The changing climate of health care has middle-market employers looking to their employee benefits brokers for services beyond the usual acquisition of health care coverage.

To get the most out of their brokers, employers need to focus on and articulate their business goals and objectives to their brokers, who in turn can provide the appropriate services that best fit the organization's needs, industry experts say.

“The days when we could just place coverage and then go play golf are over,” said Mike Brewer, Kansas City, Mo.-based president of Lockton Benefit Group, a unit Lockton Cos. L.L.C. “It's much more about the value-adds and the things we do to help that employer make better decisions about their employee benefits spend,” he said.

With the dramatic rise in health care costs in recent years, middle-market companies are paying more for their benefit plans without receiving the same value in return, said Michael Turpin, executive vice president and national practice leader of employee benefits for USI Insurance Services L.L.C., based in Briarcliff Manor, N.Y.

“Most middle-market employers are what I call generalist purchasers of services, and they've never really sat down and defined what it is that they want from a broker or an intermediary,” he said. “Against that backdrop, the demand for more services from brokers hasn't necessarily been that acute.”

But while some middle-market companies may lack defined employee benefits plan objectives, employers are increasingly competing for talent by using benefits to attract and retain employees, making the costs surrounding health plans critically important, said Kevin Krzeminski, senior vice president of sales for Liberty Mutual Holding Co.'s group benefits operation, based in Boston.

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Finding the “best coverage for the best price” historically has been the role of the middle-market broker, Mr. Krzeminski said. “But with a variety of external factors, economic factors and regulatory factors, the complexity that I believe these middle-market employers are dealing with has grown significantly.”

With that growth of plan complexity, benefits brokers have invested heavily in resources to provide middle-market companies more services outside the scope of transactional placements for employers to develop employee benefit strategies, experts say.

Brokerage services used for larger organizations have trickled down and merged with middle-market needs, said John Kirke, the president of benefits and health risk management at broker IMA Inc. in Denver.

“Right now we see the market being in heavy demand for compliance for regulatory guidance” regarding the Patient Protection and Affordable Care Act, Mr. Kirke said, noting that middle-market companies need help “navigating these waters” beyond providing papers on interpretive reviews about health care reform.

Other services include health risk management consulting, which helps employers integrate a risk strategy into their benefit plan rather than adjust the costs of an insurance plan, Mr. Kirke said.

“We're seeing more and more companies adopt a strategy that invokes risk management principles, benefit strategies, the culture inside their company and what's possible inside their company,” he said. “Those solutions have come to the middle market and are merging for those high-performing middle-market companies.”

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One of the challenges facing middle-market employee benefit planners is becoming a part of the organization's strategic planning process to promote the goals and objectives of the company, said Kent E. Lonsdale, area president of the Philadelphia metropolitan region for Gallagher Benefit Services Inc., the employee benefits division of Arthur J. Gallagher & Co.

“Mid-market organizations are pretty lean,” Mr. Lonsdale said. “Dealing with the day-to-day is all-consuming. In many situations, they're trying to survive the day, survive the quarter, survive the year, and it doesn't necessarily allow for great strategic planning.”

Brokers can help benefits planners get a seat at the planning table by providing compliance support, benefits administration services and claims resolution services, among others, Mr. Lonsdale said.

In efforts to reduce the costs of providing benefits as health care costs increase, more middle-market companies will look at self-insurance and at unbundling insurer services and outsourcing those services to third-party providers — an opportunity for brokers, USI's Mr. Turpin said.

“You don't need to use the carrier's claims and loss runs,” he said. “The brokers are going to transform themselves to a surrogate set of third-party solutions that are going to be theoretically more agnostic to the carrier and to the premium and focus exclusively on trying to get better outcomes.”

The relationship between the middle-market employer, broker and insurer has become integrated and interactive, something brokers are facilitating, Mr. Krzeminski of Liberty Mutual said.

Brokers now are helping the employers and the insurers to work together, he said. “I think that's healthy for the business and will lead to an increasing understanding and knowledge at the employer level about the plans.”