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Benefits Planning

By Peter Joseph

It's never too early to begin planning how health benefit plans will be designed and paid for, and what role you, as an employer, will continue to play in the process.

A culture of entitlement exists when it comes to health benefits, and it is safe to assume that costs will continue to rise. Expect increases that average about 15 percent but may go as high as 50 percent. Maintaining the status quo will not do. There needs to be a synergy between employer-sponsored plans and an employee-pay-all philosophy.

The key to finding a palatable medium between cost and benefits is early planning. There are several things you, as the employer, can do to facilitate this process.

Examine your company's status.

Look at your bottom line, projected profitability and a projected health benefits budget. Know what you have previously spent and have to spend versus your projected cost. This will provide a better target goal for what you can offer your employees.

Conduct a mid-year assessment.

Measure your health benefits budget against your usage. Capturing your usage mid-year paints a clearer picture of what your cost might be if you stick with an existing plan and/or carrier.

Partner with your existing carrier.

Ask it to provide possible solutions as you begin to plan for your next benefits cycle. Because you already have a relationship, it will be willing and able to help you design a customized plan.

Research the marketplace.

While many things - such as consumer driven health plans, flexible spending accounts (FSAs) and health savings accounts (HSAs) - can help reduce costs, there is no silver bullet. Rates are competitive, so employers should exercise due diligence to come up with a strategy that works.

Explore a wide variety of offerings.

There are many plans you can buy into to fit your needs and pocketbook. The more choices employees have, the more customized health benefits can be. A single employee does not need the same type of coverage as a family. A healthy employee may find peace of mind with hospital-only or supplemental coverage. Some prefer higher premiums and lower or no co-payments. Others would trade a higher co-payment for a lower monthly premium. Kids-only plans are available with some carriers.

Welcome FSAs and HSAs.

Each has its shortcomings; it can be difficult to estimate how much to set aside for health care. And while these spending accounts are gaining in popularity, they are not perfect. An upside of the FSA is portability. The downside is that unused money cannot roll over. The HSA has a rollover, but it is not portable.

Educate your employees.

Part of any strategy should continue to be employee education - notonly as it relates to the cost of care, but also how it relates to the company's bottom line. As a stakeholder in the company, employees should be wellinformed about the impact health care has on the health of their company. Using health benefits wisely is the best way to ensure an employer can continue to offer them.

Involve your employees.

Share information through news articles and materials from your carrier. Encourage employees to participate in wellness and prevention services, including annual physicals, health risk assessments, plan of treatment compliance and medical management programs. Active involvement will positively impact your cost.

Survey your population.

Do you know how much your employees are willing to share in the cost of having health benefits? There is a school of thought that asemployees increasingly share in the cost of health insurance, health care costs will begin to stabilize.

Increasing cost-sharing can be a painful yet necessary task in responding to skyrocketing health care costs. While affordability is a key element in providing health benefits, the use and employeemanagement of those benefits is vital. Developing and implementing a health benefits contribution strategy that can work for you takes time. Today is as good a day as any to start.

About The Author

PETER JOSEPH is senior vice president for commercial sales for VISTA, a health benefits company headquartered in South Florida with more than 330,000 members. VISTA, through its affiliated companies, Vista Healthplan Inc., Vista Healthplan of South Florida Inc. and Vista Insurance Plan Inc., offers a choice of health benefit plans including health maintenance organization (HMO), preferred provider organization (PPO) and point-of-service (POS). Reach Joseph through VISTA's Web site, www.vistahealth, or at (954) 858-3000. © 2005 Smart Business Network Inc. Reprinted from the February 2005 issue of Smart Business Broward/Palm Beach.


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