Getting the Most Out of Your Health-Care Benefits

Tips for employers, employees alike.

By Rob Broomfield

For many, new health plan benefits began in January, so now is a great time to review your coverage in order to get the most out of your plan, stay healthier and even help save money in 2018. 

People can save hundreds of dollars a year, even thousands, by learning how to maximize their health plan’s offerings. For employers, adding wellness programs will also create a healthier, happier and more productive work force, which can also reap financial savings for employees.

Here are some tips I recommend to employees:

Learn the lingo. Make sure to understand basic health plan terms such as deductible, copay, coinsurance and out-of-pocket maximum. A recent UnitedHealthcare survey found that just 9 percent of Americans could define all four of these important terms. Take time to understand common health insurance terms and your specific plan’s amounts, so you can make the most informed decisions. 

Know what is covered—and what isn’t. Coverage can change year over year, so it’s important to read current coverage and benefits information so you know what’s covered in 2018.
Review your plan’s information before you start receiving treat-ment so you’re not surprised by unexpected charges later. 

Stay in network. Choosing doctors in your plan’s care provider network will most likely mean you’ll pay less. Also, check out 24/7 telehealth services. “Virtual visits” can help save you time and money by providing convenient access to care for certain medical issues including allergies, bronchitis and seasonal flu.

Save on medications. Make sure your medications are covered by your plan, and ask your doctor about generics to see if there’s a more affordable and equally effective alternative. Also, getting prescriptions through the mail is often a big cost-saving option. 

Shop around and get estimates. Several health insurers offer online health care tools and resources that enable you to check on the quality and cost of health-care services and care providers before you make appointments. Be sure to double-check the cost with your care provider before getting treatments, as prices can vary significantly for the same procedure even within the same city. 

Creating wellness programs is a top priority for many business leaders and employees alike. A culture of employee wellness is a very popular business trend because it shows that leaders really care about the company’s most important assets—its people. 

Since there is no one-size-fits-all approach to creating an employee wellness program, I recommend these tips to help business owners build a culture that will effectively meet their employees’ unique needs:

Make wellness program savings tangible. Many health plans offer discounts on gym memberships and provide financial incentives, in some cases, more than $1,000 per year, simply for completing health assessments, signing up for health coaching programs, lowering cholesterol, losing weight, meeting walking goals or quitting smoking. 

Customize a program for your work force. Is your employee population sed-entary due to desk jobs? Or does harder physical labor make them more prone to injuries like chronic back or joint pain? Review historical insurance claims data to identify the most common health challenges, prevalent needs and your high-risk populations. Use this insight to
develop a custom strategy that will pro-vide relief to the groups that spend the most on health care.

Offer incentives to participate. Choose incentives that are meaningful to your employees. Do they prefer financial incentives such as gift cards, reductions in plan premiums or Health Savings Acco-unt contributions? Or would vacation days or a charitable donation be better motivators? By aligning incentives with your wellness program’s goals, employees will be rewarded for participating.

Make the healthy options accessible. It’s important to create an environment where the healthy choice is the easy choice. For example, when craving a snack, do the vending machines clearly offer healthy alternatives to candy bars and soda? During breaks, is there a walking path or an on-site fitness area with a treadmill? Is it possible to schedule on-site biometric screenings, flu shots, educational seminars or even team-building cooking classes? 

Communicate your program and support. Promote your wellness program using signage, flyers, emails, and “well-ness ambassadors.” It’s important to inform and motivate executives and supervisors about the positive role they can play to support and communicate wellness initiatives. Year-round promo-tion is crucial for success.

Evaluate results and solicit input. Evaluate your wellness program annually to assess strengths, weaknesses and progress. Work with your health plan to measure the impact on employee engagement and medical costs. Be flexible and listen to your employees on how to improve wellness offerings for the future.