Tailor coverage to the workforce's unique needs

Your employer clients can offer excellent benefit stacks and still have gaps in coverage that can challenge health equity goals. Why? Well, employees don't have cookie-cutter needs. Every employee is unique, and the needs of each employee tend to shift over time.

That's precisely why point solutions — companies that offer specialized health management services to enhance existing benefits or fill common insurance gaps — exist. There are point solutions for almost every need, from mental health to fertility support to heart health to caregiver support. In other words, point solutions provide calibrated benefits to specific subgroups of employees. They are often cost-effective and within reach for employers of all sizes, particularly given that many programs have a demonstrable return on investment.

That said, an overabundance or duplicative set of point solutions can complicate the benefits offering, presenting employees with a dizzying array of options and saddling employer clients with burdensome administration tasks. The key is to make sure employers understand that they should choose point solutions tailored to the unique needs of their workforce. Doing so can help employers prioritize a manageable number of clinically-effective benefits and avoid "point solution fatigue." 

Consider offering strategies such as workplace health surveys that employers can use to identify and respond to what their specific employees need. Make sure employers know they can take advantage of any wellness credits available to them through their insurance company, and if you don't offer consulting services in house, recommend a benefits advisor who can make sure the client's stack is optimized for their workforce.

Help employers educate their workforce

The complexity of health insurance often stands between employees and their benefits. Instead of being proactive, people tend to take a reactive approach to their health care, waiting until they need care before learning to navigate the system. Employers often pay the price when employees fail to use the system efficiently. 

Mitigate each of these problems by directly educating employees or empowering HR departments to do so. Whether you conduct educational seminars during open enrollment or provide literature to your clients, the key here is to promote health literacy. Follow best practices such as:

• Avoid using TLAs (three letter acronyms).
• Define key terms, such as deductible, copay, etc.
• Use graphics and pictures in addition to text to reach all types of learners.
• Publish the material in multiple languages as necessary to reach all employees.

In addition to explaining what benefits employees have and how coverage works, brokers can shed light on how employees can navigate the health care system, especially strategies that save them money. 

For example, you may highlight the fact that many urgent but non-life-threatening ailments, such as lacerations, sports injuries, imaging, and even minor surgical procedures, are more economically resolved at an in-network urgent care facility rather than the emergency room.

Help employers keep coverage affordable

Very few Americans choose to receive recommended preventative care, even though many preventative services are covered in full. Avoiding or deferring care can lead to missed diagnoses, delayed treatment, and other consequences that lead to expensive health claims for employees and increased health care costs for employers. 

So encourage employers to openly welcome employees to get their annual wellness visits, routine screenings, immunizations, and specialist visits and make sure employees know they have access to tools and services that can help them manage overall health and chronic conditions.

What's more, employees – regardless of income level – may defer care because they cannot afford it. To address this, employers can continue to turn to high-deductible plans with health savings accounts (HSAs) to help manage costs. HSAs can help employees pay for upfront out-of-pocket costs for health care because employers can contribute to HSAs and employees can contribute tax-free portions of their paychecks.

Ideally, employees have enough saved in their HSAs to cover upfront costs when they occur, but that is not always the case. A 2022 report showed that 60% of HSA accounts have a balance of less than $1,000. And many plans don't qualify for HSAs. That's where brokers and benefits consultants can suggest a complementary tool, the health payment account (HPA), to employers. The benefit? HPAs are a new source of funding – compatible with employer health plans – that allows employees to pay for care over time without fees or interest. 

Employers can set a limit – usually between $500 and $5,000 – on their employees' HPA cards, then employees can use them to pay for out-of-pocket costs associated with health care up to the limit. This allows employees to get the care they need now instead of deferring care or using high-interest credit cards, which end up costing employees more in the long run. Employees repay their card balances through flexible repayment plans tied to their payroll.

Help remove barriers to access while addressing social determinants of health

The benefits of achieving health equity goals are numerous, and brokers are in a unique position to help their clients remove barriers to access.

A healthy workforce is a productive workforce. What's more, a workforce that feels well cared for is less likely to leave in search of a better benefits package. And, of course, equitable health care outcomes contribute to a more just society.

Chris Labrecque is the Chief Customer Officer of Paytient, a company which helps people access and afford care.