All employers have responsibility of guiding their employees about the health benefit schemes offered by them. Even the employees on the other hand also have the right to receive information about the health benefit schemes offered to them. Therefore an employer has the right to inform the employees about certain information regarding the health benefit schemes. For this reason, organizations have created the position of Health Benefit Manager having communication as one of the responsibilities for health benefit related schemes and procedures.
Key information heads to be shared by employer
There is a plethora of information available for communication. It is the skill of the Health benefit Manager to present them in a structured manner on behalf of the employer.
– Employers need to provide a detailed list of information to the employees about what health benefit schemes are provided to them or the scheme they are entitled to.
– Providing information regarding cost sharing as well as arrangements
– To take up necessary steps to resolve problem as well as to deal with appeals.
– To provide and guide its employees about the status of accreditation, certification as well as licensure.
– Provide sufficient and necessary information about the composition of the provider network too.
– To use the emergency care services as when required by the employees of the organization.
– To obtain referrals to specialists
– Most importantly provide all the information regarding the quality, safety of the health benefit plan and the cost of the employer sponsored plan.
According to the Employer Retirement and Income Security Act of 1974, it is necessary to provide all detailed information that the employees are entitled to that includes plan rules, covered benefits, documents about the plan management and operation as well. The employees are also entitled to receive a document with the summary plan description, known as SPD. The SPD contains
– Information of the health care services that are covered in the plan.
– Description of what services are being provided by the plan and how these schemes function.
– It provides information also on how to calculate the benefits.
– Explanation on the cost that the plan covers and the cost that the beneficiary has to pay.
Tools and Methods for communicating
There are various methods by which the Health Benefit Manager, on behalf of the employers, can communicate health benefit information to the employees:
– One of the best ways is to communicate with the employees about the health coverage plan but providing too much information of it should also be avoided. The employees should be given the required time to understand the scheme and ask questions if any.
– It is best to explain the changes in simple terms to the employees to make them understand.
– Apart from the employees it is also necessary to explain the health benefit plans to the health benefit managers so that they can explain it to the employees to.
– Employers should be ready to face any questions asked by employees regarding the health benefit scheme and clear their doubts.
– It is equally important as well to be direct and honest when discussing about the coverage plan especially if employees face cost increase due to the coverage plan.
– Discussing the 5C’s too is essential with the employees. This 5C’s include cost, changes in plans, coverage of the plan, comparison of the previous year’s plan and also the current option.
– It is necessary to provide information the employees about the health care providers that are available in the revised and new plan option.
– Providing testimonials of other employees about the changes in health benefit plans can also be quite helpful for the present employees.
– Taking the help of various means like internet, face to face discussions, telephonic conversations, office intranet as well as printed materials can be helpful too. However it is also necessary to use materials that are easily understood by employees.