Building smart self-funded health plans: What’s most important?

A change in health plans affects everyone: employees, human resources, consultants and executive teams. But with the right partners and strategy in place, everyone can benefit. Follow these best practices to build smarter self-funded health plans around what’s most important to your key stakeholders.

C-Suite executive teams

Healthcare is typically the second largest expense for a business. Ensure your company can continue providing benefits that attract and retain talent by requiring:

• An independent entity that can act as a steward of your plan free from conflicts of interest.
• One integrated system with centralized experts for appeals, customer service, check-runs, COBRA and technology.
• Auditing practices that ensure no savings opportunity goes undetected.
• Line-item visibility into claims.
• Proactive and results-driven strategies for engaging with highest-cost claimants
  • Look for: A breakdown of the facilities and diagnoses driving highest-dollar claims and how they are being managed.
• Transparent Rx contracts, prior authorization and return of 100% of rebates.

Human Resources teams

When benefits are confusing or disruptive, employees look to HR for help. In our ongoing member survey, 52% of employees say that if they didn’t have access to Healthgram advisor, they would have involved HR. 39% would have avoided resolving their issue altogether. A better healthcare experience for HR should include:

• Dependable client service that allows HR to focus on strategy
• Fast issue resolution with one convenient point of contact
• Proven strategies for engaging employees in existing offerings
• Tangible examples of cost management to share with finance teams
• Notification of large claims in the pipeline
• Year-round transparency into plan performance
• Minimal disruption that allows HR to successfully manage through change

Employees

Smart benefits lead to savings and employer loyalty. Provide employees with a benefits experience that includes:

• Concierge-level benefits guidance and issue resolution with one number to call
• Proactive intervention that anticipates needs and helps them save on costs
• Personalized care plans for new and ongoing issues
• Omni-channel and customizable communication strategies

Consultants

Companies rely closely on the expertise of their benefits adviser or broker. A successful health plan partner will provide them with:

• Seamless access to on-demand plan performance data. You and your broker should have full visibility into the ins and outs of your plan so that together, you can make data-driven decisions.
• Customized recommendations for improving health outcomes and savings.
• Expertise in compliance support and accuracy of claims administration – plus a single point of contact when questions arise.
• Trusted client retention rate, so that all parties can reap the benefits of ongoing savings.