Benefits Agency

A culture of wellness

Leading by example, The Horton Group puts wellness at the center of its clients' benefits programs

By Len Strazewski

Do you really understand your client's organizational culture? Do you understand its entire range of risk? Do you know how to modify its health risks with comprehensive plan design, funding and wellness programs?

At The Horton Group in suburban Chicago, measuring health risk is the critical first step in comprehending client needs and designing individual programs that can generate a long-term return on investment. Although many agencies apply a risk management approach to property/casualty risks, Horton recognizes the impact of employee benefits costs and health issues on a client's overall risk profile.

Established in 1971, The Horton Group began as a small family-owned personal lines agency in Orland Park, Illinois, a southern suburb of Chicago. By 1982, the agency had become a full-service operation, marketing commercial insurance and employee benefits. Today, Horton is one of the largest privately owned insurance brokerages in the Midwest and ranks among the 50 largest brokers in the United States.

Horton's award-winning internal wellness program and producer mentoring initiative serve as a model for the value-added services it provides its clients to supplement their traditional employee benefits coverages, executives say.

President and Chief Executive Officer Glenn Horton says the agency's growth is driven as much by its culture as by market forces. On the agency's Web site, he offers this advice to clients and prospects:

"Hire driven, knowledgeable people who share a common entrepreneurial spirit and an enduring commitment to professionalism. Create an environment where employees are challenged and give them room to set and achieve professional goals. Hold business practices to the highest ethical standards. Continually reinvest in the infrastructure and plan for the future. That is the Horton culture."

Employee benefits now account for about 42% of the agency's revenue, and about 70 of its 220 employees work in benefits services. Clients range in size from about five to 5,000 employees. The agency represents more than 40 group life and health insurers and third-party administrators.

The agency has six offices in four states: Chicago and Orland Park, Illinois; Schererville, Indiana; Nashville, Tennessee; and Waukesha and Wausau, Wisconsin.

Cultural audit

The Horton culture drives a process of strategic planning, "five-star service" and the latest in technology, says Ken Olson, AIS, CES, GBDS, president of Horton Benefit Solutions. The process begins with an assessment of the employer's needs that goes beyond insurance issues and becomes a "cultural audit" of patterns of employee safety, wellness and satisfaction. To gauge satisfaction, Horton often recommends conducting an employee survey.

" 'Do you have a formal process for determining employee satisfaction?' That's just one of the questions we ask as we develop a risk profile of our client and begin the process of analyzing its employee benefits program," Olson says.

Horton also may recommend forming a wellness committee to build employee acceptance of and participation in a health risk management and wellness program.

An employer, Olson says, is more than just a business. It is a cultural entity that is driven by a variety of forces. Employee satisfaction, wellness, productivity and commitment are equally as important as products and market position. All of these factors contribute to the success of an organization, and all can be enhanced by effective employee benefits and health-related programs.

Once it has gained an understanding of the client's culture, Horton conducts an analysis of employee benefits costs and health-related claims and recommends plan design innovations. These can include consumer-driven health plans like Health Reimbursement Accounts, Health Savings Accounts, full or partial self-funding, or the establishment of a captive health insurance company.

Small employers usually must accept first-dollar health coverage, but these relationships provide little or no credit for an employer's efforts to control costs, Olson remarks. "There's no reward for a number of years without large claims, and claims data may not even be available to help develop a strategic plan."

For this reason, Horton attempts to move employers away from first-dollar coverage and into a minimum premium program or an Administrative Services Only arrangement with a health insurer. These programs allow access to specific claims data, which helps the agency identify "hot spots" for costs and develop preventive measures like health screenings, wellness initiatives and safety management programs.

"Strategically, we can take away some of the shocks and surprises and take some of the risks off the table with health improvement programs, and consequently improve employee productivity while reducing health claims costs," Olson says.

Winning with wellness

Wellness program design and implementation have become a cornerstone of the Horton approach, says Kevin Herman, MS, CADC, director of worksite wellness for Horton Health Initiatives, the agency's wellness services division. In September, the division received a Gold award of recognition from the Building a Healthier Chicago "Healthy Worksite Initiative." The initiative focuses on improving the health of Chicago residents and employees through public health, medicine and community promotion activities.

Horton Health Initiatives also was recognized as a Platinum-Level Fit-Friendly Worksite by the American Heart Association for providing healthy eating options and exercise opportunities at the workplace. About 100 of the agency's employees participate in an exercise and movement program, and 100 more take part in other wellness activities.

The Horton Health Initiatives division was established in 2007 with an internal wellness project, and in 2008 Herman joined the agency after 12 years in wellness and behavioral health services. The division's programs are used as a model and platform to develop ideas for clients, Herman says. The division has five full-time employees.

"The health of employees directly affects the performance of an organization," Herman says. "The Horton Group services prove time and again that corporate wellness programs are vital to the success of any company. Our innovative solutions drive real results."

In addition to promoting client participation in individualized wellness and health incentive programs, the agency also sponsors health fairs, health screenings and reward programs for meeting health improvement objectives.

What's more, to assist clients with health benefits costs, plan design and health risk control, the employee benefits division also provides a wide range of related services, Olson notes. These include worksite marketing of voluntary benefits to supplement employer-paid benefits, employee communication services, human resources management support, and regulatory compliance consulting. Horton has a compliance specialist attorney on staff and retains an ERISA specialist attorney to provide advice to clients.

Challenges abound

Although rising benefits costs are the primary concern of employers, in recent years, the uncertainties surrounding health care reform and the increasing burden of regulatory compliance also have become important issues.

Fred Garfield, CEBS, CFP®, ChFC, CLU, RHU, RPA, agency principal and senior vice president of Horton Benefit Solutions, has more than 30 years' experience in employee benefits and has been with Horton for 16 years. Over the years of his career, Garfield says he has witnessed an ongoing pattern of increasing costs, plan complexity and regulatory compliance challenges.

Today, he observes, "There is far less competition among health insurance carriers, which affects costs, and there is increasing complexity in plan design."

Benefits costs are always a concern for employers, he remarks, but today the biggest concern is the costs associated with not being prepared for the future of health care reform and evolving regulation.

COBRA requirements and state and federal compliance already have added tremendous stress to understaffed human resources departments, Garfield observes. That stress is exacerbated by the need to comply with health reform provisions like coverage mandates and state-operated health insurance exchanges, he says.

The senior executives of client companies are understandably concerned about the financial impact of these changes. Horton schedules regular educational meetings and webinars on health reform and related issues, targeting chief executive officers and chief financial officers.

"C-level executives need to be informed. They don't want surprises," Garfield says.

Eye on the future

Clients also seek stability in their agency relationships, and Olson says Horton has its eye on the future with initiatives to perpetuate its benefits and client service expertise through future generations of producers. An internal mentoring program teams junior producers with experienced senior producers like Garfield.

Senior producers and their understudies make client calls together, Olson says, with the junior producers gradually assuming more day-to-day responsibilities. The senior producers use their experience to advantage as troubleshooters and problem solvers.

Olson says the mentoring program represents an effective agency perpetuation strategy. "We recruit high-quality young talent and provide opportunities for stability and growth. Over time, we migrate our most important accounts to them as our senior producers move gradually into a back-up role. We successfully demonstrate that our resources, talent and expertise are scalable to our client needs, and we are able to maintain high levels of client and employee satisfaction."