Communicating Health-Care Benefits to Employees and Retirees

Maintaining health-care benefits is a growing challenge. Health-care benefits are generally viewed favorably, but employers have the opportunity to increase the perceived value if the benefit is properly communicated. Employers need to communicate on an on-going basis the value and prudent utilization of this benefit. This is particularly important when changes to the health-care plan are to be implemented.

1. Communicating the employer and employee rates so participants understand their responsibility relative to the employer’s responsibility.
2. Educating the elected and appointed officials, employees, retirees, labor groups, other agencies, and the public on plan and benefit provisions in a simple and straight-forward manner. For example, utilize workshops with public officials as needed to facilitate any required decision-making approvals, especially when significant changes are considered.
3. Gaining and promoting a full understanding of the plan offerings in order to educate and facilitate information to stakeholders, and supporting a smooth transition when plan changes occur, including planning and adopting a timeline to communicate the changes.
4. Sharing information on the impact of rising health-care costs on the government and the health care benefits it provides, what cost containment efforts the government has adopted as well as any preventive measures, and how the rising health-care cost and cost containment efforts may affect plan participants. Include data from outside experts to enhance credibility and to benchmark data from comparable entities.
5. Informing participants about responsible health-care consumerism by seeking, producing, and distributing educational materials that clearly promote plan participants to be educated consumers when seeking goods and services provided by the plans. Examples include 1) communicating benefits of participating in wellness programs; 2) reminding participants that their purchases directly affect the future premium costs of the plan for themselves and all participants; 3) distributing local pricing differences for common procedures or common prescriptions; 4) promoting in-network versus out-of-network services as well as utilization of cost saving services such as telehealth.
6. Providing participants with information and resources, including
   1. enrollment resource with contact information of all plan carriers and products,
   2. coverage choices for required and voluntary plans offered that best meet their needs,
   3. Evidence of Coverage detailing the benefits covered,
   4. how to locate and evaluate health-care providers, and
   5. implications for utilizing in-network or out-of-network providers (for example: some plans may not include any out-of-network benefits and the insured will pay all costs for out-of-network providers).
7. Determining what kinds of communication work best considering technology and meeting accessibility for the participant population, including employees and retirees.
8. Using focus groups, surveys, and participant committees to solicit feedback and disseminate information when undertaking a significant new initiative or change. Examples of the type or scope of plan or benefit changes that may warrant participant involvement include:
   1. material increases in deductibles or co-pays
   2. material changes in coverage, including access to prescription drugs
   3. changes in availability of dependent coverage
   4. changes in providers or in the process for accessing providers, including step therapy, premium surcharges, or incentives
   5. changes of the carrier that may also include changes in provider network
9. Some jurisdictions might find it necessary to retain outside expertise to help them implement their communication and migration strategies. The outside advisor's role should be explicitly stated.