way of serving the American family. I do believe that brokers do play such an important role. We predominately distribute our product through brokers. They are our customers along with HR administrators and employees and their families.

EBN: How do you see technology affecting benefits within the next year? 10 years?
Gidwaney:: I think that in the short term technology has been the biggest driver of change in the world of benefits. If you’re involved in any capacity in benefits, again as an insurance company, as a broker, as an employer, as a TPA, and you do not have technology as part of your thinking, you're already irrelevant. The smart ones are the ones who open the conversation with technology. The not-so-smart ones wait for the employer to say, ‘Hey, I heard about some type of technology and tell me about it.’ Those guys are the guys that are falling behind.

What is the role of technology and benefits in the next 10 years? It’s a lot, obviously. I think the things that are really going to be interesting are the fact that employers’ roles when it comes to benefits are going to completely change. In 10 years, the notion of buying your own insurance product, let alone buying health insurance and then dental and vision insurance and life insurance, or just frankly thinking about insurance that way, and then somehow having this card that you take to the doctor and needing to pay for things out of pocket, is going to feel like going to the record store and buying a CD today.

Technology’s going to solve that. It’s going to build all those layers and push them below the surface and say to the consumer, ‘You want help? Sure.’ It’s a service. It’s an app. Here you go. That doesn't mean it’s pop a pill, I do nothing, and I'm healthy. I still need to do things. [But] I get to interface with that world in a way that I want to interface, which is caring about me and my family and our healthiness and financial freedom.

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