How to Become a Life Saver to HR Directors in the Middle Market
by Jeff Rosenblum

Corporate mergers and acquisitions are all the rage in todayÕs business environment, particularly in the middle market. Yet, when the dust settles from a merger or acquisition, the surviving human resources (HR) director must make strong decisions amid the noise and chaos of disparate benefits plans. The HR director has to deal with multiple enrollment and eligibility issues as well as numerous arrangements for spending accounts, debit cards, COBRA, and retiree plans. They often inherit grandfathered relationships for life insurance along with arrangements for specialized coverage for some employees.

Whether dealing with the complexities of a merger or acquisition or simply

managing the administrative details inherent in a growing, mid-sized company, HR directors find themselves in a quandary. They face decisions that are not in their traditional comfort zone Furthermore, as healthcare spending consumes a large portion of the corporate budget, CFOs and financial analysts are increasingly focusing on benefits administration. Increases in health benefits costs are much steeper for middle market companies than for larger organizations and double-digit spending growth can threaten the corporate financial picture.

Be prepared to rescue your clients with a one-stop solution for benefits administration by offering an integrated model that can be tailored for even the most complex benefits plan. HR directors at mid-sized companies need a lifesaver and you are well positioned to bail them out.

Overcoming Pain Points

HR directors in companies with 500 to 1,000 employees often recognize their benefits administration pain points, but wonÕt pay for an outsourced solution. They expect you to cover the costs of resolving problems. On the other hand, HR directors for employers with 1,000 to 10,000 employees cope with big problems and recognize that they have to pay for a solution. However, they may ask you to subsidize the solution.

Regardless of your typical client size,

you need to take a strategic position to benefits administration and become part of the solution. You cannot take a passive role, because if things go badly, you will be seen as part of the problem. Instead, a proactive approach that mitigates risk, whereby you bring in the right benefits administration company, is advisable. The wrong partner could spell irreparable damage to the client relationship and cost you the entire account.

Criteria for Selecting a Benefits Administration Partner

Brokers are well-advised to look for a benefits administration partner that helps employees make more informed benefit choices and promotes employee satisfaction. Make sure the company has a proven track record of client retention and expertise in serving companies with 500 or more employees. The benefits administrator should be focused on easing the employerÕs burden and providing a single source for complex benefits administration services without significant capital investment.

To deliver cost-efficient benefit programs, employers rely on the benefit administrator to support a full range of programs and offer guidance on a multitude of activities.

At its foundation, any integrated benefits administration solution must support the employerÕs healthcare strategy and keep hassles to a minimum for the HR staff. Annual enrollment must be planned, executed, and reviewed carefully. It should include targeted initiatives for outstanding customer support from a dedicated team of benefit specialists and IT professionals.

In addition, the benefits administrator should offer a positive enrollment experience to drive employee satisfaction for the benefit package. Look for an online self-service portal that gives employees a single point of access to make all benefit elections. Giving employees the ability to change personal information and access spending account information is critical to how satisfied they will be with the benefits package.

Finally, the benefit administrator should handle administrative tasks expertly to avoid errors when employees leave the system. For example, failing terminate health coverage promptly for ineligible employees can cost employers millions of dollars each year. An integrated solution ensures that health coverage costs are tracked accurately.

Integrated Capabilities

Must Include:

¥ Eligibility and Enrollment. Employers value rapid set-up application processes with strong quality control. A comprehensive self-service portal should give employees easy access to benefits-related answers. From a technology perspective, a robust editing application should screen data to reduce errors. Providing useful benefit information and comparison tools can help employees make informed decisions about healthcare benefits at key enrollment points. Additionally, effective communication materials should ensure legal compliance and give employees important benefit information.

¥ Spending Account Management. Flexible spending accounts, health reimbursement arrangements, and health savings accounts can drive desirable employee behaviors, such as participating in a wellness program. They also provide a tax-advantaged way for employees to pay for out-of-pocket healthcare expenses.

¥ COBRA. COBRA management should include enrollment, premium billing, participant communications, and call center support, as well as legal guidance to changing regulations. COBRA management should also support individual billing for retirees, leaves of absence, and other direct billing events.

¥ Premium Bill and Pay. Employee eligibility errors make up as much as 5% of the enrolled population. Premium bill and pay services enable employers to reduce expenses by eliminating overpayment of premiums, administrative fees and claims for employees who are no longer eligible.

¥ Employee Contact Center. Providing a high-quality call center for employees and their families provides financial and operational advantages to employers. The contact center should have experience in administering benefit programs consistently, seamlessly, and cost effectively.

¥ Online Health Portal. Employees should have access to online self-care resources including a drug database, symptom triage, condition and treatment content, personal diaries, and tracking tools.

¥ Health Risk Assessment. A health-risk assessment should make it easy for employees to recognize their unhealthy behaviors and risk factors. It should also provide guidance on what they can do to improve their health. Most often, the assessment is completed before lifestyle management or behavior coaching and incentives are offered to encourage employee participation.

¥ Decision-Support Tools. Annual enrollment can be complicated, frustrating, and emotionally charged. As such, employees need support in making the best choices, from enrolling in a health plan to contributing to a spending account. Decision support tools should be incorporated seamlessly into any benefits administration platform and be customizable to the employerÕs benefits plan.

¥ Corporate Benchmarks. Narrowing down the search for a benefits administration partner requires due diligence on several levels. It is important to verify scalability, reliability, and opportunities for future growth. The ideal partner offers turnkey solutions that can be implemented rapidly. An agile technology platform should allow employers to execute benefit programs quickly without investing in expensive technology. Systems should allow for continuous updates, refined features, and new platforms, without causing service interruptions to the employer and employees.

Look for a partner that offers a team of client service managers, benefit specialists, and operational experts to provide exemplary customer support. These teams should be thoroughly trained on the clientÕs program and be accountable for delivering outstanding results to each client.

Finally, evaluate your partnerÕs commitment to coordinated health advocacy solutions including disease management, case management, utilization management, maternity management, wellness programs, and 24-hour nurse lines. Once reserved for large self-insured employers, these programs are becoming available to mid-sized companies.

Brokers need a benefits administration partner that understands their needs and provides complementary services that maximize results for shared clients. This coordinated approach is not only good for your business, but it also drives better outcomes and satisfaction for everyone involved. q

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Jeff Rosenblum is executive vice president of Channel Solutions, SHPS. The company provides analytic services and health management tools to promote healthcare consumerism, support health advocacy and self-care, and deliver a solid platform of health benefits administration. SHPS focuses on large and mid-market employers, brokers, business process outsourcing/human resource outsourcing (BPO/HRO) firms, third party administrators (TPAs), health plans, and government agencies including Medicaid and Medicare. E-mail jeff.rosenblum@shps.com or visit www.shps.com.