Five Principles for Health Benefits Plans

by | Mar 8, 2024 | Take 5 Articles

The most significant change in group health benefits in the past 20 years? Mindset.

Small and mid-size employers are taking “more of a conscious approach when looking at their benefits plan,” explains Sunil Hirjee, Vice-President, Sales and Partner Experience at Beneva, a preferred provider partner of Benefits Alliance (BA).

“Ten to 20 years ago, benefits plans were perceived as more of a cost of doing business,” he recalls. “Today plan sponsors are recognizing it’s a very big part of the way they can win the war for talent. More are recognizing that it’s become an extension of the organizational health culture that they want to put in place.”

As well, more data is shedding light on the ROI of benefits plans. “No one is going to argue against the fact that if I’m happy and healthy, I’m more productive. That awareness has heightened the sense of need from plan sponsors,” says Hirjee.

With this new mindset in mind, Hirjee outlines five core principles to help steer the future of health benefits plans.

He expands on these points and more in a recent podcast with BA’s President Carolyne Eagan and board member Rob Green, President of Green Benefits Group. You can also check out Beneva’s webinar on March 27 on the building blocks of benefits programs for small and mid-size employers.

1 – Know your objectives

Hirjee observes that plan sponsors’ number-one question when assessing their plan is usually, ‘Where do I start?’

Before moving forward, he recommends plan sponsors and their advisors step back. “What is the ultimate objective for your plan? What is your organizational culture? Then build your plan to support that culture.”

He stresses that this is not a theoretical exercise. Factor in information such as the type of business, demographics of the workforce, the work environment and where employees live. And conduct surveys. “There are many easy-to-use online tools now for a pulse check on what’s important for plan members. Then work with your advisor and insurer to address the objectives that come out of this data.”

2 – Achieve balance

Today’s labour market demands a strong benefits plan, but financial constraints can be more challenging than ever. Data analysis and planning are key to strike a good balance. “A lot of data is available from insurers, but it’s surprising how little it is utilized, even today,” says Hirjee. This is where the benefits advisor and insurer come in, to crunch the numbers and map out priorities.

Hirjee recommends reporting on a quarterly basis, including comparisons against the prior year. “You’ll know the areas to tackle proactively to avoid a surprise increase due to claims utilization.”

3 – Integrate with public insurance

Perhaps the most important guiding principle for plan sponsors is “everything we do in the benefits world is supplemental to our universal social assistance programs in this country,” states Hirjee.

Yet there are often gaps in understanding how to access and combine universal social assistance and private drug plans. Step one is to work with an insurer and benefits advisor who gathers intelligence on what’s available through public plans. “It is very important when we’re building our benefits plans to integrate with those programs that we get as Canadians. And then determine how to help plan members navigate and access that coverage.”

4 – Strategize communications

Today’s technologies—and consumers’ digital savvy—pave the way for smarter, targeted and timely communications. “People don’t want information when someone wants to tell it. They want information when they have a need for it. We are working on ways to make it available and easily accessible when it’s needed,” says Hirjee, adding that providers today should also be making “a very conscious effort to simplify the language.”

However, technology should not override the human connection, emphasizes Hirjee. Even today, employees almost always go to their frontline manager first with questions about their health benefits. “I’m seeing more of a trend to train team managers to have enough familiarity with benefits to help their direct reports, especially when it comes to the employee assistance program,” says Hirjee.

5 – Lean on your advisor

With more options in benefits than ever before, an advisor is “an absolute necessity,” he states. “The best advisors understand the needs of their plan sponsors. They are an impartial resource to look at all options available and pick the carrier that suits their clients’ needs best,” says Hirjee.

This article is brought to you by Beneva, a gold preferred solutions provider for members of Benefits Alliance and their clients.