Health benefits literacy

Health benefits literacy — the ability to understand and navigate health insurance options and benefits — is essential to helping employees take the first step as savvy health care consumers.

Workers are progressively more responsible for managing their health care as consumer-directed health plans gain in popularity. At the same time, they are expanding their roles in seeking information, measuring and monitoring their health, and making decisions about insurance and options for care.

With 3.2 million Americans covered under some form of a consumer-directed plan, it is increasingly important that employers take rapid steps to educate employees about this new role. Employees need the tools, information and support to make well-informed decisions. At the heart of this effort are employee communication and education, both critical for a successful transition to consumer-directed health care.

Here are some suggestions to help get you started.

Pre-enrollment ­ a rationale for change

Managers play a significant role in shaping employee opinion. This is especially critical once the decision has been made to move to new plan designs.

Beyond presenting advantages and features of the plan during this transition period, employee communications should demonstrate the need for change and highlight the support available to employees. Consider using communication avenues such as announcement letters, newsletter articles, pre-enrollment posters and independent, third-party viewpoint articles to address policy changes and answer employee concerns.

Enrollment — cultivating an informed consumer

The enrollment phase focuses on helping employees fully understand the consumer-directed plan offerings and assists them in making their health plan election through tutorials and interactive tools.

Decisions workers make now can impact their future. Cultivate an informed consumer by providing access to interactive decision-support tools

* Plan selection and cost estimator tools. These interactive decision-support tools assist employees in making their health plan election during open enrollment. Members input basic information about their utilization of health care services to estimate their out-of-pocket health care costs. The tool then compares available plan offerings and allows employees to see estimated costs associated with various health care scenarios.

* Health savings account (HSA) savings calculators. These tools demonstrate the potential savings and tax advantages associated with an HSA. Members provide basic information about their age, annual HSA contribution, expected interest rate from the HSA administrator and marginal tax rate.

The calculator provides the potential HSA balance over time, a comparison of HSA savings to other after-tax, interest-bearing savings vehicles and the potential tax savings for HSA contributions. The tax savings illustration is helpful in understanding the differences between using the HSA for current medical expenses versus growing the HSA over time.

* HSA/health reimbursement account (HRA) online tutorials. These are designed to help members better understand these products and aid understanding about how the rise in health care costs has led to the increase in health care consumerism; the benefits available through HRAs and HSAs; the basic structure of the benefits plans; and the tools and resources that support these new offerings.

Post-enrollment — supporting consumer responsibility

It is important to continue to support consumer responsibility during the post-enrollment period. Making the change to a consumer-directed health plan is not a one-time event, it is a strategy carried out over several years.

During post-enrollment, the focus is on reinforcing employee involvement in the decisions made about their health care, updating them on new tools and services available, and reminding them of the existing tools. Ongoing communications throughout the plan year also provide additional opportunities to strengthen employees’ abilities to get more involved in their health care decisions.

Increasing health benefits literacy provides a pivotal opportunity for employers wanting to increase the adoption rate of consumer-directed health plans. Working in partnership, health benefits providers and employers should provide educational materials in easy-to-understand formats, along with credible health information and tools that support informed decision making.

Paul Martino is vice president of sales and service, covering Illinois and Wisconsin. He is responsible for managing sales and client management for Aetna’s middle market segment, which includes businesses with 51 to 3,000 employees. Reach him at (312) 928-3754 or [email protected].