Understanding Employer’s Expectations by Karen Gustin, LLIF When you prepare benefit proposals, have you taken the time to understand the employer’s expectations? What do employers hope to accomplish and what do they expect from you? Which benefits do employees value the most? You will identify components to incorporate into the plan by comparing expectations to usage trends. The following guidelines will help you understand employers’ expectations so you can design the best mix of benefits: • What is the company’s philosophy on benefits? Why does the company offer benefits to employees? • Have certain benefits been important for recruiting and retaining the right employees? • Does the company have multiple locations that require flexible benefits to reach all markets? • What are the company’s business strategies and growth projections? Will the company be expanding operations in the upcoming year? Will the company need more employees locally or in different markets? • Is the employer facing a slower market and diminished demand, resulting in workforce reductions? • What is the company’s goal for long-term growth? • Do union contracts require certain benefits? • What benefits are direct competitors offering? Consider utilization trends as you review the information you have gathered. The answers to the following questions may uncover important details: • How many employees participate in the benefit plans? • Has enrollment been stable, increasing, or declining? • What percentage of employees select single versus family coverage? • Which features are used most and by which age groups? • Can you identify claims trends? • Are there unique demographics or special circumstances? • How much do employees spend on healthcare services for themselves and their dependents? • What average and maximum out-of-pocket healthcare costs do employees incur? • What are the major health issues, procedures, or cost allocations for these groups? • Does the company anticipate major changes with medical benefits that could affect ancillary benefits? • Does the company expect to change what it spends on employee coverage for all plans? You could make minor changes to many packaged plan options to personalize them for the employer. But, this strategy rarely results in ideal solutions for most employers. Your job will be easier if you partner with carriers that offer a variety of flexible solutions to fit employers’ needs, provide an analysis of benefits offered by competitors, identify costs and trends, and design stable and appropriate plans. Link Plan Needs with Carriers Many employers have a list of expectations for their insurance carriers. Smooth and seamless administration is often high on the list. Employers do not want to have to worry about problems that employees are having with insurance issues and claims. Since every carrier has different strengths, work with those that are experienced in meeting the employer’s specific needs. This will increase your success and long-term business growth. As you review insurance carriers, ask the following questions: • What is their case makeup (size of employer groups, industry experience, and financial expertise)? • How stable is their business? • What is the average lifetime of cases on the books? • How do other employers who contract with the carrier evaluate the quality of the benefits? • Do terminated employer groups return? • What is the size and makeup of the provider network? • How satisfied with the carrier are participating offices? Flexibility Employers need to adjust operations frequently to accommodate market changes. Insurance carriers with flexible benefits options and a broad selection of plans can offer customization to fit a variety of employer needs. Some important considerations are carriers with multiple product options, provider networks that are large enough to serve company locations across the country, and the willingness to build solutions to fit the needs of employers. Accurate and Efficient Benefits Administration It is important to work with carriers that can manage employee information accurately and efficiently since insurance plans encompass a lot of employee data. Review the carriers’ capabilities in client reporting, long-term financial expertise, business management, and actuarial and underwriting experience. Read the Fine Print Compare coverage levels, features, participant qualifications, and disclaimers. A plan that looks great up front may not provide the coverage and value that employers expect. Does the carrier communicate coverage limitations or prerequisites clearly or hide them in the text? Real Customer Service Many insurance companies talk about great customer service, but few actually deliver. Look for carriers that provide the customer service your employers expect and carriers that can demonstrate sustainable service levels over time. Employers are overwhelmed by the complexity of benefit options. Many are looking to their producers to help employees make the appropriate benefit decisions. Work with employers to develop charts to help employees understand their choices. The charts should include examples. The charts should compare cost savings among plan options and without insurance. Encourage employers to repeat this information frequently throughout the year, reminding employees to take advantage of their benefits. Once the right plans are in place, work with employers to explain options so employees can make the best choices. Employee satisfaction is a key ingredient in client satisfaction. –––––––––– Karen M. Gustin, LLIF, is vice president of Group Marketing and Managed Care for Ameritas Group, a division of Ameritas Life Insurance Corp. with headquarters in Lincoln, Neb. Ameritas provides dental and eye care products and services. She serves on the board of the National Association of Dental Plans (NADP) and chairs the Statistical Task Force. For more information, call the Ameritas Group Marketing Department at 800-776-9446.