How to be ready for this year’s benefit season and make optimum decisions

Open enrollment is starting for many organizations. This is when employees can enroll in benefits, move to a new plan or change their coverage amounts. With all the recent changes in health insurance, organizations are challenged to make sure their employees make informed decisions.

“The conversations surrounding open enrollment are much different than we’ve seen in the past,” says Amber Hulme, Medical Mutual Vice President, Central and Southern Ohio. “Organizations are faced with more choices, and so are their employees. Making the right decisions has become more complicated.”

Smart Business spoke with Hulme about what types of decisions organizations need to make during open enrollment this year, what they can do to prepare and how the process can help their employees become better health care consumers.

What big decisions do organizations need to make?

The first decision is the type of plan. For example, instead of offering co-pay plans with a monthly premium, employers might consider moving to a high-deductible plan that can be paired with a health savings account (HSA). With the HSA route, organizations need to think about funding arrangements and how much they want to give their employees.

Another possible option is defined contribution, which is getting a lot of buzz lately. With defined contribution, organizations give their employees a certain dollar amount every month. The employees then use that money to pay for whatever health plan they choose.

Lastly, there is the funding type. Organizations can choose to be either fully insured through their carrier or self-funded, where they pay their own claims. Self-funded plans aren’t subject to as many of the federal fees that started this year, so that can be a good option for employers that have the cash flow.

How does open enrollment usually work?

There are many variables involved depending on the organization and its employees, so every situation is different. The most significant differences are dictated by what the employees can handle in terms of technology. For example, defined contribution requires employees to have Internet access. So, if most of the population doesn’t have access to a computer, defined contribution probably wouldn’t be the best choice.

Open enrollment meetings are another variable. They are an excellent opportunity for employees to review their benefit information and ask questions. That’s especially important when organizations change plans. But there can be logistical challenges when employees are spread across multiple locations or working different shifts. We always try to accommodate whatever arrangement works best for the organization and its employees.

What are a few best practices?

Every organization wants to know what it can do to make sure employees are using their health care dollars wisely. So once they choose the plans they are going to offer, it’s critical for organizations to educate their employees to be better consumers. But they need help.

Employees have a lot of questions during open enrollment, and they need to be able to call their health insurance carrier or human resources department for answers. It’s the carrier’s job to provide the educational tools to help the organization provide that support. The key is to be prepared.

What else should organizations ask their carrier?

Organizations need to know how options have changed or if plans work any differently. They need to know about new resources their employees can use, such as wellness or disease management programs. They need to know what tools are available to help employees become better consumers, and be familiar with what they can do and how they work.

Having that information ready will help the organization prepare for open enrollment and empower its employees to manage their health care spending.

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