The larger an organization, the more enrollments, changes, and cancellations there are to manage in your health insurance programs. It can be difficult to keep track, even with a benefit management portal. Many organizations review benefits once a year during open enrollment, but are you being as efficient and budget conscious as possible? Many organizations are wasting time and dollars without even knowing it! This article will review various health insurance assessments that can improve the overall efficiencies and compliance with the benefits you offer.

Selecting the Right Broker

Before jumping into the weeds of benefit assessments, it’s important to assess the tools and resources you have available to help you manage your benefits, in general. Simply put, if you don’t have a broker or if you’re not pleased with the one you have, times are changing! There are so many national or local options to choose from and many come with their own online benefit management systems as well. Additionally, brokers can help your employees better understand available benefit offerings and make more appropriate choices for their unique medical situations. As consultants, we work with many brokers and are here to make recommendations if you have any questions!

It All Starts with OE

Open enrollment (OE) is an election period once a year in which all employees are invited to revisit benefit offerings and make changes. These open election periods are required by the Patient Protection and Affordable Care Act (PPACA) for most organizations and are typically open from 1 to 2 weeks. During this time, benefit-eligible employees do not have to have a qualifying life event (QLE) in order to enroll or change their elections such as health, vision, dental, life, disability, spending accounts, or any other offered benefit. Compliance all starts with open enrollment, and many of us are used to going through the necessary steps, checking the box, and pulling teeth to collect paperwork. But this may be the perfect time to shop competing carriers so you can be sure the benefit options you offer are the best balance of coverage and affordability. Taking the time to assess your options by requesting a request for proposal (RFP), may provide the best overall plan for your employees. In many cases, brokers will help you take care of this and present you with options.

Benefit Needs Assessment

Another assessment many employers are choosing to do is an internal benefit needs assessment. We have seen the most success when organizations use the time before OE to survey their employee population and inquire as to which benefits would be most valued. For example, if an employee population is young and mostly in the childbearing state of life, perhaps investing in a paid parental leave program would be more beneficial than investing those dollars in an accidental death and dismemberment (AD&D) plan if the regular working conditions aren’t hazardous or dangerous. Asking, rather than assuming, can be a great way to put together a comprehensive and competitive benefit package that appeals to your workforce population. It’s about time we start asking!

Brokers are a big help in this endeavor as well. After your benefit needs assessment if you find your employees are interested in tax-advantaged benefit accounts, for example, brokers can help you get quotes and weigh the pros and cons of adding these options, such as health savings accounts (HSA) or flexible spending accounts (FSA). But it doesn’t stop there; many times, these additional benefits can be confusing to those who have never heard of them before. Brokers can also educate your team on the perks and differences between the two, so they can make educated decisions regarding their enrollments.

Dependent Audits

Did you know, some estimate that as many as 10% of all dependents of an organization’s employees are incorrectly enrolled in their employer’s health plan? In other words, there could be many who have health insurance sponsored by an employer that are ineligible to participate in these plans! If this is the case for most employers, how many non-dependents do you have on your employee’s health plans that you are contributing to?

Performing a dependent audit can help reduce unnecessary employment overhead costs and ensure the compliance of your enrollment process. These assessments include the following steps: you determine the timeline, assess the tools you have access to, put together a communication plan, and launch! Generally, this involves obtaining proof of the employee’s relationship with each claimed dependent. Some dependent audit services boast they can save an organization up to $3,500 annually, per dependent that is removed from the plan. The bigger your organization, the more certain you can be of a return on investment.  

Benefit Reconciliations

The last benefit assessments we’ll cover today are benefit reconciliations. These should be done quarterly, if not monthly, and can also save an organization money if we are ensuring the proper participants on each plan’s bill. This assessment looks for discrepancies between your carrier statements and the actual enrollment/termination records you are housing internally. In other words, if Joe just started and enrolled with us in January, are his benefit elections reflected on the February bills? On the flip side, if anyone cancels their benefits or resigns, are we issued a credit the following month if they have already paid in advance? This process is much easier if organizations are using an electronic health record system so a report can be pulled in real time for each audit; however, we still work with organizations monitoring any elections and terminations on Excel documents, when necessary.

Call to Action!

As you can imagine, these proactive, voluntary assessments can save you time, money, and effort. By putting together a schedule and properly assessing the variables associated with benefit management, you can stay ahead of any changes and ensure you are offering the best possible plan for your employees.

Do any of these assessments appeal to you? Whether or not you need the extra bandwidth on your administration team, or you’re just looking for more information, let’s unpack these proactive assessments together. For support or questions, Skywalk Group has your back and can help launch a project or can complete an assessment for you! Reach out to our team today:

By Samantha Rogers