Much has changed about healthcare over the last few decades. That makes it an even greater challenge to properly educate and enable employees before asking them to choose health benefits.
“It’s really easy to run through an open enrollment presentation and forget about the impact of the decisions being made,” said Justin Holland, chief executive officer and founder of HealthJoy, a company created to give employees the tools and framework they need to make the right decisions for them.
Having a day or two to make major decisions just isn’t enough.
“Open enrollment is obviously a very important time to educate employees on benefits, but there’s 364 other days a year they’re using those benefits,” Holland said. “Our vision is that healthcare education be available at the right place at the right time.
“When a kid is sick at 2 a.m. and you’re going to the ER, chances are slim you’re going to remember what was said in that open enrollment meeting six months ago,” he said.
“Now more than ever, employers feel a mandate to take good care of their people,” Biro said. “That responsibility is bigger than how best to empower a remote workforce. It is more complex than deciding the right time to bring them back on site.”
Companies struggle with benefits education. Too often, benefits specialists are assigned their position without training and experience. When service is poor, employees complain, “If it was the specialists’ paychecks, they’d get action.”
Easy-to-understand terms matter
“Many organizations don’t really know what benefits education means,” Biro said. “Deciphering the complexities, learning the terminology, identifying the needs of each employee—that’s a start.
“Companies need to prioritize educating their employees so they are empowered to make the best choices,” she said. “The struggle for companies is also based on the past, when benefits were simpler, billing was simpler, costs were simpler. Today, understanding benefits takes far more than a presentation and a booklet.”
Likewise, leading the way must be more than an annual special occasion.
“Education needs to be year-round—not just when electing for benefits—and personalized at scale,” Holland said. “Employee surveys show 90-plus percent of people don’t understand insurance basics. Those same people won’t understand in five years. That needs to be OK. You need to give employees the tools throughout the year.”
The solution is active, continuous intervention.
“Education needs to be at the right place and right time—when it is needed,” Holland said. “Ultimately, it’s really hard to be at the right place and the right time unless you have a benefit experience platform that is present with your employees through their episodes of care.”
Closing the gap at employee onboarding is more of a hit-or-miss experience.
“It’s so important to realize benefits education is a 365-day job,” Holland said. “That one or two days during onboarding is not enough.”
Show employees in person that management truly cares even though “caring” on paper is easier.
“Having that empathy—especially as it pertains to the health and wellness of your employees—is vital, especially when pandemic cutbacks loom,” Holland said.
Better education, better savings
Reducing healthcare costs comes from education and incentives—not punishments. Emphasize the benefits of good healthcare practices.
“A really important strategy: Educate employees to ask the right questions so they can make better decisions at the point of care,” Biro said.
“There are amazing disparities, not just between versions of the same prescription drug but also the same procedure, depending on where an employee elects to have it done,” she said. “They need more information to be able to make the right choice.”
Technology also offers untapped benefits for benefits.
“Telehealth, virtual primary care and digitization are making a huge difference for companies,” Biro said. “They’re going to bring costs down. Companies need to make sure they’re leveraging those innovations in their benefits programs.”
Plans should have enough options to fit any employee’s needs.
“Ensure you have high-deductible plan options compatible with health savings accounts,” Holland said. “Educate your employees on what they mean.
“Give your employees a centralized experience—such as HealthJoy,” he said. “That 90-plus percent of people who don’t understand isn’t going anywhere. You need to make it easy.”
He cited other considerations:
- Prioritize primary care in your plan design. Think of the copays and coinsurance as your leverage.
- Ensure you have a transparent pharmacy benefit manager contract that has drug rebate pass-throughs. Bring this up with your benefit consultant.
- If you have over 100 employees, you should have the self-funded conversation with your benefit consultant. There are also alternative funding options that may be more appropriate, depending on your region and profile.
Capitalize on wellness
Underlying everything should be a push to maximize wellness.
“The wellness return on investment has been so challenging,” Holland said. “It’s hard for human resources teams to think on a 10-year-plus horizon, but that shift is important for the proper funding of those programs.”
Benefit plans must be written on an eighth-grade reading level. That’s not an insult. That’s the most comfortable level for people regardless of their education. Write for people—not lawyers—to read and understand. Then have competent experts to explain.
“Too often decisions on benefits are made in the moment: I’m fine, my family’s fine, so we don’t need that much,” Biro said. “Yet, emergencies happen. Illnesses—as we all know so well—happen. Educate employees to choose benefits for the worst-case scenarios.
“Like anything else, effective benefits education can’t just happen over the course of one day,” she said. “Coaching, self-service, frequently asked questions, additional information—all should be part of an ongoing package that employees can continually access.”
Benefit specialists must understand that one size does not fit all.
“Everyone has different needs,” Biro said. “One generation’s needs are so different than another’s. Choosing the right benefits is also about understanding what will work best for each individual.”
Holland has a checklist to assess benefit support:
- Take accountability for your employees’ plan decisions.
- Empower them with the right information.
- How risk-loving or risk-adverse are they?
- How much can they afford in certain circumstances?
“Give employees a framework,” Holland said. “Select benefit administrators who have decision support.
“Don’t forget the ancillary benefits during education,” he said. “Those additional benefits are typically decreasing risk—and cost—across different episodes of care. Make sure it’s clear to employees how those benefits fit in.”