November 12, 2020
Employers are now in the midst of open enrollment, helping employees select the health plans and programs that are right for them. Open enrollment will be different this year in large part due to the COVID-19 pandemic. Just as organizations have had to adjust to a remote-work model, open enrollment will also have to adapt accordingly. Here are five factors to consider for your open enrollment strategy:
During open enrollment, employees have always had the opportunity to consider various health plans offered by their employer and to choose the coverage that’s right for them and their families. Under normal circumstances, many employees would opt for the status quo. However, this year with the pandemic, employees will want to take a closer, more careful look. They may be more open to considering a new plan and even taking on new behaviors. As such, it’s a good opportunity to use their attention to drive smarter health benefit choices that can improve financial outcomes for both your organization and your employees.
Employees are experiencing a lot of financial anxiety right now. Millions of people are unemployed. Some employees may have had family members laid off or furloughed – or continue to face the prospect of such hardship.
With these types of worries, they’ll want to ensure that their families have the healthcare coverage they need, during a pandemic when their health is at risk. They’ll want to know how their coverage options can help keep them stay safe during COVID-19. And certainly, choosing a health plan can be a significant factor in providing cost savings. As such, employees want to take a closer look at various plan options, potential costs under each plan, and make changes they might not otherwise have made in years past. Be mindful about carefully communicating the differences between plans, such as PPO, HMO, or high-deductible plans, the benefits and drawbacks of each, and how each plan can help them keep money in their pockets.
Health plans are complicated. Providing easy-to-understand educational material can go a long way towards helping employees understand their options. With COVID-19 making paper-based material problematic, try to provide downloadable resources online, perhaps hosted on an online member portal. Materials should break down the member’s coverage options in easy-to-understand language instead of healthcare jargon. Try to consolidate benefits information, so members can consult a single source as opposed to sifting through various websites and documents.
An online comparison tool can be very useful. It quickly outlines key differences between plans, such as costs of premiums, deductible amounts, and out-of-pocket maximums. The tool should enable employees to drill down for more information, such as understanding the level of copayments required for various levels of care, such as primary care, specialty care, preventive care, urgent care, or emergency care. Employees should also be able to seek more information on in-network versus out-of-network costs, and whether there might be a tiered-network program – again, all with an eye toward how plan design affects their healthcare decisions and costs.
Under normal circumstances, some employers just cover the basics of what health plans are offered and what’s new. However, since employees are paying more attention this year, there’s more bandwidth to fit in education and reminders on how employees can use their benefits to build good health habits and cost-saving strategies throughout the year. With that in mind, here are some messages to consider reviewing:
Minimize emergency care. Encourage employees to utilize telemedicine or to visit their primary care provider or even an urgent care center rather than going to an emergency room. First, ERs are dealing with COVID-19 patients, so avoiding them can reduce exposure to the virus. Minimizing use of the ER also saves tremendous costs. The average ER visit is about $2,200—10 times more than care at an urgent care center for the same diagnosis*. Not to mention that employees can avoid long wait times.
Ask for generic prescriptions. Remind employees to ask for a generic prescription, if one is available, rather than a name-brand pharmaceutical. The FDA estimates that generic drugs cost 80 to 85% less than name brand drugs on average, but doctors are often more likely to remember and prescribe a recognizable brand-name drug.
Leverage preventive care. During COVID-19, employees may have chosen to miss skip preventive care visits. However, there are safe options to keep preventive care appointments in place. In addition, preventive care is usually 100% covered by most plans. Similarly, remind employees not to forgo ongoing care for chronic conditions, such as diabetes and high blood pressure. It’s also a good idea to let them know that their plan administrator can help them research alternative venues to obtain vaccinations, physicals, and other preventive services.
It’s possible to host in-person open enrollment meetings using social-distancing measures. However, with employees working remotely, most employers are planning to host virtual enrollment meetings via a group conferencing platform like Zoom or WebEx.
Hosting these sessions “live” enables employees to attend and ask questions. If possible, offer several sessions at different times so employees can choose one that works for them. Consider recording these sessions and making them available after the fact. In this way, employees can revisit information, or employees who missed it can still view it on demand.
Employers should round out enrollment communication with a mix of other channels, such as emails, texts, downloadable material (such as program brochures and plan documents), and inquiries via the online member portal. Email can be an excellent way to communicate shorter bites of information, such as reminders about sessions or deadlines. Employers can use emails to provide links to more information.
You might also consider a virtual benefits fair. These days it’s difficult to gather employers into a conference room to talk about benefits, but you could simulate a benefits fair online with sessions held over the course of a few days. Engage your plan administrator and other service providers to present plan and program information during allocated times.
Given the pandemic and current remote work environment, it’s important to make adjustments to your open enrollment strategy to ensure it’s safe, successful, and effective.
This year, you have an opportunity to help employees think more critically about their health benefits because of what’s happening in the world. Employees may feel a lot of financial pressure, so it’s important to provide them with proper tools and resources to help them evaluate their situation and make choices that are right for them and their families.