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Designing a custom benefits plan that suits your company and your employees

Published on November 19th, 2019 by Triton Benefits & HR Solutions

Health care costs are on the rise, and this can translate not only to more expensive doctor visit and pharmacy bills for individuals, but a higher cost of health care coverage for employers as well. In fact, according to our own Triton Benefits & HR Solutions research, spending on health care services by employers rose a staggering $1 trillion in the two decades between 1996 and 2016.

Premium costs for individuals and families are on the rise as well, with individuals paying 3% more, and premiums associated with family coverage increasing by 5%.

In this type of health care landscape, employers must look to their benefits services to ensure that they are offering employees a package that helps keeps these rising costs at bay, while also addressing staff member and dependent health needs.

Recently, our Triton Benefits & HR Solutions team hosted a webinar to discuss the best ways in which to design a custom benefits package. Let's take a closer look at some of the highlights of that webinar, and how you can apply these lessons to your company.

Options for plan design

Currently, there are a few different types of benefit plan designs that employers can choose from:

  • Fully insured plans include a monthly premium for enrollment in medical, vision and dental coverage, a specific deductible amount that must be met before insurance pays out, and a maximum amount for out-of-pocket expenses like co-pays and co-insurance.
  • Self funding plans incorporate the total variable costs and total fixed costs of health care services into account for the plan's maximum cost amount. This style of plan also encompasses aggregate attachment and expected claims.
  • Level funding plans are a bit more complex, but can support the economic advantages of a self funding plan with the reliability and predictability of a fully insured plan. In this way, level funding plans include pre-set premium amounts based on actual enrollment, monthly claims reports, reconciliation of these claims through assessment of claims funding and surplus amounts, and finally an admin fee credit for the company's portion of the claims funding surplus.

Building out your plan: Designing your benefits offerings 

Creating your ideal benefits plan isn't just about health service funding, however. Your plan should also include benefit offerings that can help employees (and the company) keep costs down while ensuring robust access to necessary medical and wellness services.

Some key benefits offerings and approaches to consider here include:

  • Cost saving measures for prescription drugs: Recommending the use of generic drugs can save around $3 billion annually, according to the FDA. In addition, third-party prescription mail services can provide drugs at a lower rate, and tier-cost sharing programs can help lower employee co-pays.
  • Telemedicine: This health care and benefits strategy has become increasingly popular recently. A telemedicine service can put employees in touch with physicians, nurses or other health care practitioners, and enable them to video conference or otherwise connect through technology. In this way, workers can get the health care advice they need in a less expensive and more convenient, remote way. What's more, telemedicine is particularly beneficial when employees need to see a specialist – a patient can get guidance without ever leaving their home, eliminating office co-pays.
  • Other support services: It's also advantageous for benefits packages to include supplemental offerings like access to nurse advice lines and case management. Research has shown that around 70% of doctor visits and 66% of ER trips are unnecessary. A nurse advice line can enable patients to get the medical information they need without having to visit a doctor or hospital.
  • Employee education: Besides more traditional health service offerings, today's benefits packages should encompass a wellness educational component. This can include discussions around the impacts of workplace stress, and ways to manage stress through exercise, open communication, meditation and other approaches.

To find out more about the options to consider when designing a custom benefits package for your organization, check out our webinar. Partnering with an expert benefits service broker can also be a significant advantage – visit our website for more information today.

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