Helping Your Staff Make Better Decisions During Open Enrollment

A successful open enrollment requires giving every employee a meaningful opportunity to understand their options and select coverage that fits their health care and financial needs.

However, a survey by human resources firm WorldatWork found that roughly 50% of employees spend less than an hour choosing their health plan despite the financial and health consequences that decision can carry throughout the year.

Employers and HR teams preparing for open enrollment should prioritize clear communication, decision-support tools and access to human resources staff that can help employees make the right choices for themselves.

Helping your employees

One of the biggest risks is that employees focus on the most visible costs like their premium contribution while overlooking out-of-pocket costs that could have a greater effect on their finances.

Consider an employee choosing between two plans. One has a lower deductible, making it appear to be the better deal. But it may also require higher coinsurance for a medication the employee takes regularly. Depending on the drug and its tier, those costs could outweigh any savings from the lower deductible.

Many health plan details are easy to overlook but can have significant financial consequences later. Encourage employees to choose a plan using the following checklist:

• Consider all costs. That includes your share of premiums, deductibles, copays, coinsurance, out-of-pocket maximums for medical services and prescription drugs.
• If you take medications, check the plan’s formulary before enrolling to ensure yours are covered and how much you would be expected to pay for it in copays or coinsurance. Mind the deductible as well.
• Look for prior authorization or other requirements that may affect access.
• Confirm that your physicians, specialists and preferred facilities are in the network of the plan you are considering. If you want to stick with your current plan, check to see that your preferred providers are still in network.

Provide different ways to get help

Employees have different preferences for learning about their benefits. They may benefit from a combination of benefits guides, webinars, question-and-answer sessions, benefits fairs and online decision-support tools. Use as many as you can.

Technology can help you compare plans based on their family circumstances, prescriptions, expected medical needs and preferred providers.

Additionally, set aside time for staff who may need one-on-one guidance so they can ask questions and understand their choices. Consider providing access to knowledgeable people who can answer questions when an employee’s situation is too complicated for an online tool.

The takeaway

While you invest heavily in your group health plans, if your staff are not reviewing all of their options, they may discover after enrollment that the plan they selected doesn’t work as expected.

Start communicating early, use multiple channels and give employees time and resources to compare their options carefully. We can help.