Aon, UnitedHealthcare, other top firms using AI to personalize benefits

Employers are seeking more precision in employee benefit options. This requires brokers to be more in tune with the data and analytics behind every health plan and voluntary benefit offered to clients.

Business owners want to combine the traditional elements of benefit planning, such as staying within budget, with what employees deem to be important.

Unfortunately, companies are often at a universal data disadvantage with their benefit plans, says Bob Gearhart Jr., partner at DCW Group and co-author of Breaking Through the Status Quo. They typically make very expensive insurance decisions with limited data. “Reducing the overall premium by a few percentage points is far less important than making sure those dollars are being spent effectively by your partners,” Gearhart says.

Aon is one brokerage working to change that. Tim Nimmer, global chief actuary, says the firm’s databases, ability to utilize machine learning and artificial intelligence all provide real-time data on benefit trends. Through a combination of data submitted by brokers to Aon and third party surveys where employers explain the thought process behind their benefit offerings, Nimmer says he is able collect data on the offerings advisers are recommending to their clients as well as determine the reasons why an employee is choosing one plan over another.

Beyond revealing how many employees are enrolling in a healthcare plan, Aon’s analytics determine why an employee chooses a high-deductible health plan over a standard PPO, where employees are seeking care and how often they are going to a healthcare provider.

“Many of our clients are trying to be more sophisticated and intelligent when they make their benefit offerings,” Nimmer says. “Are they throwing bad money into a good pot by giving [employees] something that they don’t appreciate as much, or can the employer take those same dollars, find benefits that employees appreciate more and have a bigger impact on their staff?”

Carrier role
DCW Group’s Gearhart says an employer should always demand more data. If a carrier partner is unwilling to disclose the level of information that the employer deems acceptable, it’s time to find a new partner. “Insurance carriers, brokers and wellness providers must earn their revenue by reducing the business owner’s expense and not simply going through the motions,” Gearhart says.

One platform that is utilizing data to interpret employee reasoning behind plan enrollment is UnitedHealthcare’s Health Plan Manager. Craig Hankins, vice president of digital products, says the program combines all of the information on a particular employer’s employee population to determine the demographics within the company and how their staff is organized based on health plan enrollment. “[It] also combines claims analytics into its data consumption,” Hankins says. “We can look at medical claims, behavioral claims and even pharmacy claims as well.”

Hankins adds that the platform can also identify clinical information from employees, such as health risk assessments, and where employees are most commonly seeking treatment, either from a hospital or a private physician.

“Employers are looking at their health plans from the lens of what is driving health cost and what can they do to bring costs down,” Hankins says. “If there are opportunities to improve tactics and address emerging issues, that can lead to informed conversations between our account teams, the clients and involved brokers to discuss what is seen in the data.”

Once Health Plan Manager identifies the variables effecting healthcare spend, Hankins says the program can then drill down to the overall clinical trend drivers to determine if healthcare patterns within the company expand out into multiple locations or if the trend can be narrowed down to a single location or a group of employees.

“Even if it is a matter of doing an email campaign to a set of employees because there is a trend of employees going to freestanding ERs, for example,” he says. “We can identify these opportunities and rapidly act on them to see if it can impact cost.”

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Derek Rine, vice president and benefits practice leader at David Rine Insurance, estimates that 95% of employees at an average company approach their healthcare differently from the informed way they price shop for cars or groceries.

“They need some guidance and education on how to become smarter consumers of healthcare in areas that are well within their control,” he says.

Aon’s ability to gather data on the individual level is similar to the way Amazon identifies shopping patterns. Nimmer says when an employee enrolls in a particular plan the demographic of that employee is stored and their benefit choices are then submitted as options to other employees with similar demographics.

“It is a form of profiling based on certain data elements we already know about an individual, such as basic information from human resources,” Nimmer says. “When you start to combine these data sets together I wouldn’t be able to identify an exact individual, because that would violate privacy laws, but when an employee inputs self-identifiers, that AI or machine learning will store that information.”


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