Health and Safety

Effectively Communicating Plan Design

September 22, 2016 
By David Stoddard, ASA, MAAA

As multiemployer plans focus on delivering health benefits to their members in a cost-effective and efficient way, a key component is clearly and concisely communicating the thought process behind plan design and plan design changes.

Given the limited amount of money available to spend on benefits, multiemployer plans must avoid unnecessary services and reduce waste in an effort to contain costs. As a result, increased member cost-sharing, restrictions on certain services, and more tightly-managed benefits are often implemented to manage the plans’ spending.

However, despite these changes mainly being made for the “greater good of the plan,” they will be interpreted in different ways (generally negatively) by the membership. For example, a plan with high emergency room use (for non-emergencies) may increase the emergency room copayment (and perhaps lower the primary care physician copayment as an offset). For a member who legitimately needs to use the emergency room, an increased copayment will feel like a punishment. But if the change is communicated effectively, along with the reason(s) for the change, members may be more likely to be amenable to the change.

Effective communication to members includes delivering the message via email, pamphlets, mailings, bulletin board postings, or meetings – any mode of communication that reaches the membership. The message should be concise – the fewer the words, the more likely members will listen – and it should be repeated often. For example, if the plan wishes to emphasize preventive care to avoid higher cost services in the future, the headline could be “The Importance of Preventive Services,” and members should have multiple opportunities – at least once every three to six months – to receive the message until the plan is sure that the message has been heard. If the membership understands the plan’s goals in administering benefits, the plan is more likely to achieve or even surpass these goals.

For more information, please contact Paul Bonsee at paul.bonsee@milliman.com.

September 21, 2016

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