Commentary: Helping employees be better consumers for their health care benefits

Most people wouldn’t buy a car without shopping around and doing some online research first. They want to make sure they’re getting the best value for their money, that the vehicle will suit their specific needs, and that they’ll be able to safely transport their families where they need to go.

You’d think that people would show similar interest when shopping for health insurance. Yet research from Aflac’s WorkForces Report shows that 89% of people select the same health plan year after year, even when given other options. The same survey shows that 49% of employers agree that benefits communication must be improved, yet most employers aren’t doing anything to address the issue. 

So what’s the disconnect? 

Employees often fail to evaluate their benefit options for several reasons. New employees may be overwhelmed with information upon starting a new job and may simply view benefit selections as another item on their to-do list. Veteran employees may view the paperwork as cumbersome and confusing so they retain their existing plans, deciding that what was good enough for last year will also work this year, even though their needs may have changed.

See also: 10 questions to help clear up health plan confusion for employees

And that’s only with their base benefits. The situation is even worse with voluntary benefits, such as life insurance and disability. Unfortunately, it’s not uncommon for employees to realize that they failed to sign up for disability only at the time they go to file a claim. Or, employees may hear about voluntary benefits from another employee and complain that they didn’t get the chance to enroll as well.

What happens then?

There are several risks involved with uninformed or under-informed employees:
 

  • They may miss out on benefits they’re entitled to
  • They may choose a plan that is not appropriate to their needs 
  • They may choose treatment options that are more expensive than necessary. For example, they may seek treatment at an emergency room when they could’ve visited an urgent care facility instead at a lower out-of-pocket cost

Each of these possibilities creates risk for the employer as well; these types of behavior cost employers money. On top of that, organizations may eventually face legal trouble if their employees don’t understand their benefits. If an employee or dependent is denied benefits after death or disability—or if they believe they weren’t given the opportunity to elect benefits when eligible—the employer may have a lawsuit on its hands.
Missed deadlines have recently become even more critical. With healthcare reform, there’s decreased ability to retroactively add people to plans if they miss sign-up deadlines. In the past, carriers may have been more inclined to back-date an enrollee. That option is now off the table.  

How to close the information gap

So how can you help ensure that employees are taking a proactive role in their healthcare selections? Stop treating them like employees and start treating them like insurance consumers. Here’s how:

1.      Create a consistent message about your organization’s healthcare offerings and then disseminate information the same way you would a marketing campaign. Schedule your message to repeat three to four times per year. Deliver the information in bite-size chunks in the form of fliers, email messages, and posters. Remember that if people feel overloaded they’ll tune your words out, so be as brief as possible.

2.      Encourage employees to meet with you face-to-face if they have questions.

3.      Be a translator. Break down any dense language so your workforce is able to understand what features are included in different plans (i.e., how their deductibles function, what it costs to go to an out-of-network doctor, etc.).

4.      Make sure employees know where to go to find information, such as your company’s intranet. Keep in mind that the harder it is to find information, the less likely people will be to seek it out.

Encourage employees to approach benefit shopping the way they would car shopping. Then give them the tools to do so.

  • Suggest they compile their yearly healthcare costs—such as the estimated number of doctor visits, special procedures, and prescriptions—and run side-by-side comparisons in their benefits administration platform to determine what their actual costs will be. Remind your employees that a higher cost plan doesn’t always equal a better-quality plan.
  • Link to your insurance carriers from your intranet so that employees can view benefits easily.
  • Suggest online tools to compare costs and features of different plans.
  • Provide tools that help decipher the costs of service at different providers, as well as prescription cost calculators.

Some helpful websites include:

If an employee needs treatment for a condition, encourage a consultation with your broker’s employee advocacy support representatives to find out which healthcare providers have the best outcomes for certain procedures.
The upshot: Understanding that employees may need help digesting benefits information is key to ensuring that they’re are able to take full advantage of their insurance options. Giving them the tools to ease this process not only helps ensure healthier employees with higher morale, it helps contain costs for the company. 

Stephanie Ward is senior regional vice president for Corporate Synergies, an employee benefits consulting group.

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