What used to be a simple, two-prong decision—HMO vs. PPO—has grown to a much more labor intensive and research demanding decision. For the roughly 149 million nonelderly Americans covered under employer-sponsored insurance, the selection of health benefits has moved from dilemma to complex decision, as many more options exist for consumers to pick what matters most to themselves and their families—consumer driven healthcare.
This rise of consumer-driven health plans comes with good reason, too. According to the recent Kaiser Family Foundation 2014 Employee Health Benefits Survey, average health insurance premiums have skyrocketed in the past 10 years ($9,950 in 2004 to $16,834 in 2014), and consumer-driven health plans help both employers and employees to control these costs.
This move, however, does create a fair amount of confusion and frustration for employees, and even if employees adopted your company’s high-deductible health plan en masse, questions will undoubtedly arise when they try to use their plan.
While your benefits team may not be the first point of contact for employees, concerns will reach you, and preparation is key.
A major point, according to Workforce Magazine, is that education is no longer the number one concern. Although you should offer educational resources, employees at this time don’t want HDHP education—they want specific questions answered and concerns alleviated.
From point of service sticker shock to HSA and preventive care confusion, you should focus your time and energy as a benefits department on managing the following concerns:
- Point of Service Perplexity: With HDHPs, employees may experience sticker shock, especially when seeing what used to be a $20 prescription jump to $130.
- Remind employees that prescription spending does apply to deductible.
- Provide use of a transparency tool, promoting it as a healthcare shopping service
- Promote prescription drug comparison tools
- HSA Funds Befuddlement: Early year confusion may have already began for your department, especially if employees weren’t prepared to see that there is no money in their accounts. Brief employees on this by communicating the following:
- Promote all of the HSA resources you made available to employees during open enrollment.
- Simplify and shorten your HSA education resources into easily digestible information.
- Time your messaging based on common concerns.
- Preventive Care Coverage Confusion: 100% covered preventive care, helping your employees to stay healthier and detect disease before it becomes a major concern. The major concern, however, is when the bill comes for treatment. Brief employees, remembering the following tips:
- Remind employees that while preventive care (example: Diabetes Screening) may be free, treatment will not be.
- Drive home the value of covered care in real dollar values.
- EOB Ennui: When something looks like a bill, but is not, employees are bound to get frustrated—especially when there are words like not covered right next to prices. Even if these come from the provider, be prepared to answer questions if they arise.
- Explain the value of lower premiums.
- Consult with providers to see if they prepared any “How to read our EOB” documentation.
- Be ready to explain how deductibles and maximum out of pocket limits are met.
For a full explanation of how you can better prepare for the questions that will arise, read the entire Workforce Magazine Article, How to Get Consumer Driven Health Plans in Gear.
For other advice on helping employees better understand coverage, benefits, and more, sign up for the Healthcare Trends Institute e-newsletter, and read the following resources:
In January, the Society for Human Resource Management (SHRM) released findings from their annual Strategic Benefits—Health Care survey of HR professionals, which looks at the ways employers are addressing their rising healthcare benefits costs. READ MORE
High deductible health plan (HDHP) conversations are extending to the payer-provider relationship. Continued adoption of these plans by employers remains as a forefront option for companies looking to control their health care costs. READ MORE
More people are beginning to use their health savings accounts in conjunction with their 401(k)s to reduce taxable income and save for retirement. When HSAs were first introduced just over ten years ago, they were seen primarily as accounts that people with high-deductible health plans used for paying their annual qualified medical expenses. READ MORE
The results of Healthcare Trends Institute’s second annual nationwide survey and benchmark study on employee healthcare benefits is now available. READ MORE
Technology has impacted the business of health insurance advisors almost as much as health care reform has. READ MORE
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