BY BEN CONNER
With Halloween around the corner, our kids have talked non-stop about costumes. After wandering through rows and rows of Sonic the Hedgehog, Spiderman, and clown outfits, I started thinking about our professional alter egos. With a laugh, it occurred to me that the executives and HR professionals who actively strive to streamline and enhance their health benefits plans are the unsung heroes of the business world. Although they don’t swing from rooftops in the middle of the night, these leaders are like Batman, the hero their company needs to protect them from the evils hidden within their benefits plan.
Health Care Plans Are Gotham City
For all of its beauty and grandeur, Gotham City is a hotbed for crime and corruption in the Batman universe. Although you may not realize it, your health benefits plan could hold numerous similarities. Your benefits plan is supposed to protect your employees, but different villains are actively working against them.
Here’s how the villains of Gotham City are infiltrating health plans all over the country:
Two-Face: The Two-Face of your benefits plan is the insurance carrier who originally had good intentions. They wanted to protect your workforce while offering a fair deal. Now, however, misaligned incentives have made them money-hungry, and they spend their time reducing benefits and plan options while increasing costs.
Bane: Because this Batman villain relies on a potent mixture of chemicals to maintain his incredible strength, he is the perfect metaphor for the pharmacy benefits manager (PBM). PBMs should support their clients by assisting in sourcing medication and forwarding rebates, but many retain those rebates for themselves while charging unnecessary administrative fees and using spread pricing to boost their revenue on prescription drugs.
Scarecrow: In the Batman series, Scarecrow exposes his victims to a powerful fear toxin. In the real world, the hospital systems have grown so complex, some employees are intimidated by their exorbitant, opaque billing practices. Overnight stays are overly expensive, the costs are rarely spelled out before a visit, and many hospitals profit from delivering subpar services.
Joker: The Joker of the modern health care plan is the broker who recommends the same plan to everyone, regardless of the client’s specific needs. This broker is willing to risk the company’s health, employee retention, and revenue in order to generate profits for his own business.
Like Batman, you can defeat each and every one of these villains. In most cases, you are likely the only person at your company who has an opportunity to defeat them.
You have the authority and responsibility to pursue plan optimizations that benefit your workforce. Whether you execute on fighting these villains today or tomorrow, you have to start preparing now. If the villains don’t descend today, they’ll come eventually.
You don’t have to face these challenges alone. Batman has help.
Rely on Alfred
If you become Batman, the dedicated advisor who supports your progress and assists along the way is your Alfred—the unsung hero of the Batman series. Alfred is Batman’s rock, a resource for sage guidance and a tireless leader who works to keep Batman’s entire operation running smoothly. Likewise, your advisor is an experienced professional who understands the best options to support you and your employees.
Lean on your benefits advisor. Together, you can systematically dismantle the crime in Gotham City and eliminate the dangerous villains working at the top.