All employers are responsible for guiding their employees about the health benefit schemes they offer. Employees also have the right to receive information about these schemes.
Therefore, an employer has the right to inform employees about certain information regarding health benefit schemes. For this reason, organizations have created the position of Health Benefit Manager, with communication as one of the responsibilities for health benefit-related schemes and procedures.
Key information heads to be shared by the employer
There is a plethora of information available for communication. The health benefit Manager’s skill is to present it in a structured manner on behalf of the employer.
Employers need to provide detailed information to employees about what health benefit schemes are provided to them or to which they are entitled.
– Providing information regarding cost sharing as well as arrangements
– To take the necessary steps to resolve the problem and deal with appeals.
– To provide and guide its employees about the status of accreditation, certification, and licensure.
– Provide sufficient and necessary information about the composition of the provider network, too.
– To use emergency care services when required by the organization’s employees.
– To obtain referrals to specialists
Most importantly, provide all the information regarding the quality, safety, and cost of the employer-sponsored health benefit 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 on the health care services that are covered in the plan.
– Description of what the plan is providing services and how these schemes function.
– It also provides information on how to calculate the benefits.
– Explanation of the plan’s cost 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 answer any questions employees may have 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 increases due to the coverage plan.
Discussing the 5Cs with the employees is also essential. These 5Cs include cost, changes in plans, coverage of the plan, comparison of the previous year’s plan, and the current option.
Information about the health care providers available in the revised and new plan options must be provided to the employees.
Providing testimonials from other employees about the changes in health benefit plans can also be quite helpful for current employees.
Various means, such as the Internet, face-to-face discussions, telephone conversations, the office intranet, and printed materials, can also be helpful. However, it is also necessary to use materials that employees easily understand.
