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Communicate Health Benefits Information More Effectively




All employers have the responsibility of guiding their employees about the health benefit schemes offered by them. On the other hand, even the employees also have the right to receive information about the health benefit schemes offered to them.

Therefore an employer has the right to inform the employees about certain information regarding the health benefit schemes. For this reason, organizations have created the position of Health Benefit Manager, having communication as one of the responsibilities for health benefit-related schemes and procedures.

Key information heads to be shared by employer

There is a plethora of information available for communication. It is the skill of the Health benefit Manager to present them in a structured manner on behalf of the employer.

– Employers need to provide a detailed list of information to the employees about what health benefit schemes are provided to them or the scheme they are entitled to.
– Providing information regarding cost sharing as well as arrangements
– To take up necessary steps to resolve the problem as well as to deal with appeals.
– To provide and guide its employees about the status of accreditation, certification as well as licensure.
– Provide sufficient and necessary information about the composition of the provider network too.
– To use the emergency care services when required by the employees of the organization.
– To obtain referrals to specialists
– Most importantly, provide all the information regarding the quality, the safety of the health benefit plan, and the cost of the employer-sponsored plan.

Regulatory directives

According to the Employer Retirement and Income Security Act of 1974, it is necessary to provide all detailed information that the employees are entitled to, including plan rules, covered benefits, and documents about the plan management and operation. The employees are also entitled to receive a document with the summary plan description, known as SPD. The SPD contains

– Information of the health care services that are covered in the plan.
– Description of what the plan is providing services and how these schemes function.
– It provides information also on how to calculate the benefits.
– Explanation of the cost that the plan covers and the cost that the beneficiary has to pay.

Tools and Methods for communicating

There are various methods by which the Health Benefit Manager, on behalf of the employers, can communicate health benefit information to the employees:

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– One of the best ways is to communicate with the employees about the health coverage plan, but providing too much information should also be avoided. The employees should be given the required time to understand the scheme and ask questions, if any.

– It is best to explain the changes in simple terms to the employees to make them understand.

Apart from the employees, it is also necessary to explain the health benefit plans to the health benefit managers to explain them to the employees.

– Employers should be ready to face any questions asked by employees regarding the health benefit scheme and clear their doubts.

It is equally important to be direct and honest when discussing the coverage plan, especially if employees face cost increase due to the coverage plan.

– Discussing the 5C’s too is essential with the employees. These 5C’s include cost, changes in plans, coverage of the plan, comparison of the previous year’s plan, and the current option.

It is necessary to provide information to the employees about the health care providers available in the revised and new plan option.

– Providing testimonials of other employees about the changes in health benefit plans can also be quite helpful for the present employees.

Taking the help of various means like the internet, face-to-face discussions, telephonic conversations, office intranet, and printed materials can be helpful too. However, it is also necessary to use materials that employees easily understand.




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