Healthcare Guidance: Employers Best Hope to Tackle Rising Costs

Healthcare Guidance: Employers Best Hope to Tackle Rising Costs

Companies are losing the battle against rising healthcare costs without healthcare guidance. Costs are continuing their steady climb with annual increases this year forecasted at 4.3 percent – double the 2017 inflation rate – according to the National Survey of Employer-Sponsored Health Plans. The sticker shock continues!

The situation isn’t any better for employees, 40% of whom fear the lack of clarity and transparency in healthcare according to a Prophet survey. The same number of people also believe that the healthcare system is more concerned about money than their well-being. It’s not hard to see why they feel this way; out-of-pocket costs are expected to increase by 7.2% this year. The average expense is set to hit over $5,200 in 2018.

Why Are Healthcare Costs So Crazy?

There is waste everywhere you look. We’ve used the analogy that the consumption of healthcare is similar to visiting a restaurant with a menu that has no prices. People consume whatever is recommended without any thought of costs – until it’s too late. This way of consuming healthcare has got to end.

A few examples of the waste that is pervasive in the healthcare journey:

  • Costs for an MRI can vary by 10X, even with in-network providers
  • American physicians say that up to 30% of medical services are unnecessary
  • Patients Overpay For Prescriptions 23% of the time
  • 28% of men and 17% of women don’t have a PCP
  • The wrongly vetted PCP can recommend services that are 2-3X higher in price

The Kentucky Hospital Association said that 58 percent of hospitals reported losing more than $100,000 annually per employed physician.  Why do you think they would lose money by employing them? Because the affiliated hospitals generate almost $1.5 million per physician each year through tests, procedures and prescriptions according to the Merritt Hawkins’ 2016 Inpatient/Outpatient Physician Revenue Survey.

There are so many pitfalls within the healthcare system that it’s impossible to expect employees to make the right decision on their own. It’s no wonder costs are out of control.

Healthcare Guidance: Helping Employees Make Better Decisions

Providing employees with a concierge and healthcare guidance service can seem like a luxurious perk – and it is – but the secret is that it can also drive down a company’s healthcare costs. WIN – WIN!

Employees Win – Using a healthcare guidance app like HealthJoy simplifies the healthcare experience. Employees are no longer at the mercy of the overly complicated healthcare system. They have a single place to turn to when they need to use their employee or healthcare benefits. We are a neutral third party that’s always looking after the employee’s best interest to get them the best quality of care at a fair price. We typically save employees a few hours and hundreds of dollars a year dealing with healthcare. Our use of artificial intelligence and virtual assistance technology allows us to be proactive in our recommendations and outreach.

Employers Win – All our employers have achieved a positive ROI within 90 days using our service with a mean return of 4.5X. Several highly engaged clients have hit as high as 15X. Our offering uses a hybrid approach of live concierge that’s supported by an AI-driven virtual assistant that will help your employee make better healthcare decisions. We’ll even save your human resources department time spent administering your employee benefits.

Taking Command of the Employee Benefits Experience

Individual employee benefits vendors traditionally manage their customer service, but the quality is low. Employees complain that they might be on hold with an insurance provider for an hour in the fourth quarter or get suspect recommendations for service. Human resources spends hours every month helping employees navigate the experience rather than focusing on the work they want to address.

HealthJoy changes this model and becomes the first stop for all an employee’s benefits needs. The platform combines online doctors, healthcare Concierge, bill review, Rx savings, benefits wallet and more into an easy-to-use app that employees love. We have hundreds of cost-containing strategies that we use when recommending any service. Our members have given us a satisfaction rate of over 95% and bundling our service will even increase the Net Promoter Score of your existing health insurance plan, regardless of the offering.

When it Pays to get a Second Opinion: Bill Reviews with HealthJoy

When it Pays to get a Second Opinion: Bill Reviews with HealthJoy

Medical billing errors are still vastly misunderstood, and reliable statistics on the issue don’t exactly agree: The American Medical Association estimated that 7.1 percent of paid claims in 2013 contained errors, a 2014 NerdWallet Study found mistakes in 49% of Medicare claims, and studies run by groups that address billing issues put the error rate closer to 75 or 80%, resulting in $68 billion in unnecessary healthcare spending in the United States If anything is certain, it’s this: it pays to get a second opinion before paying that medical bill.

Saving 7x at Alpine Painting

At HealthJoy, that’s just one way we save our members money. Here’s a taste of what our team worked on, just in the past month! 

An employee at Alpine Painting needed to locate a new provider and chatted with JOY and the HealthJoy concierge team to find a new doctor in his network. The HealthJoy concierge team took it from there, researching providers, comparing facilities, confirming an office could properly address his needs, and even scheduled an appointment for him.

The employee paid his copay at the doctor’s office and the appointment went off without a hitch, but he was surprised to receive a bill for $342 after the visit that should have been covered by his insurance.

He took a picture of his medical bill and submitted it to the HealthJoy concierge team for review via the HealthJoy mobile app. The team reviewed the bill, and reached out to his insurance carrier directly. They were able to identify that the doctor’s office had listed the wrong address to submit a claim to the member’s insurance carrier, and worked with the office and the carrier to resolve the issue on his behalf. The office updated their claims process, and he was able to disregard the bill, saving over 7X.

Spelling errors have steep consequences

An employee at Morgan Creek Capital had some routine lab work done as a part of his preventative care visit, all of which should have been covered by his insurance policy.

He was surprised to receive a bill from the lab, which wasn’t properly submitted. He took a picture of the medical bill in his HealthJoy app and the HealthJoy concierge team stepped in. They noticed a spelling error in his name and called the lab to correct his name and his insurance information, and helped the lab properly submit the claim to the third party administrator Morgan Creek works with. The concierge team confirmed that he wasn’t responsible for any of the charges, followed up with the member to disregard the bill, and ended up saving him $651.98.

Want to see how much HealthJoy can save your employees? Reach out for a demo.

Why Drug Costs Are Rising, and What to Do About It

Why Drug Costs Are Rising, and What to Do About It

Drug costs are out of control, and one culprit has recently been placed in the hot seat: prescription drugs. Yearly price hikes for prescription drugs are now an accepted norm: In 2014, drug spending rose by 13%, the most significant increase in over a decade. In the past three decades, drug prices increased by nearly 2X, far exceeding the rate of inflation. All the while, drug companies have been enjoying higher profit margins— merely because they can.

Without regulations or consumer knowledge of prices, the sky’s the limit for the manufacturers who produce the drugs we depend on. The business model for increasing drug prices indiscriminately has worked for years, presenting a lucrative jig for big pharma.

The Special Role of Specialty Drugs

To investigate the forces behind spiking drug prices, Congress ordered a study from the US Government Accountability Office (GAO) in 2016. The report found that the use of expensive specialty drugs, which are medications that treat chronic conditions, is fueling much of the rise in drug spending. This is concerning given that specialty drugs only make up 10% of total prescriptions filled.

The Role of Patents and Politics

This trend is no accident. Specialty drug makers are known for aggressively claiming and holding on to patents, which win them exclusive manufacturing rights to their drugs. Drug patents are valid for 20 years, not counting the 5+ year extension periods that are currently allowed. Because patent holders have intellectual property rights to their drug, new manufacturers can’t access vital information such as how to produce the drug or what its formula looks like. If they want to create a low-cost generic, the expensive R&D process has to start from scratch.

Large drug companies may even go so far as to pay other manufacturers not to develop their drug. Even if new manufacturers decide to go ahead and produce a generic version of a brand-name drug, the process for approving new drugs is demoralizingly long and complicated. What results is that few companies are willing to enter into this expensive and lengthy process of creating a low-cost generic. The system makes it hard for underdogs to join the playing field, and easy for veteran pharmaceutical companies to enjoy a long-lasting reign on a throne of overpriced brand-name medications.

In the political arena, big pharma is a heavyweight champion. Financially powerful interests have ensured that the Orphan Drug Act along with biologic drugs are legally untouchable. Orphan drugs and biologic drugs treat rare conditions and were deemed necessary by the government to be set at higher prices (to incentivize development) and have longer periods before patent expiration. The longer a drug company has exclusive rights to its drug, the longer they can get away with charging whatever they want. In recent years their market share of new drug approvals has increased.

The R&D Drug Costs Rationale

The pharmaceutical industry’s primary defense for racking up their medicine prices is the costliness of drug research & development. A drug company might need over 10 years and up to $2.6 billion to bring a drug to the marketplace, according to Tufts University. Yet, pharmaceutical companies remain some of the most profitable businesses in America. In response to the high price of R&D, drug manufacturers have found lucrative workarounds. They’ve been choosing to spend less money developing antibiotics, which are unprofitable. Instead, they’ve turned their focus on specialty orphan drugs that earn a high payoff. This behavior is reinforced by the government, which gives tax breaks for orphan drug development. In 2016, the drug industry brought home $1.76 billion in tax credits for orphan drugs.

The government struggles to balance a need for innovation (through R&D) with a need to keep drug prices low. They want to encourage new treatment discoveries, yet pushing R&D has only given drug companies another excuse to set high prices. At the same time, forcing fixed prices or cost caps on drugs causes companies to complain about stifling innovation. All in all, there’s yet to be a clear political path to reduced costs. Like most issues driven by intertwining and complex factors, there’s no “easy win” that everyone can get behind.

The Role of Generics on Drug Costs

Generic drugs play a critical role in patient care, accounting for 90% of prescription spend. Because of their prevalence, generics are an essential channel through which to reduce health care costs. Yet doctors are as much in the dark as their patients when it comes to finding affordable generic alternatives to brand-name drugs. Not only are doctors heavily marketed to and influenced by drug companies, they also lack basic information needed to compare generic alternatives to the brand name drugs that they’ve probably been using for years.
While specialty drugs have been skyrocketing in price, most generic drugs have seen a steady decrease in price over time.

If only some of these legal barriers to producing generics could be removed, America would be looking at a much lower set of prices for their prescriptions.

U.S. Versus the World

Unsurprisingly, prescription drug costs in America are some of the highest in the world. US drug prices for several life-saving drugs are found to be wildly higher than prices for the same drug in comparable nations. Humira, a drug prescribed for rheumatoid arthritis, is priced 96% higher in the US than in the UK and 225% higher than in Switzerland. Tecfidera, used for multiple sclerosis, is priced 174% higher than in Switzerland and 668% higher than in the UK, according to Peterson-Kaiser Health System Tracker. Why might this be? Well, whereas other countries exercise tight control over drug companies, the US essentially allows them to set their own prices. Not only that, but we don’t impose any caps on costs like some European countries and Canada do. In Canada, drug companies can’t raise their prices faster than the inflation rate and can’t exceed the highest price of the drug in other countries. That surely isn’t the case in the States.

We’re also less likely ever to deny insurance coverage for certain medications that are overpriced for the value they deliver. Americans are prone to believe that one should be able to spend as much as they want for good medical care. In England and Norway, however, coverage for cost-ineffective drugs is outright rejected if they don’t have enough clinical benefit to justify their high price.

On a fundamental level, no single U.S. government entity can bargain with drug companies on behalf of patients. While nationally-funded healthcare systems in other countries have a single payer (the government), the US has a patchwork system of private insurers, public providers, employers, and state programs. Thus, Americans lack bargaining power that many other countries expect.

Finally, nowhere in Europe is it legal for drug companies to market directly to consumers. The countless sentimental or even frightening commercials you’ve seen on TV advertising certain meds are just not allowed in other countries.

And the marketing game is no small piece of the puzzle: drug companies spend upwards of $24 billion per year marketing to health professionals alone. Astonishingly, 9 out of 10 pharma companies spend more on marketing efforts than research, according to Global Data. This gives drug manufacturers another excuse to ratchet up their prices since they can happily label their marketing campaigns as “capital costs,” allowing them to overstate the real costs of production. Pharmaceutical companies have such a firm grip in Congress that they can get tax incentives approved while spending so much on advertising and mislabeling the expense

Drug Prices: Not What You Think

It’s almost impossible for consumers to know exactly what the real price of a drug is because so much goes on behind the scenes to produce the final copay dollar amount. Unlike pricing schemes for other healthcare services, Rx prices aren’t just negotiated between your insurer and the drug company. Instead, most insurers today work with pharmacy benefit managers (PBMs) who negotiate rebates for insurers and their payers. While they offer the potential for savings, PBMs add another layer of complexity to the prescription prices that can be difficult to make sense of. According to a Creighton University School of Pharmacy and Health Professions report, “spread pricing” by PBMs average $5.00 per fill but can run as high as $200.00. If you are getting a “free” PBM rather than paying a fee, you should look at the details of your plan.

Even more shockingly, insurance isn’t always the cheapest option for refilling your prescription. Our Concierge have found many times that shopping around offers patients a better deal than insurance. Online pharmacies, coupons and discounts, independent pharmacies, and supermarkets may provide dramatic cost-savings. Insurance can be great, but not when your drug isn’t covered, you haven’t satisfied your deductible, or you’re on a high-deductible plan. It’s worth it to compare your copay amount with all the available discounts.

The Solution: Enlist the Experts

Navigating the prescription drug market can be overwhelming. Luckily, you don’t have to go it alone. In recent years, a cohort of services has emerged to meet the needs of confused patients on prescription drugs.  As variations in drug prices become cloudier, it’s becoming more necessary to engage with a healthcare concierge service, which goes through the pain of price checking and comparisons so that employees don’t have to. In other words, finding your way through the maze of distorted prices doesn’t have to be done firsthand. Given the hefty out-of-pocket burden of Rx, delegating the task of “finding the best price” to knowledgeable partners will certainly lead to large returns for employees and employers alike.

Ultimately, the simple answer to why drug companies can charge so much is that there’s nothing stopping them. Consumers are expressing outrage over drug costs, especially since they’ve been shouldering a larger and larger portion of the cost, but their voices are weak compared to “big pharma.” The reality of this aggressively capitalistic industry means that it’s more important than ever for consumers to realize that they have choices. Many drugs have identical effectiveness but considerable differences in cost, and it’s up to you (and your healthcare concierge) to make the financially sound decision. 

Premier Consulting Associates Selects HealthJoy as Employee Guidance Platform

Premier Consulting Associates Selects HealthJoy as Employee Guidance Platform

HealthJoy has partnered with the dominant agency in Western New York and we’re excited to share the news. Premier Consulting Associates has selected HealthJoy as their preferred technology solution for employee guidance. They are an independent consulting firm that works with employers of all sizes to manage their healthcare benefits. Premier manages over $1 billion in insured, self-funded and prescription drug claims. Their clients will now be able to add HealthJoy as part of their benefits package and leverage artificial intelligence to lower their healthcare costs.

“Premier has a track record of selecting the best technology solutions for their clients,” said Doug Morse-Schindler, President and Co-Founder of HealthJoy. “Healthcare costs continue to rise and the executives at Premier understand that the only way to tackle the problem is to help empower employees to make better healthcare decisions. Their reputation for bringing forward-thinking approaches to benefits attracted us to partner with them, and we’re glad to work together to bring our solution to market.”

HealthJoy has the ability to help companies contain healthcare costs by redirecting care to higher quality, lower cost providers. For example, we can encourage the use of an online doctor consultation rather than have an employee go to the emergency room in the middle of the night. Or our concierge staff can recommend that an employee go to a specific MRI facility that uses the same equipment but charges thousands of dollars less than other facilities nearby (sometimes this difference can be 10X.) Both employees and employers benefit from HealthJoy’s easy-to-use and time-saving resources.

“In today’s on-demand world, employees expect a better experience from their employee benefits. HealthJoy has built the most advanced healthcare guidance platform on the market,” said William Brothers, CEO and Founder of Premier Consulting Associates. “Their use of technologies like artificial intelligence are years ahead of the competition. They can provide personalized communication at the member level based on their specific healthcare benefits.   We are excited to bring this solution to all of our clients.”

For more information about how we’re helping Premier Consulting Associates clients transform benefits for their employees and contain costs visit: www.premierconsultingassoc.com.

8 Best Interview Questions To Ask An Employee

8 Best Interview Questions To Ask An Employee

If you have a favorite question when interviewing a job candidate, you aren’t alone. Most seasoned human resource professionals develop a short list of interview questions over time that allows them to quickly find out what they want to know. These questions can become the backbone of an interview process and lead to more effective hiring.

The best questions typically focus on three things: the candidate’s ability to make a meaningful contribution to your company, whether they have the skills to make this contribution, and fit within a company culture.

One of my favorite interview prompts for people applying to HealthJoy is, “Walk me through a time where you brought joy to a customer.” To me, this is a great question to figure out if someone is a good cultural fit here at our company. We want to make sure that our people care about our members, clients, and brokers and want to work every day to make other people’s lives better.

I thought it would be interesting to ask a few experts with different backgrounds about their single best interview question and what they are trying to accomplish with that question. Here are some of my favorite:



Dr. Timothy G.. Wiedman, SHRM-CP
Retired Associate Prof. of Mgt & Human Resources
Doane University

“Tell Me About Yourself”

As a former hiring manager at two different ‘Fortune 1000’ companies before becoming a management professor, I often used open-ended questions of this sort at the beginning of an interview.  And since there’s really no “right” answer, it’s generally a low-stress way to relax applicants — and get them talking. But while there may not be any “right” answers, there are definitely subjects that wise candidates would avoid.  For example, if an applicant is recently divorced and is now the primary caregiver for an elderly parent with Alzheimer’s disease or two preschool toddlers, those would generally be topics to avoid during a job interview. So given that caveat, what is a potential employer really looking for?  In a single phrase, “organizational fit.”

As a general proposition, organizations seek people who can help them grow stronger. Thus, they want folks who will solve problems, not create them. So as much as possible, I looked for applicants who discussed the relevant transferable skills and related experiences that they could bring to a particular job, a work team, and the overall organization.  Further, answering by weaving the notion of enjoying challenging work and the sense of accomplishment gained for a job well done also earned high marks during my evaluations. But, on the other hand, I always expected the whole truth: folks who over-embellished important facts were routinely “discovered” down the line since my organizations (like most, these days) did thorough reference checks and background investigations.


Marisa Sniff
Senior Talent Acquisition Specialist
Combined Insurance, a Chubb company 5,000 employees

“What are you looking for in your next opportunity?”

I purposely leave the question pretty open-ended – some candidates interpret this as salary, culture, actual job description, location, work/life balance, etc. This gives me a lot of insight into their pain points in their current role without asking that directly (I have found asking for pain points elicits ‘politically correct’ answers.) By asking a general question, it gives me the immediate awareness of what is most important to each individual candidate.


Matthew J. Brosious
CEO
FreightCenter, Inc – 200 employees

What do you think we do at our company?”

I meet with every potential candidate and always make a point to ask them what they think we do at FreightCenter. It’s a loaded question that quickly sums up if a candidate has visited our website, researched our industry, or desires to know more about what we do. Without a basic understanding of what we do, a candidate wouldn’t be able to translate their past skills to the job in front of them. Many of our candidates don’t come to us with prior freight experience; therefore, it’s helpful for them to make those connections for me. They should know how to apply what they know to what we need.


Laura Handrick
Human Resource Reporter
Fit Small Business

“Tell me how your co-workers and direct reports describe your management style?”

I prefer behavioral interview questions that allow the interviewee to share a story or example. Candidates with poor management skills will struggle to come up with examples, instead, they’ll use “I” statements, like “I’m a direct leader and my team members like that.” Whereas, candidates with excellent leadership skills, will probably have a good example of a time a peer or direct report praised them for leadership, can name the person that said it and tell you about the situation that prompted the person to compliment them. Those examples give me insights into the candidate’s temperament and leadership approach.


Fred Coon, LEA, JCTC, CRW
Chief Executive Officer
Stewart, Cooper & Coon

“What Is Your Value Proposition?”

For Functional exploration, I ask: “What Is Your Value Proposition?” Their answer tells me whether or not they understand the role they play in past organizations, whether or not they can quantify their accomplishments, and provide examples of how they solve problems. I am seeking to learn if they understand their full impact on top and bottom line. But that is only one aspect of their performance.

We want to hire people who understand how to play well with others. People repeat behaviors. Exploring their past behaviors carefully provides a predictor of future behavior. Therefore, I not only ask functional and technical questions, I also explore their behaviors and try to understand their EQ. My purpose is to understand the candidate’s behavior (EQ) in multiple roles they play in a given work day. A few of these would be leader, follower, mentor, collaborator, and servant leader, to name just a few. I am also exploring their current leadership skills and their potential to grow into more senior leadership roles.

I believe that diving deep on functional and/or technical skills, and then simply brushing over the behavioral skills leads to problems, both short- and long-term; these problems manifest themselves in lower productivity, unhappy team members, possible disruptive behavior, and eventual turnover. Turnover is one of the most serious hidden bottom-line costs all companies face today.



Jerry Haffey Jr
President of Business Development
Ambrosia Treatment Center

“Where do you see yourself in five years?”

My favorite interview question and the one I use most frequently is “Where do you see yourself in five years?” It’s a classic, and sometimes overused, but in a sales-focused environment, it can reveal a lot about the person I’m interviewing.

The answer reveals how goal-oriented a person is, and what kind of goals they are setting. I always look for an answer with a good balance of career-focused goals and personal or family goals. That tells me that they are a well-rounded individual and are developing in more than one aspect of their life.

I also look for goal-setting that is realistic and attainable, but still outside the comfort zone. In my opinion, that is the sweet spot for growth inside and outside of a company.

If someone struggles to come up with an answer or says something that sounds overambitious, it’s a red flag and an indicator that they might not be right for the role. Setting goals and achieving them is crucial for any sales position.


Frankie Russo
CEO and President
Potenza

“Can you tell me about a situation from your past where you had an issue with a supervisor or coworker and how you resolved it?”

This question accomplishes a lot. On its face, it offers me a concrete example of a situation the candidate found him or herself in and how they handled it. Did they forge a win-win for everyone? Did they look to ‘win the argument’ at all costs? Or to maintain or strengthen the relationship?

“It also gives the candidate a chance to shine, or to trip up, insofar as helping me understand what they think is appropriate to say about former bosses or coworkers, about whether they’re going to throw someone under the bus or show me how self-aware they are, and what they did to control the only thing they can control, their own actions and reactions. And finally, it gives me insight into their problem-solving abilities and their willingness to learn from their mistakes and take actionable steps to handle a similar situation better the next time around.


Nigel Green
Vice President of Sales & Marketing
Relode

“What was your first job, and what did you do with the money?”

I clarify that I’m asking about their first job, ever. Not their first job out of college. I ask the question to get a sense of their work ethic. If they had a job at 16 vs. 22 that tells me a lot about their enjoyment of work, their relationship with balancing work and life, plus most people who started working at a young age aren’t entitled.

So what did you do with the money? Sometimes I hear that they used the money to pay for college or to buy their first vehicle. This tells me about their independence, resourcefulness, and determination. People like this set goals, and don’t let circumstances prevent them from being successful. That’s the type of people I’m looking to hire.

Navigating an Employee Benefits Plan Design Change

Navigating an Employee Benefits Plan Design Change

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’s 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.

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 a 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.