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Health insurance software taps data analytics for plan ideas

The Hixme cloud platform uses data analytics to recommend health insurance plans tailored individually to the needs of employees and then automates all payments.

For one major reason, Peter Baer is elated with new health insurance software by Hixme.

Baer said he uses the Hixme platform, which frees up HR to deal with HR, not health insurance, to provide and administer health insurance for his business. The health insurance software enables employees to choose their own plan, paid for by employer and employee contributions.

"Hixme takes health insurance out of my company, out of HR and puts it on Hixme. I love it that it is no longer administered by my HR department. To me, that is a gift," Baer said.

With data analytics, Hixme recommends health and other insurance plans tailored individually to the needs of the employee and employee's family, according to the vendor.

"I have been in business for over 30 years," said Baer, founder and president of Strategic Acquisitions, a real estate investment firm based in Los Angeles. "We have offered health insurance since day one. I've never had a single year when employees were happy with health insurance. It's been very frustrating. All the complaints eventually roll up to me."

 Health insurance is costly venture

Of his 150 employees, 68 have signed up for coverage through the health insurance software, he said. His company is offering the benefit for the first time this year through Hixme.

With Hixme, health insurance at Strategic Acquisitions costs about $456,000 a year. The company pays 50% of that cost and employees pay the rest. Baer said his company saved 10 to 15% by using Hixme, and he used the savings to offer company health insurance to about 15 part-time employees.

In an important part of its model, Hixme exists as a qualified employer group program, assuring that employee and employer shares of payments are made before taxes just as they are today, said Denny Weinberg, CEO of Hixme, which is based in Agoura Hills, Calif.

If an employer uses Hixme health insurance software, the employer initiates the normal open enrollment process by sending an email to employees inviting them to register. Employees click on the email and the Hixme platform pops up, with all the information on coverage and purchasing assistance.

Employees interact with the prepopulated information from their current plan enrollment to customize their needs and concerns, allowing Hixme to make relevant and meaningful recommendations for each employee, he said.

Automation is key aspect of Hixme

Employers will pay a certain maximum dollar amount as their share of health insurance. Those dollars from the employer could be more than the cost of the insurance chosen by the employee in Hixme if it is an inexpensive plan. That means employees would get money back.

If it is a more expensive plan, those employer dollars might only come to 50% of the cost, for example.

All payments are automated -- the money taken from the worker's check, the employer's share and money to the carrier, he said. "Once you make your selection and say purchase or send to cart, we take over and our platform manages all the rest."

Weinberg said employees using Hixme often will pay less in premiums because they are purchasing health insurance in the individual, lower-priced retail market. Because of changes spurred by the 2010 Affordable Care Act, premiums for individuals in the retail market, in most cases, are less than substantially similar coverage provided to employer groups under the current employer-sponsored traditional models, he said.

Employer-sponsored plans are highly customized and very expensive, he said. In addition, employers often need expensive advisors of their own, such as actuaries and benefit consultants, just to craft a customized plan year after year; that doesn't fit any one employee's personal needs very well, he said.

Meanwhile, an insurer such as Blue Cross and Blue Shield possesses the resources to design and update plans for the individual market. Insurers know what they are doing and can provide plans for the individual market that are much more effective and economical, Weinberg said. "These plans are time tested with millions of members, versus a typical employer plan which is designed generally for just a few hundred or at most a few thousand employees and which has to be recreated each year," he said.

Hixme is similar to a reseller, because it becomes an employer's supplier of benefits, he said.

Employees can borrow to finance health care

Hixme's revenues come from fees and commissions paid by various insurers whose products are sold through the Hixme cloud platform.

Hixme's Hixpay platform also allows employees to save by bundling even the most basic, economical health insurance with high deductibles with a specialized line of credit that allows employees to borrow money from future paychecks if faced with unexpected, expensive medical costs and out of pocket exposures such as a high deductible, he said.

This cost-saving option might work for young, healthy employees who are willing to take the risk of health emergencies in exchange for large savings on health insurance premiums, he said.

Hixme piloted its product last year and the health insurance software currently is used by about a dozen employers, all headquartered in California. Hixme is licensed in virtually every state and is currently in discussions with employers in the states of California, Washington, Missouri, Pennsylvania and Colorado.

Next Steps

Federal health law prompts need for automation

Private health insurance exchanges thriving

More health information stored in private cloud

This was last published in April 2016

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