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Health Plans Step Into Retail Operations

Margaret Dick Tocknell, for HealthLeaders Media, November 8, 2011

Within the rather staid and traditional health insurance industry there is a lot of discussion about the paradigm shift that must be made from a wholesale model based on large and small groups to a retail model focused more on individual policyholders.

One industry observer sees the advent of the retail health insurance store as a master stroke in terms of reaching out to customers on a one-one-one basis."Your customers are sitting right there in front of you. It's a great opportunity get feedback on what tweaks you might need to make on existing products, programs and services to prepare for the tremendous influx of new members expected in next few years," said Rittman, senior healthcare industry consultant for SAS, a Cary, N.C.-based business analytics firm.

Health insurers are pursuing a variety of models in developing their retail stores. Highmark has located its eight Highmark Direct facilities in storefronts in shopping centers. The Florida Blues prefers the free-standing model for its seven stores. UnitedHealthcare has used storefronts for its four consumer support centers. Most are located in high-traffic areas that offer increased visibility.

The insurers are interested in locations that put them close to existing members but also offer them exposure to the members they want to attract—an important distinction as guaranteed issue means health plans will no longer be able to rely solely on risk underwriting for member selection.

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