Advisers Urged to Enter Health Plan Advising
Panelists highlighted concerns with major insurers’ fee practices and control over care pathways.
At the PLANADVISER 360 conference in Scottsdale, Arizona, on Tuesday, health care experts discussed the growing need for financial advisers to expand into health care plan advising, emphasizing the potential economic impact and the demand for fiduciary oversight.
Panelists outlined the industry’s problematic structures, shedding light on how major players like Blue Cross Blue Shield, UnitedHealthcare, Cigna and Aetna allegedly obfuscate fees and manage care pathways in ways that could pose conflicts of interest.
Jamie Greenleaf, co-founder of Fiduciary In A Box, pointed to what she called the “BUCA”—for health care insurers Blue Cross Blue Shield, UnitedHealthcare, Cigna and Aetna—as creating an environment such that “money is often hidden within the system.” She compared this practice to how certain investment platforms previously limited investment options to their own funds, thereby obscuring fees.
“They’re hiding things among the different pieces of the puzzle that employers are using,” Greenleaf said.
Hugh O’Toole, CEO of Innovu, echoed this sentiment, specifically singling out UnitedHealthcare.
“They are the largest owner of primary care in the country,” O’Toole said. “They own the entire value stream, which includes directing patients to specific primary care providers for their benefit.”
O’Toole suggested that the current system, which has created an industry on which almost 20% of U.S. gross domestic product is spent, requires urgent reform. “Moving this down even to 15% could have a monumental impact on the economy,” he added, highlighting bipartisan support for health care reform through the Consolidated Appropriations Act, which survived transitions between the administrations of former President Donald Trump and President Joe Biden.
Expanding Fiduciary Duty to Health Care
As advisers navigate the evolution of their roles, the question arose: Should they also provide fiduciary services for employers’ health plans? Sean Bjork, president of Bjork Asset Management, moderated the panel, prompting the speakers to consider this opportunity and asking how advisers might approach such a shift.
Greenleaf responded by outlining a natural progression for financial advisers. She reflected on the industry’s evolution from brokers to fiduciaries and emphasized that a similar model could apply to health care. “I’m more of a fiduciary consultant now,” she said, noting that advisers do not need deep expertise in health care to guide employers through a fiduciary process. Instead, they need the curiosity to “ask the hard questions.”
Greenleaf described advisers’ potential impact: “You’ve made a difference in retirement; now it’s time to make a difference in health care by running a fiduciary process and identifying red flags.”
Looking Ahead for Advisers
The panelists concluded that while the transition may be challenging, advisers are well-positioned to make an impact. Greenleaf stressed that as fiduciary advisers for health plans, advisers can help employers navigate complex fee structures and compliance issues, just as they have done for retirement plans.
“Employers are seeking help to fulfill their fiduciary duties, and advisers are uniquely equipped to sit at the table and advocate for them,” she said.
Greenleaf and O’Toole were aligned on the idea that as health care reform continues to be a bipartisan priority, advisers’ expanded roles could contribute to a more transparent and accountable system, ultimately benefiting employers and employees alike.