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As a benefits professional, you often wear many hats, and communications could be one of the more challenging roles you encounter. You’re required to not only inform but inspire employees to take action at critical times during their employee benefits life cycle.

Employers usually offer a range of benefits, including health, life, disability, employee assistance programs (EAPs), work-life services, voluntary and retirement plan benefits, that are designed to meet the diverse health, financial and personal needs of employees and their families. Communicating—some would argue advertising—the benefits that the plan offers is important because such efforts help to reinforce or solidify a key part of the employee value proposition. You want to see a return on the significant financial investment, and that return can be measured by the impact it may have on people’s lives.

A big part of the benefits communication challenge is that employees are not benefits experts, and many would argue that they shouldn’t be. But they do need some basic level of knowledge or awareness of how benefits work to make the best decisions, and many lack these fundamentals. Take health insurance as one example. Surveys have shown that about half (51%) of Americans do not understand basic health insurance terms like premium, deductible and copay. This lack of health insurance literacy has a very real impact on their coverage and their finances. For example, about 61% of people chose the wrong health plan for their needs where they could have saved an average of $372 annually (probably more).

One of the key tactical aspects of benefits that employees are not so keenly aware of nor take consistent action on are the administrative tasks required to enroll and maintain benefits throughout the employment life cycle. You may do your best to publish a list of qualified life event rules on the intranet site, for example, but most employees will not take the time to find out that such rules exist, let alone remember what they were told several years ago during a new-hire onboarding meeting.

That’s where benefits professionals come in. Rather than making it harder for employees to learn about and navigate through all the benefits offered, why not meet employees where they are and when they need you, especially for benefits that have critical compliance components?

Providing Timely and Meaningful Communications

As a benefits communicator, you can leverage your knowledge of those compliance moments. You can proactively inform or remind workers about actions they can or should take to impact or take advantage of benefits offered and potentially avoid mistakes. This endeavor might require moving outside your comfort zone and utilizing every means possible to connect with employees prior to when they need to take action. This includes using communications techniques, the human resources information system (HRIS), onboarding and vendor interactions to point people in the right direction before it’s too late.

A simple example of the birth of a child illustrates this practice. Typically, an employee has 30 days to notify their health plan or employer to add a new child. While this seems like a logical thing to do, the employee may neglect to enroll the child. They may be caught up in taking care of their newborn, managing their own health recovery after the birth, balancing home and family responsibilities as well as thinking about whether they forgot to complete a work project. Low health insurance literacy could even delay the enrollment of their child. The employee may have assumed that the newborn hospital claims processed by the insurance company triggered automatic and permanent enrollment of the child into the health plan.

The parental leave discussion between an employer and employee is the perfect time to introduce reminders to the employee about potential benefit changes once the birth occurs, such as enrolling the newborn within 30 days of the birth and furnishing a copy of the birth certificate. Periodic reminders prior to the employee taking leave can be integrated into the administration process. You could ask your leave administrator to add verbiage or a document in the leave of absence package that summarizes a list of simple benefit reminders or action steps. Leave administrators can play a vital role in communicating with employees since this is often the time the employee wants to know how they will be paid while on a leave of absence. The leave administrator could include as part of its own discussion a list of items to review while on the phone with the employee. Ask your leave administrator what flexibility it has to support communicating important benefit reminders to employees on leave.

Benefit Event Touch Points

There are numerous other touch points throughout an employee’s benefits life cycle where a simple reminder about a benefits opportunity they may want to take action on could help the employee. Following are examples of benefits touch points and actions to consider.

Children Turning 26

Most health plans only cover child dependents through age 26. The typical HRIS generates reports on this topic since it is an event that triggers Consolidated Omnibus Budget Reconciliation Act (COBRA) requirements. To help families plan ahead, inform the employee two to three months in advance of the child turning age 26 (or other age cutoff) about what to expect, including when coverage will end, the dependent’s rights under COBRA, how much COBRA coverage will cost and other alternatives to obtain health coverage. Do you offer a special advocacy service that could help the employee or dependent child manage the process of finding other health insurance?

Does your HRIS automatically trigger a change in coverage tier when a child is no longer eligible? Remind the employee what action they or you may need to take in the HRIS to lower the payroll contributions if there is a reduction in coverage tier because the employee is switching from family to employee-plus-one coverage.

Employees or Spouses Reaching an Age When Life Insurance Coverage Gets Reduced

Reductions in life insurance can be a surprise, especially when you’re over age 65 when it may be more difficult to obtain life insurance on your own. Check to see whether your HRIS will automatically change the payroll contribution as a result of the life insurance volume change.

Life insurance carriers may consider the reduction in coverage an event eligible for portability or conversion. Portability and conversion options allow the employee to continue paying for the original coverage (without the reduction) or the entire policy on their own. Inform your employee about the process to port or convert, what to expect or actions they would need to take. Important information includes the deadline they may have to act upon the option if they want to continue paying for the reduced amount of life insurance as a direct pay option with the life insurance carrier.

Retirement

Your HR department may know of an employee’s intent to leave the company months before their retirement date. Having a close partnership with HR is key since you would want them to advise you of this retirement date or encourage the employee to contact the benefits team about any transitional matters as they relate to benefits. HR may enter retirement dates in the HRIS in advance. Identify whether you can get a notification or report to identify retirements before they occur.

Depending on the employee’s age of retirement, you may also have additional points of discussion to help an employee make the best decisions, such as whether to elect COBRA if they are also enrolled or eligible for Medicare at the time of retirement.

Home Address or Relocation Change

If your health plan eligibility is based upon home ZIP code, you will need to take extra steps to ensure that you stay on top of employee moves. For example, an employee who moves to a state where the health plan doesn’t operate will need a different plan. If your HRIS has the functionality to trigger a benefit event for when an employee enters a home address change, you’re in good shape. A move can be a signal that an employee has gotten married, been promoted or experienced other life changes, so it is also a great time to revisit life insurance beneficiaries as well as health savings account (HSA) and 401(k) contribution levels.

Life Insurance Beneficiary Change

If an employee changes their beneficiaries due to a marriage, a divorce or some other significant event, they may fail to make any changes to their elections for other benefits, such as health insurance, or to change beneficiaries for retirement plans. Review the form to identify whether the employee could take other actions they are not aware of.

Reaching Medicare Eligibility Age

Employees who continue to work beyond reaching Medicare eligibility age can have important decisions to make with respect to their medical and pharmacy coverage. Depending on the plan, Medicare may be considered primary or secondary coverage, or even eliminate eligibility altogether for an employer plan. Inform the employee in advance of turning age 65 of possible questions or scenarios they may experience.

Collaborate With Others

While benefit professionals need to own the design and management of communications triggers to support a proactive benefits administrative model, you can also cast a wide net and include others from within and outside the organization to play a key role in this endeavor.

The recruitment or onboarding process is an ideal time to inform new hires about benefits. Include a list of benefit administration reminders in a benefits presentation and in welcome emails as well as the intranet page for new hires. If you deliver new hire presentations, sending an automatic invitation through an email can help to guarantee an audience for whom you deliver your benefit reminders, because it places the event automatically on the employee’s calendar. It’s also a good idea to contact new employees who haven’t completed their benefits enrollment prior to the end of a 30-day new hire period.

Inform the HR partners in your organization about all of your communications tactics as well as the more important compliance aspects of benefit enrollments. Because they often work closely with business units and employees, they can be your eyes and ears for employee events that could potentially benefit from a benefit change such as a birth, marriage, divorce or relocation.

Partner with your HRIS team to leverage whatever technical triggers, notifications, messaging, reporting, reminders and approvals that can be built into the system or online process to help make your life easier. This may not solve all your challenges, but data can drive the triggers and inform all who may need to know. Include brief but actionable communications within the HRIS for employees to read that will help them complete their benefits enrollment in the moment.

The benefits and insurance industries will continue to evolve and change, requiring benefits professionals to stay ahead of the curve and find ways to bridge the knowledge gap for employees. You cannot expect employees to be benefits experts, but you can make the process simpler for them by meeting them where they are when they need you the most.

Endnotes

<1>Jean Edward, Ph.D., R.N., Amanda Wiggins, Ph.D., Malea Hoepf Young, M.P.H., CHES, and Mary Kay Rayens, Ph.D. ”Significant Disparities Exist in Consumer Health Insurance Literacy: Implications for Health Care Reform.” Health Literacy Research and Practice. Published online, September 23, 2019 https://doi.org/10.3928/24748307-20190923-01.

<2>www.cnbc.com/2022/04/20/how-to-choose-a-health-insurance-plan-that-saves-money.html.

William J. Pokluda, CEBS, is a director of benefits at Gartner, Inc. where he supports benefits strategy and administration that reaches more than 18,000 employees in over 30 countries.  Pokluda is also a staunch advocate of health insurance literacy which he promotes through his book and blog. He earned a B.A. degree in psychology from William Paterson University and an M.B.A. degree in marketing from the University of Connecticut.  

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