Health Benefits Communication in Post-Reform World

by Cathy Miller on April 21, 2014

in Health Insurance

pensive man with question mark in text bubbleHealth benefits communication has a long tradition.

Not all of it has been pretty.

  • Legal language written like − well, legal language
  • Lists of exclusions and limitations that grew longer
  • The introduction of health reform’s Affordable Care Act

You know you are in trouble when the government starts offering templates for Summary of Benefits and Coverage.

The good news − at least we are talking about keeping it simple.

Health Benefits Communication for Consumers

One of the goals of health reform was simplifying the health benefits process.

At the center were easy-to-understand options for employees or individuals purchasing coverage. A lofty goal, to say the least.

The concept of an informed healthcare consumer is not a new one.  In the late 1990s, Consumer-Directed Health Plans (CDHPs) hit the scene.

CDHPs place more of the decision-making for health benefits on you − the consumer.

  • CDHPs came with options for personal savings accounts
  • And plans with higher individual deductibles ($1,000 or more)

The idea was that consumers would have information about doctors, hospitals, and health care costs. You would decide how you wanted to spend your health benefits dollars. All while saving for your rainy days of retirement when chances are you’ll require more health care.

Reality did not meet expectations.

If we have learned anything from those plans, it’s this ~

Calling plans consumer-directed does not make it happen
without better communication.

Enter Health Reform

Consumer-directed health plans were not the booming success supporters had hoped for.

Health reform may change that.

  • Many plans in the insurance marketplace are high-deductible health plans
  • Some qualify as tax-deferred health savings account plans
  • Employers also continue to shift to CDHPs

Results will vary for your insurance marketplace options; however, 30 percent of my options qualified as Health Savings Accounts (HSAs).

Unfortunately, poor health benefits communication still exists.

Do not be surprised if later in the year there is an outcry from consumers who did not know what they were purchasing.

  • High deductibles (some over $6,000 for an individual)
  • Large out-of-pocket expenses for certain services
  • Narrowed networks of providers, which may not include their doctors

Improving Communication

Several vendors with a mission of simplifying health benefits emerged from the chaos.

At this point, most work with brokers and employer sponsors of benefits. Others, like eHealthInsurance, focused on the individual market.

Health reform presents tremendous communication opportunities. Let’s just say there is plenty of room for improvement.

The following are a few suggestions.

1. Keep it simple.

We are living in an incredible time for communication. We have more tools and resources at our fingertips than ever before − if we learn how to make the most of them.

The brilliant minds who simplify our lives through technology sometimes forget that one user’s simple is another person’s confusion.

Health benefits technology needs basic how-to for even the simplest process.

  • Assume nothing – better to state Click Here than assuming users will do that
  • Step-by-step instructions means just that
  • Make help easy to access and simple to find

Employer sponsors of benefits should think about the changes they need for open enrollment meetings.

  • Consider one-on-one help with online kiosks
  • Make sure vendors provide training and assistance
  • Look for support that helps employees with decision-making
  • Give family members access at home where many decisions are made

Technology is powerful. But only if you know how to use it.

As shocking as it may be, not everyone has access (or wants access) to online benefits enrollment and information.

Fifteen percent of American adults do not use the internet at all.

Print to the rescue.

  • Test your print explanations on those who do not understand the process
  • In health benefits, that should not be too hard to find

You could arrange for non-online users to hook up with tech-savvy people. Some techies really get a kick out of helping others to navigate through the process.

Even with that option, I would recommend delivering printed benefits information for the person. Think of it as the equivalent of the hardbound book to a Kindle-adverse reader.

Happy consumers − fewer complaints.

2. Make it fun.

Who says health benefits have to be boring?

Okay, so I’m your basic benefits geek. I’m also the geek who received thanks for making health privacy training fun. And my fellow presenter was an ERISA attorney. Ah, fun times.

  • Technology can make benefits fun − software apps, videos, online challenges
  • Benefits geeks can make it fun − find a partner who is passionate about what he or she does

As far as I know, no one got sicker as a result of laughing too much.

3. Explore information resources.

There is no reason to reinvent the wheel. There are several good resources to help employees or individuals in making better decisions about their health care and/or benefits.

Some work with brokers and employer sponsors of benefits. Others are for the individual consumer. The following are a few examples.

Insurance brokers for employers and individuals should also have resources for vendors and private exchanges.

Quite Simply

Health benefits communication does not have to resemble pages from Congress.

  • Keep it simple
  • Make it fun
  • Get help

May the force be with you.

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Helping you Keep it simple, clear & uniquely yours – contact me for help with your business writing needs. Visit my business blog, Simply stated business.

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Notice of Disclaimer –Cathy Miller is not an attorney or health care provider and cannot provide legal or health care advice. The information provided is for your general background only, and is not intended to constitute legal or health care advice as to your specific circumstances. We recommend you review legislation with legal counsel and visit your physician for health care issues.

BigStock Photo Credit

 

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