How Do You Choose the Right Health Plan Decision Support Tool?
Employees value their health insurance, but when it comes to selecting the best health plans for themselves and their families, they often don’t make the best choice. Before working with our clients, we’ve seen up to 80% of their employees pick the wrong plan for their needs—often spending too much money.
I’ve been there. With work, family and shuttling kids around, spending time thoroughly researching my health plan choices was never at the top of my to-do list. I didn’t consider switching plans. Instead, I decided to stay with the same PPO plan that had a lower deductible and higher premium– just in case. The $1000 employer HSA contribution didn’t even factor into my decision, at first.
And I’m not alone. Employees don’t spend the time needed to understand their plans. In fact, the stats show that 93% of them just stick with the same health plans year-after-year. 1
Health plan comparisons
When trying to select your benefits, a health plan comparison is better than nothing. It displays a static side-by-side description of each plan. Employees still need to spend time analyzing their expected medical costs and how they apply to each plan. The comparison provides some data, but it requires employees to do additional research.
Health insurance decision support tools
Before working at Tango Health, I thought a decision support tool was all about an employer pushing me toward an HDHP. But now, I understand it’s about estimating your future healthcare costs and looking at the best plan based on the numbers. A health plan decision support tool should be dynamic and guide employees step-by-step through the decision process. At the end, it gives personal recommendations for the least expensive plans for the employees’ unique circumstances and lets them look at different spending scenarios. The good tools also let you see how tax savings from HSAs / FSAs affect the total cost.
My top 3 picks—what to look for in a health insurance decision support tool
I’ve quickly realized not all tools are equal. There are many factors to consider when selecting the right tool. Here are a few that I think are the most helpful to me:
- Easy to use: It should be quick, easy-to-use and explain concepts clearly without being distracting. If employees invest too much time or become sidetracked by additional information, then the tool isn’t doing its job as a helpful guide. While mixing benefits education with decision support can be helpful, it shouldn’t be at the expense of getting to the best plan recommendation.
- Personalized with claims: A personalized medical decision support tool will pull in medical and pharmacy claims information—either individual employee claims or claims from “people like them.” This gives employees a place to start as they estimate their expected costs. Some decision support platforms like Tango Decision Assist™ can even show employees which plan would be best for them based on last years’ claims at the start.
- Accurate recommendations: Employees should be able to run different medical-spending scenarios and transparently see how they impact plan costs. This means they should be able to be as specific as they want with estimating their healthcare expenses. Know they’ll have a baby next year or have the knee surgery they’ve been putting off? They can include that in their expected expenses. Do they expect to have a brand name prescription? They can include that expense as well. When employees can add the specific medical expenses they expect to have, they will trust the resulting health plan recommendation and choose the right plan. They also gain awareness of the true cost of healthcare and can reconsider that brand name prescription for a generic alternative.
After using Tango Decision Assist, I’ve gained a much better understanding of HDHP and how HSAs equal significant pre-tax savings. I am now happily enrolled in an HDHP and helped convince my husband to do the same.
We’ve identified 6 key questions to ask as you consider the right benefits decision support tool to help guide employees to select the best health plans for their needs. Check out our e-book, 6 Vital Questions: What to ask vendors before selecting a health plan decision support tool.
Originally published Sept. 5, 2017; updated Dec. 18, 2019
12016 AFLAC Workforce Report
Categorized in: Benefits Communication & Decision Support