Navigating an Employee Benefits Plan Design Change

by | Mar 28, 2018 | Benefits

Every year, companies have to decide on how much to change in their existing employee benefits. With companies seeing real annual rate increases, it can be financially painful to stick with the status quo. Companies are working with their brokers to make more frequent and significant plan design changes than ever before.

Here’s a few trends in the marketplace. In 2018, there was a 20 percent increase in the number of employers offering at least one high-deductible health plan (HDHP) compared to 2016 in their plan design. Of those on HDHPs, the use of health savings accounts is skyrocketing. In the last year alone, HSA participation grew from about 50% in 2017 to 81%. Even the makeup of voluntary employee benefits has changed drastically. Identity theft protection usage is up over 50% since 2016, while even Fido’s lot has improved with 80% more companies offering pet insurance.

Changing your plan design can be jarring for employees, especially because most employees don’t understand the basics of their insurance plan. In fact, according to the UnitedHealthcare 2017 Consumer Sentiment Survey, only 9 percent of the U.S. population showed an understanding of all four of these basic health insurance terms: plan premium, deductible, coinsurance, and out-of-pocket maximum.

What to Highlight During an Employee Benefits Plan Design Change

Companies typically hold annual open enrollment meetings to explain plan design changes. The meeting might be accompanied by the distribution of a few – often lengthy – manuals. Employees are then left on their own to make decisions throughout the year, seeking help from human resources from time to time. Enrollment meetings should be laser-focused on a few key changes within the plan design to help employees understand how they can use their benefits properly. Here are the key takeaways that employees should understand.

Premiums vs. Deductibles

As much as employers might not like the term “cost-sharing,” with the rising cost of benefits,  employers and employees are splitting the bill more evenly. For group health insurance, the cost structure basically hinges on two things: premiums and deductibles.

  • Premiums – the portion that employers and employees pay for insurance, usually on a monthly basis.
  • Deductibles – the amount of money the employee is responsible to pay before their insurance begins covering expenses (except for preventative care – usually). In general, the higher the deductible, the lower the premium.

Provider Network – Employees need to understand changes to the provider network. They should be encouraged to check if their existing doctors are still in-network on their new plan. Employees should also be encouraged to develop an emergency care plan that contains in-network hospitals, urgent care and a new primary care physician (PCP) if needed.

Formulary – If an employee is on a monthly maintenance drug, they should verify that the drug is within the same pricing tier under the new formulary plan. If the pricing has changed, they should understand the new cost before they go to the pharmacy to avoid any surprises. They could also have a doctor adjust their medications based on their new formulary.

HRA / HSA / FSA – Health savings account usage is growing but most employees don’t understand how to use them nor their enormous benefits. Understanding what’s an eligible product or the ideal time to spend your money depends on many circumstances. Providing employees with ongoing resources for these types of accounts helps to maximize their benefits. Otherwise, employees may not receive the same value and end up switching back to a more expensive plan.

Read our Employee Benefits Communication Guide for more.

Using HealthJoy To Ease Plan Design Changes

HealthJoy is designed to be the first stop for all your employees’ healthcare and benefits needs. Changing plan designs is simple with HealthJoy because the member experience stays the same. The broker and human resources work together with HealthJoy’s implementation team to update the information within our system and make note of key changes in each member’s plan design. At launch day, employees will see their new selected benefits and all their personalized information within their benefits wallet.

Deductibles are instantly visible within the benefits wallet and consistently updated for compatible plans. JOY, our virtual assistant, becomes instantly aware of changes to provider networks and formularies. JOY and our Concierge can work on helping employees find a new local PCP, make an emergency care plan and conduct an Rx Savings Review to see if any medication could be adjusted to save them money. Even health savings account balances can be accessed within our app and our Concierge can assist with any questions.

Plan design changes have previously caused employee confusion and frustration, but that changes with HealthJoy. We welcome Human Resources to lean on our team to make the transition as seamless as possible. We can even design custom onboarding so that JOY can educate your employees on key changes to their plan. At HealthJoy, our mission is to simplify the healthcare and benefits experience.

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