Finding the right group health benefits for your organization can be daunting. Start by finding a trusted business partner who can help you navigate the various options available so that everyone benefits. We’ve provided a checklist to help you get started on this journey.
Develop a strategy –Determine who will oversee and manage the plans internally and any goals you may have, including recruiting and retention goals.
Research – Familiarize yourself with basic healthcare terminology as well as different types of plans and coverage available. Determine if you want to stick with the basic health and welfare plans (medical, dental, and vision) or offer additional voluntary coverage for life, injury/illness plans, pet coverage, long- or short-term disability, etc.
Assess the needs of your business and your employees – Before searching for a broker, be sure to (1) know the amount you are willing to contribute to employee premiums; and (2) estimate how many employees will accept your coverage. Engage with your employees to know their preferences (i.e., prefers a higher monthly premium and lower cost for care or vice versa).
Search for a Broker – While conducting your search, find a broker specializing in health insurance. Ask for recommendations and referrals. In addition, ensure the broker has experience servicing businesses comparable to your size and they understand your growth plans and strategy. You’ll want to make sure the broker is knowledgeable about your industry.
Client Advocacy – Once you select a broker, share some of your business knowledge and industry norms with them to best serve you. Consider which options you want to present for health and wellness and voluntary plans to your employees.
Take Advantage of the Broker’s Expertise – Be sure to ask them about health care trends and their recommendations. Your broker should provide ongoing support throughout the year, including managing and updating your coverage. Brokers should understand your business goals and be invested in your company’s future.
Open Communication – Your broker should periodically request feedback from you and your employees. They should also provide you with “experience reports.” Mid-year is a great time to review your experience report to understand your employees’ behavior and plan for the upcoming renewal. Requesting feedback ensures that everyone’s needs are being met and if changes to the health benefits are needed for improvement.
Other Health Benefits Factors to Consider
When looking for a professional insurance broker:
- Check with other local business owners for recommendations. Be sure to interview at least two, but no more than five, before making a selection. Consider who will lead your team and their expertise, especially with new plans, similar size, support team availability, reports availability, and service guarantees.
- Contact your chamber of commerce or local business groups or associations.
When deciding on whether to use a certain broker, be sure to:
- Ask about: (1) the amount of any fees or commissions; and (2) if any separate fees will be added to the premium by the broker.
- Restate the services you will receive.
- Discuss how the broker will assist you during the year.
- Know which services are “in-scope” or “out-of-scope.” In their presentations, they may talk about services that will be an additional cost and not provided as a standard part of the agreement.
Great things to ask a potential broker before signing on:
- Ask them if they have consolidated billing or to explain their billing process.
- Ask about compliance practices; how they manage required notices, disclosures, audits, and any other Employee Retirement Income Security Act (“ERISA”) of 1974 requirements? Ask how often they do a compliance audit and updates. Ask how they handle COBRA. Ask if they use a “wrap document.”
- A “wrap document” incorporates certificates and booklets of each health benefit. It satisfies the “ERISA” requirement that applies to these plans. This also allows employers only to file one 5500 rather than a separate one for each health benefit. It also helps you if your plans are ever audited.
- Do they have an online enrollment program, or is enrollment handled through paper?
- Ask how they plan to communicate open enrollment each year? Who prints material to go to employees without access to a computer (employees on leave, warehouse workers, etc.)? Will they host an annual open enrollment event for your employees? Will they also provide a separate wellness event mid-year?
- A wellness fair is usually held mid-way through the annual open enrollment date, designed to educate employees on the available services. It can include biometric screenings, vision exams, safety-related, first-aid preparedness, stress reduction, smoke cessation, health club benefits, nutrition support, etc.
- What type of access will employees have with them? Will they have a dedicated toll-free number? What frequency do they plan to meet with employees? Do they have an app?
- Ask them about their onboarding process for new companies. Find out the time and resources you will have to dedicate for this to be a successful process. Find out the resources they provide to you to assist with the onboarding process.
- Check for broker’s reviews online. Before signing on with them, be sure to ask for references. Give them specific types of references that you’re looking for, i.e., one newer client (under two years), one client similar to your size, and one client that has had a major overhaul to their plan in the last five years.
- Make sure all plans meet the requirements of the Patient Protection and Affordable Care Act (PPACA), also known as the Affordable Care Act (ACA)
One last thing. I would highly recommend an Employee Assistance Program (EAP) be added to every plan. It is a very inexpensive plan, paid 100% by employers, and available to all employees to support them through various life scenarios. The service is free and confidential to employees, available 24/7, and is a great resource to employees, leaders, and families. It provides access to local health professionals for mental health support, access to free legal consultation, and help navigate a challenge like elder care or even addiction issues. Ask your broker for more information on these and other types of plans.
Offering employees a health benefits package that is well thought out, suits your business needs, and is comprehensive enough to satisfy the needs of your team will go a long way to attracting and retaining good talent.
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