Effective communication is key to any internal businessendeavor - some would say benefits most of all. And if your business is like many others across the country, it is considering - or already implementing - a shift toward defined contribution or consumer-driven health plans, an effort that may well require your biggest communications campaign yet.

Life Technologies, a California-based medical research and life sciences company with more than 10,000 employees, shifted its workforce to a CDHP in 2010. Benefits leader Carole Mendoza says the education and communication effort for that change ran the gamut from bathroom newsletters (the old "porcelain press") to blogs, webinars and social networks. She says Life Technologies offers its workers a health savings account incentive for subscribing to its benefits Twitter account, but that it's hard to beat basic email for a direct message.

Mendoza recently walked EBN through that communication campaign, from the high-tech to the low, and looked ahead to the benefits communication future.


What was behind your decision to move to a CDHP?

Well, like a lot of employers, we were looking at costs that were continuing to rise in spite of a pretty healthy workforce, and we thought that continued cost-shifting was really unsustainable. So we wanted to do something that would engage our employees and help lower costs for the company and for employees, too, by helping them to be healthier.

We have one high-deductible health plan; we launched with two and required a screening and a health assessment to get into the richer of two plans. We did that for the first year, and this year we have one plan. And we require a screening and a health assessment to get any HSA funding, because we still want the data. But heavily incentive-based - all HSA contributions are based on either outcomes from the biometric screening or activities. Our deductibles are as low as they can be.


What about the communications effort?

It started out very low-tech, feet-on-the-ground, explaining all of these changes to our employees so that they had an opportunity to ask these questions. We also rolled out [health care transparency through] Castlight at the same time to help employees with cost and quality questions because they were kind of insulated from those issues in a PPO/HMO world. We have an intranet that's on a Jive platform, so [it's] very social network-like, like Facebook, [and has] lots of blogs, articles online, as well as discussion boards. So we get the good, the bad and the ugly with what's going on with our employees.


What do you mean by starting low-tech?

We did a benefits road show. All of the team went out to our 16 largest sites in the U.S., all that had more than 50 employees. They went through first a presentation and then a Q&A on the changes. And we followed that up with another presentation right after we rolled out the plan, so the first one was before open enrollment, and the second was the February the year after, because we figured a lot the questions were going to come up when people were actually living it - so two sets of road shows, with lots of webinar support as well.

We also do low-tech communications for the home; we want to make sure that we hit spouses. So, as much as we'd like to go green, we do print an annual benefits summary each year with a cover letter explaining the changes. And then traditional "porcelain press," especially for our manufacturing and distribution employees who aren't in front of a computer all day. We have LCD screens around our sites as well, so we'll put up benefits messaging when appropriate.


And the not-so-low-tech initiatives?

We have that intranet site that I mentioned. Lifelink is our intranet, and it has polls, blogs ... and that's also where we'll take things that are topical, like what's the difference between an HSA and an FSA, and just write a blog on it, and then include a link to that blog in our weekly digest that all employees get through email. We can do some quick hits on things that may be confusing or interesting or important for an employee to hear.

Then we also have the benefits portal that is with our benefits administrator, Aon Hewitt. So we use them for enrollment purposes, and then we put a dashboard on top of their enrollment tool that has links to 401(k), to health and welfare, to Castlight, Aetna, Medco, a link to anyone you could possibly want to talk to about benefits, including ADP, who manages our payroll, and a single sign-on within the firewall so you don't have to remember all those usernames and passwords.


When you first informed your population about the switch to CDHP, how did you do it and what kind of feedback did you receive?

[Feedback was] poor, initially. It was a big change, and we launched it just a couple of months before open enrollment. We weathered the [economic] storm of 2008, we were still paying very high bonuses, we had a very rich 401(k) match. But, starting in 2010, we were starting to pull things away like service awards, our PTO was frozen, so [employees] started to feel some pressure. And then you add this on top of it, so, in context, there was a lot of change.


What happened after that, with the implementation?

We ripped off the Band-Aid and made all of the changes at once, instead of little tweaks year after year, expecting that the change was going to be quite dramatic and that the initial reaction might be poor. [Indeed], the first year we took a hit on engagement scores. Year two was significantly improved, back up to the 2010 levels.

Since then, we have had a 4% reduction in health risks among our population. Our screening results - glucose, blood pressure, BMI and cholesterol - have all improved, so the number of employees and spouses in the healthy range has increased year-over-year. We've [also] been able to hold the line on cost, so no increases in deductibles, out-of-pocket maximums, paycheck deductions, and we've actually been able to increase the contributions through HSAs.

And the noise has died down among employees - they're living it now, they kind of get it, and the HSA balances are starting to rise because people are saving. We're doing fine.

With a large switch like this, you quickly figure out where the holes are.

We moved to that benefits portal with single sign-on to everything, so it's a one-stop shop for everything benefits related. It's really improved the employee experience.

The biggest challenge we have is that this is really confusing, and people don't know where to go for information or what to do. So, the extent to which we can take friction out of the system and help employees get the information they need as quickly as possible is good, because then they can get back to the important work of trying to cure cancer.


With benefits messages now, what methods do you use?

Still email. [But] we have 20% of our employees who are in manufacturing and distribution sites, and we need to get to them as well, so we still use the low-tech, the "potty press" and those LCD screens.

We launched the Twitter account and actually provided an incentive in the HSA for those who started following us on Twitter, just to give people reminders about deadlines, for example, or to say, "Did you know that X number of our employees are in the healthy range for blood pressure?"

And then we're also launching an external microsite that is mobile-enabled to allow employees and spouses - and candidates - easy access to information that is not personal, but high-level benefits information with links to all of our vendors again.


Sounds like you're more than ready for complying with the Patient Protection and Affordable Care Act?

(Laughs) We think so. The good news is we already have salary-based contribution, so four tiers, which makes us "affordable" for everybody, so we don't anticipate having to make big changes in the near term.


Where are you seeing the very best return on investment, dollar for dollar?

Actually, targeted pilot [programs] at particular sites. We did a prediabetes pilot. So, we had all the glucose data for 90% of our employees and spouses, and we went after those who were prediabetic - a blood glucose between 100 and 125 - and offered them an initial test [for risk]. If they were deemed at higher risk for diabetes, we offered them a diabetes management program to help them work on their lifestyle. We had very good results with that on a target population, and we think we can be more targeted at specific sites with specific populations to see if we can make a difference.

We have used different ways of communicating to make things simpler for employees, and I think making them simpler makes [employees] more likely to engage and get excited about it. Just cutting through all the clutter and making things easy to access has been well-received, and I think has helped to impact our results.

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