Feb. 28, 2012 - When Ronda Austin's employer stopped offering health coverage last spring, she bought an individual
policy from Blue Cross and Blue Shield of Florida. A month later she was given a diagnosis of multiple myeloma and began chemotherapy at her
oncologist's office near her home in Tampa.
But after several sessions, the physician's office said that her plan covered chemotherapy only if it was provided in a
hospital and told her she owed the practice $15,000. Austin called her plan's member-services number but didn't get anywhere.
So she stopped in at a new kind of insurance facility — her local BCBS of Florida retail store. There, a customer service
rep sat down with her and called up her plan information online. She referred Austin to nearby
Moffitt Cancer Center for subsequent chemotherapy treatments and explained how to address the
problem with the oncologist's billing department, which had misread her policy. The problem was quickly resolved.
"It's a great feeling to know the insurance company is standing behind you," says Austin.
Health insurers increasingly want to make shopping for a new health plan as easy and convenient as dropping into a local
retailer to buy a TV. In recent years, a number of them have opened stores where consumers can stop by to talk with a customer service
representative about buying a plan or resolve questions about their current coverage.
Some stores also sponsor health fairs or community
seminars on nutrition and exercise. A few have primary-care doctors on-site.
Highmark aims to keep seniors healthy and active
Highmark serves the needs of seniors in our service area by giving them the products
and support that they need to remain healthy and active. Since Medicare began in the 1960s, Highmark has been providing products and
support to meet the needs of seniors. Today, we serve more than 500,000 members through our senior markets business, process some 16
million claims and have some of the highest-rated quality plans in the nation.
Florida Blue says:
In 2006, our first Florida Blue store opened in Jacksonville, making access to health
care coverage easier and in-person. It was quickly followed by a second location in Pembroke Pines.
In 2010, Florida Blue expanded services to its members and the community, creating a
free-standing center. In addition to helping people select their health care plan, the new center is also designed for member
education sessions, shopping for health services, care planning and support with a registered nurse, and community health fairs. The
Florida Blue centers are now open in Tampa, Miami, Jacksonville and Orlando with Ft. Lauderdale coming in early 2011.
Are You Turning 65?
As you approach age 65, one of the most important things you will do is make
decisions about your health care coverage. To help make your transition to Medicare smoother, Florida Blue offers monthly informative
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"The stores are big, bold and easy to see," says
Marc Pierce, president of
Stonegate Advisors, a research and strategy company in Chicago that has helped several insurers
evaluate retailing. "For insurers, the impetus is to provide a tangible touchpoint so they can provide more value for their customers." The
trend should continue, he says, unless the U.S. Supreme Court strikes down the 2010 health-care law.
The number of individual health insurance customers is expected to grow significantly in coming years. Employer-sponsored
health coverage is eroding, and in 2014 the law will require nearly everyone to have insurance, adding millions to the ranks of the insured.
The stores are "a reaction to the shift from wholesale to retail in insurance sales," says
Paul Ginsburg, president of the Center for Studying Health System Change. "In wholesale sales,
employers were the buyers. Now insurers are recognizing that retail will be more important."
Bricks and mortar
Highmark in Pennsylvania and
BCBS of Florida have the largest retail presence to date, with several stores throughout those
states. In New York,
UnitedHealthcare recently opened a 16,000-square-foot facility in the Flushing section of
Queens; it operates a number of smaller storefronts as well.
As insurers see it, bricks-and-mortar stores are one more way, along with online and telephone support, to reach out to
consumers. "This is a third service option for people that like high-touch service," says Craig Thomas, senior vice president for consumer and
government markets at BCBS of Florida.
Insurers also hope that their visible presence in communities may generate some positive buzz. "We don't really drive a
whole ton of word-of-mouth on the positive side," says Matt Fidler, vice president of consumerism and retail marketing at Highmark, a BCBS
BCBS of Florida and UnitedHealthcare both emphasize providing comprehensive services. At the Queens store, for example,
visitors, many of them Asian American Medicare and Medicaid beneficiaries, can get their claims questions answered in their native languages
and get help signing up for social services programs such as food stamps and a pharmaceutical assistance program for seniors.
"We want to afford people a 360[-degree] experience, and give people access to all the information they need to take care
of their health care," says Yasmine Winkler, UnitedHealthcare's chief product and marketing officer. Offering a smorgasbord of services also
keeps people coming back, creating consumer "stickiness," she says.
Strip mall service
In Pennsylvania, Highmark stores focus on sales. Ninety percent of the traffic at its eight stores is sales-related, says
After being laid off from her job, Heather Manning bought insurance at the Highmark store at a strip mall in Easton
shortly before her second child was due.
Although she wasn't able to get coverage for herself until after she had the baby — her pregnancy was a preexisting
condition, which individual insurance policies typically don't cover — she bought coverage for her 6-year-old son. Once the baby was born in
January, she bought a separate policy for the two of them. She pays $400 a month for all three of them.
The experience was very positive, she says. Before signing on with Highmark, she had gotten online quotes from several
other insurers, which led to a barrage of sales calls from agents.
Highmark customer service reps, however, don't get sales commissions. "It sets the tone to have it be educational," says
Fidler. "It differentiates us [from brokers] from the get-go."
Although there are many upsides to the new insurance stores, Pierce cautions that they could backfire. Consumers already
think that health plans make too much money, he says. "Here's the potential for consumers to say, 'Why are you building this big store? Why
don't you just reduce my premiums by 20 percent?'"
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