As the dust settles from your January open enrollment it is a good time to reflect on the coverages selected and any overlap that may exist among your core benefit offering.

coverage duplicationOver the past few years, many insurance companies and third-party administrators have begun to add enhanced services to core products. These may include nurse lines, advocacy services, employee assistance programs (EAP) and the like. Although these benefits can provide great value, they may overlap with other coverages which causes confusion and unnecessary spend. When your vendor partners provide enhanced service for “no cost” it is critical that you take the time to examine the following:

  • -Do I already have this service as part of another coverage that is already in place?
  • -If not, do I want/need this new add-on service?
  • -Where is the cost for this service being spread and does that make sense for my population?
  • -If I were to find a partner without this add-on service would I pay less in premium and/or fees?
  • -Does this add-on service really provide value to my organization and its employees?

Meeting deadlines for open enrollment can provide timelines that do not allow for aggressive review of each plan provision. Having said that, it is important that each detail be reviewed and overlap be considered and when appropriate removed. Program reviews may often highlight an overlap in plan design. For example, some programs may already include an EAP component. This is common for health plans, disability plans and life plans.

If your organization has multiple EAP programs it is likely that employees will be confused about the program and participation may actually decrease. Another common overlap within plans is a transport option which will transport employees who may be traveling home when unique circumstances arise. This may be within a health plan, life plan or business travel accident plan.

It is critical that employers highlight the value of their benefit program to employees. When plans overlap it is often difficult for employers to communicate the plan and therefore employees are not aware of the value that exists.

In addition, many employers may pay for separate programs when they have core benefits with similar coverage built into the agreed upon pricing. Work with your vendor partners to set the plan designs that work for your organization and communicate those benefits effectively. If you feel overlap exists in your offering talk with your vendor partners and link in a broker or consultant if you need assistance.

Image Credit: striatic

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Teri Weber

Teri Weber

Partner at Spring Consulting Group, LLC
Teri Weber, ACI is a Partner with Spring Consulting Group. She has over 10 years of experience in health and welfare plan strategy, design, pricing, and implementation. She also works with absence management programs, including disability, family medical leave and leave of absence tracking. Her areas of expertise have allowed her to work with diverse employers and vendors to streamline processes and programs to meet the needs of insurers, administrators, employers and employees. Teri is on the Board for the New England Employee Benefits Council (NEEBC) and recently served as lead editor for the Disability Management Employer Coalition’s (DMEC) Return to Work Program Manual. Prior to joining Spring, Teri worked with Watson Wyatt, Buck Consultants and AON Consulting. In addition she was an Account Manager with Health Direct, Inc. Teri earned a BS at the University of Connecticut and a MBA at the University of Massachusetts. She holds an ACI designation and is a licensed broker in the states of MA and CT.