The guiding ethos in developing and bringing new types of benefits to the market is: drive the cost curve downwards while providing a quality product.
Telehealth is one of the primary areas for cost reduction while improving services. The Mayo Clinic defines telehealth as, “the use of digital information and communication technologies, such as computers and mobile devices, to access health care services remotely and manage your health care. These may be technologies you use from home or that your doctor uses to improve or support health care services.”
As early as 2020, McKinsey predicted that up to $250 billion dollars of the current U.S. healthcare spend could be saved through telehealth and digitization. Still, in order to achieve such a goal they added, “it will require new ways of working for a broad set of providers, step-change improvements in information exchange, and broadening access and integration of technology.”
More Savings Can be Realized Through Benefit Tech Products
It is not just the direct service side of the healthcare industry that is shifting to tech solutions. Insurance and benefit entrepreneurs are also entering the market. These firms use technology and big data to offer consumers more choice and greater savings on benefits and insurance. These products also provide better service. Some prevalent examples are Bento Dental and Lensabl.
Through Bento Dental, founded in 2017, patients have access to a pool of 350,000 dentists across the U.S. Plans are available through all of the traditional sources: employers, small businesses, associations, third-party administrators, and direct-to-consumer.
Lensabl makes it possible to take eye tests and order eyeglasses online, offering all the selections and variations customers desire. Lensabl will even put lenses in existing frames, a service difficult to find in traditional outlets. Programs start at as little as $7.99 a month.
Both these entities and many others allow consumers to conduct all their business, from finding a dentist to scheduling an eye exam online, or better yet through an app.
What’s Driving the Shift to Telehealth and Insurtech?
Benefit entrepreneurs are seeing opportunities in the marketplace, and they have the technology to take advantage of these chances. The expansion of the marketplace is in response to the needs of both employers and end-users who want a product that meets them in the 21st century:
Employers. Companies competing for top talent know that the potential employee is in a position to make demands. This was a trend even before the pandemic. In 2019, MetLife released its annual Employee Benefit Trends Study. The study revealed that 80% of employees agree that benefits play an important role in workplace culture, and 93% of employees want the ability to customize their benefits.
Employees. Benefits consumers no longer have what we at Genius Avenue call the “group number and membership card mindset.” They can view their medical history and insurance details in minutes. Health plans and benefits providers like digitization for the same reason: it puts the consumer in control and takes the pressure off their customer success department.
Gig Workers. Our recent blog post cited another study that revealed 67% of employees are interested in gig work instead of their current jobs, and 35% of employers have hired or are planning to hire more gig workers. Another 43% of gig workers say that employers that offer them better benefits can attract them to a full-time job. Many of these benefits are offered off-payroll. Participants pay for it by credit card, ACH, or some other arrangement.
Changes in Healthcare and Benefits are Constant
There are challenges for those approaching the healthcare and benefits market with an entrepreneurial spirit. New technologies come at a rapid pace. The local, state, and federal levels constantly explore new legislation and tax opportunities as these products evolve. It’s easy even for the most experienced entrepreneur or innovator to overlook an important regulation or miss a new marketing opportunity for their latest product.
At Genius Avenue, it is part of our mission to understand the latest trends and regulations so we can offer answers and solutions to our clients. That is why we came up with the top 3 most overlooked topics when launching a product:
1. We Help with Bringing Your Product to Market
New products and improvements to existing products are important to any industry. Employee benefits are no different. The key is finding the right channels through which those products can be presented to the decision-maker.
Our business is helping companies bring their products to market using the latest technologies. These web-based platforms allow employees, in real-time, to see the cost of the benefit, how much their employer will cover, and what their financial responsibility is.
The Power of the Platform
One of our recent clients was struggling to administer multiple products through benefits enrollment. Making sure the end-user was aware of the complete offering was difficult, especially since some of the employers were spread out through many states, and often state laws changed the way the product could be offered. We developed a platform that managed these challenges, realizing $100 million in invoiced revenue.
Where is Your Customer?— At Genius Avenue, we help entrepreneurs determine the best channel to offer their product, whether it is an employer benefit, an off-payroll benefit, an association offering, or direct to consumer. We recently worked with a pet insurance company to offer their product through an app. Our services included helping the firm market the service in such a way that users were guided to an online sign-up process.
The Latest Technology
Gen X and Gen Z generations have been and will continue to be the major influencers in this shift to tech-enabled benefits. Technology has always been part of their life; they expect it. As soon as older co-workers see their younger colleagues pulling up an app to sign up for a new offering or check out their latest blood test results, they will want it too. Everyone looks for simplicity and ease in their life.
Merchant Portals—At Genius Avenue, we offer product developers a portal into individual platforms so that they can make changes to their products in real-time. This is important because innovators know that products need to evolve. They solicit and monitor feedback from end-users, then use that feedback to make improvements.
Mobile Capability—Our mobile app optimization has successfully and significantly increased benefit enrollment for our clients. According to SaleCycle, the rate at which people add to their shopping cart on mobile devices, known as the add-to-cart rate, is almost 9% for mobile as compared to 4% for desktops. Considering that 97% of U.S. adults own a cell phone, and 85% of those are smartphones, any product that markets and functions specifically for an app has an advantage.
2. Resolve the Nightmare of Sales Tax
This is one of those areas where government regulation is ever-changing and always confusing. Sales tax varies from state to state, and often even from city to city. Added to that, many tax agencies levy stiff penalties for non-payment. They also often lack any flexibility for missed payments, even if you honestly were not aware of something as small as a one-half percent sales tax in a city.
At Genius Avenue, we developed a software platform to create a sales tax solution. We started by maintaining updated sales tax tables by state and municipality. The program then makes sure the applicable tax is applied to each transaction, whether it is through a payroll deduction or an off-payroll benefit that is paid through ACH or with a credit card. Upon receiving funds, Genius Avenue processes the payment and makes sure that taxes are properly credited to each account, paid to the jurisdiction in question, and then recorded. Reports are produced and distributed so that each partner has a record of payment.
Of course, if there is ever any question during an audit, Genius Avenue can produce reports verifying all payments.
Tax and Virtual Currency
The confusion about sales tax is only getting worse for consumers as states complicate the laws and regulations. In a January 25, 2022 blogpost on the Avalara website, it was explained this way:
“ … many states currently don’t tax transactions occurring in virtual worlds. Although all sales transactions are presumed taxable in states with a sales tax (unless there’s a specific exemption or exclusion), most states haven’t yet clarified which sales tax laws apply to sales made in the metaverse. When will they start? And how will they go about it?
David Lingerfelt, senior director of North America tax content at Avalara, says one of the biggest hurdles to taxing transactions in the metaverse is that many tax and government officials don’t know what the metaverse is. They don’t understand non-fungible tokens, or NFTs [or cryptocurrencies]. “And if you don’t know what something is, you can’t know how to approach taxing it.”
At Genius Avenue, we work with clients who accept cryptocurrency as payment for insurance and benefits. The question follows: How are the sales tax agencies in the various states planning to approach cryptocurrency as payment? We don’t know yet. Very few, if any, agencies have addressed this issue.
This is an area that Genius Avenue will constantly monitor. We want to make sure our partners have the latest information when it comes to how sales tax affects them, especially in the metaverse.
3. Genius Avenue Reconciliation: Goodbye to the Month-End Panic
Anyone involved in insurance benefits, enrollment, and administration knows that month-end is a nightmare. Making sure payroll deduction is accurate and up-to-date is only the first step. Then comes the task of establishing who in the distribution channel needs to be paid and making sure that payment gets to them. If you are an entrepreneur with limited staff, this is time-consuming and fraught with human error. Missing one payment is an endless exchange of emails and phone calls.
After all, delivering the best in benefits and insurance is a complex business with multi-tier broker commissions, carrier and partner company payouts, and service fees for platform providers.
It’s a challenge to make sure new enrollees into a benefits plan are dutifully recorded so that their coverage begins appropriately, whether it is a payroll benefit, an off-payroll benefit, or a product in the wider market. Too many of us have experienced or know of a horror story about someone who needed a health benefit and human error left them uncovered. No one wants to be a part of such a scenario.
At Genius Avenue, we offer a payment processing service designed to take the burden off you and your employees and ensure everyone is paid in a timely manner. Insurance products and payroll benefits require a network of professionals to make the system work smoothly, and everyone deserves to be compensated in a timely manner. Our system automatically computes multi-level payouts and addresses downstream compensation.
We developed this reconciliation service to support some of the most complex insurance products on the market. We have a U.S.-based in-house development group constantly working as new products are added and new channels of marketing and distribution are developed. Our system is API-enabled, which means it easily integrates with your existing benefits system, third-party administration, or other billing systems.
Of course, almost all benefits involve security issues. Our software is HIPPA-compliant and designed to comply with payment card industry data security standards (PCI-DSS). Detailed monthly reporting and partner portals provide full transparency.
Realize Your Full Entrepreneurial Potential
This is an exciting time for healthcare and employee benefits. The need to innovate during the pandemic, the ongoing expectations of end-users, and strides in technology have made so much possible. This access to technology and push for innovation means it is the perfect time to introduce disruptors into the market.
If healthcare and benefits entrepreneurs are not careful, they can overlook new opportunities or requirements that can have serious consequences. That’s why it is so important to have companies such as Genius Avenue to address the needs of the market. Our push to explore new healthcare insurance and benefits opportunities helps our clients save time and effort by integrating our tools for their success.
Our experts at Genius Avenue have a successful history of developing solutions and unlocking new opportunities in healthcare and wellness benefits, especially through apps and online platforms that put the consumer in charge. Simultaneously, these delivery vehicles take much of the burden off of other participants in the system.
Genius Avenue firmly believes in investing time and energy to improve technology and innovation for solutions in the world of insurtech and benefits.
