The Employee Benefits market is projected to see a continued increase in health plan costs for 2024. With costs rising, employers are being forced to decide between pushing additional costs to their employees, taking on more costs themselves, or finding alternative risk management solutions that may offset some of the increased burden. No matter which direction your company chooses to go, it is crucial that you support your employees and provide them with the education to improve their healthcare literacy as well as make cost effective decisions throughout the year.
1. Improve your Communication: (for plan selection and throughout the year)
Many organizations have an opportunity to provide more effective communication when it comes to plan selection as well as throughout the year. Employees benefit from clear and simple messages that can be repeated across multiple platforms. Keep in mind that your organization may be made up of different generations with many different health concerns. Your organization should offer open meetings to talk directly to your employees and give them insight to your overall benefits strategy. You should also offer clear opportunities for employees to ask specific questions that might be sensitive in nature.
Once employees have selected a plan, it is helpful to provide an easy and accessible place for them to find key details about their plan. Major health insurance carriers offer apps that have some of this information, and you can also use an intranet or benefits portal to hold this information.
Explain the reasons behind any changes in your benefits program or its cost
- Rebound in healthcare usage after COVID-19. People that put off doing certain procedures or treating certain conditions during COVID-19 pandemic are now seeking treatment. causing a rebound in usage
- Inflation, particularly in the cost of healthcare organizations' supplies, technology, and employee wages
- Higher cost of prescriptions and availability of new, expensive medications- especially when it comes to diabetes and obesity drugs
2. Provide better education & encourage members to improve their Healthcare Literacy
Employees who do not understand their healthcare plan are more likely to make expensive decisions or avoid care altogether. With healthcare cost rising, it is more important than ever that you provide resources for your employees to educate themselves and make informed, cost effective healthcare decisions. Encourage employees to learn more about the specifics of their plan and to ask questions as they come up throughout the year.
It can be helpful to provide examples of common care scenarios and to show what different courses of action may cost. For instance, an employee whose child needs stiches may have the option between going to an urgent care clinic or an emergency room, and the cost of these approaches to the same treatment may be very different. By prepping people in advance for situations they may face, they are likely to make better decisions around the cost and quality of care.
3. Get more involved in employee Plan Selection!
Plan Selection is overwhelming and confusing to so many employees. Without guidance, employees may end up selecting a plan that does not support their needs or the the needs of those on their plan. Incorrect plan selection can cost your company any your employees an enormous amount of money, so there is a clear benefit to providing better guidance.
For example, employees who are generally healthy may want to select a plan with lower premiums and a higher deducible. Other employees who are planning to have a baby, need an expensive procedure, or have a chronic condition are likely to need a plan with higher premiums and a lower deducible. That said, individual biases may lead people to make decisions that aren't optimized for their needs. Improving your education on how to pick a plan and where to ask specific questions is a great way to save your organization unnecessary spending this upcoming year.
Keep in mind that your workforce may include several different generations with drastically different needs. It's important to provide them with a safe space to ask questions specific to their plan and care.
4. Encourage your employees and the members on their plan to take advantage of preventative care
Blow out the match before it becomes a forest fire!
Everyone should have a Primary Care Physician!
So many issues can be addressed before an emergency room visit is necessary. Symptoms like a lingering cough, an unusual pain, or occasional shortness of breath can be good triggers for contacting a primary care physician, but may develop into more serious problems if allowed to persist. Your doctor will know your situation and can provide knowledgeable advice on the next steps for your care, if needed.
5. Explain Proper Care Settings- be transparent on cost
Another common and expensive mistake that can usually be avoided with proper education is picking a care setting. Where your employees go for care matters! Not only is it important that they stay in network, but it is also important that they understand the cost behind where they are going. For instance, if an event is life threating, they should go to the emergency room. However, for events that are not life threatening they may be fine to save the money and go to Urgent Care. Every plan is different, but you need to make sure your employees understand that going to the Emergency Room should be reserved for the most serious situations.
Another important factor to call out is their care setting for testing. If your employee needs to get a test done, they should first check which care settings offer the particular test they need. If the test they need is available at an outpatient or standalone center they should always select one of those options before selecting a hospital setting.
However, sometimes they will not have a choice in care setting for a certain test and they need to understand the extra costs they may incur. For example, if a doctor has ordered an MRI with contrast this test will only be performed in a hospital because of the need for a nurse and an IV. Anytime your employee visits a hospital, even if it just for a routine, non-emergency test, they are spending more money than if they got the same test somewhere else. If a hospital visit is needed, you should educate them on how to determine a rough estimate of the cost before going to the visit.
You can help your members prepare by walking them through the process for Verification of Insurance. First, they should call the care setting and confirm that they are in network. It is very important to highlight that asking "do you take my insurance" is different from "are you in my network". Next, they can request the care setting to provide a Verification of Benefits for the procedure. Requesting this will prompt the care setting to reach out to their provider to get a diagnostic code so that a proper estimate can be developed. This will ensure that your employee will have a reasonable estimate of the cost of the visit before they arrive. This also gives them a chance to consider payment plans or other methods.
Reminder to your employees: it is a good idea to be aware of the Urgent Care options in your area and their hours so that you are prepared when needed. Employees who do not understand this are more likely to make costly decisions that could be avoided.
6. Provide Support throughout the year
Providing your employees with a direct support or nurse line can also be a great way to control costs, especially outside of business hours when an employee needs to make a quick decision about care. If an employee who is concerned about symptoms is able to call a nurse line, it will help them quickly make an informed decision about which care setting would be most appropriate. Other lines, that allow them to call an insurance representative can help them understand the cost associated with their care before they go. You will also want to make it easy for your employees to call in and check if their provider is in network or find doctors that are in network.
7. Encourage employees to contribute to an HSA
Why is it important for your employees to build and maintain a well-funded HSA account? Healthcare savings accounts are a great way for your employees to save money to pay for medical expenses. They are tax-advantaged and will help your employees with eligible higher deductible plans afford out of pocket medical expenses. The money is set aside on each paycheck and provides a savings buffer for when medical bills are higher than expected. Pairing an HSA with a higher deductible health plan may be an option for members to set off higher monthly premiums.
Looking for help keeping your People and Benefits package competitive? Our team is here to help you max savings, educate your employees, assist with customer service and ensure everyone on your plan can get the answers they need.
Note: This article is not meant to be legal advice and does not speak to the specifics of every plan. It is simply meant as guidance. Please reach out to your broker for specifics on your plan.