Small Changes to Health Plan, Big Improvements in Employee Health

Compensation Administration
by Amanda Hurlburt

 “A lot of folks don’t understand their health benefits and their pharmacy benefits as well as they could,” says Ed Pezalla, M.D., medical director of Aetna’s Pharmacy Management Program. That incomplete understanding impacts employee health much more than you might suspect. And what impacts employee health impacts your company’s healthcare dollars.

Pezalla suggests some minor changes you can consider that could potentially help your company save money by improving the health of your employees. The first is to recognize that employees can’t use their benefits effectively if they don’t understand them. “These things are very complicated,” he says, “and most people only think about them once a year when they go to sign up for their coverage.

“It really does help people to be reminded about their benefits and how to use them wisely. Open enrollment time is hard, because people have so many things to do already: enroll in their 401(k) or their Roth IRA, decide about dental benefits and whether or not their spouse should have life insurance. These are all complicated things that require a lot of research people may not have time for. So it may be better, once that is all over, to take a little bit of time to educate people about how their benefits work.”

When things have cooled down from open enrollment season, take advantage of the lull to educate employees about how they can save money with benefits they already have. For example, says Pezalla, many people don’t understand that they may have first-dollar coverage on some treatments when they’re covered by a high-deductible plan.

“Often, things that are considered preventive care are covered right away, without a deductible,” he says. “We have a list of medicines that fall under that preventive care rule, so members of Aetna who have high-deductible plans can get coverage right away. The same applies for some things on the medical benefits, too, like mammography and other screening tests that are important.” Check with your medical plan provider to find out if your plan also offers first-dollar coverage for preventive measures.

“Generic drugs save significant money for employees and the employer. Their use can sometimes be increased by educating employees about the benefits of using them. “There are many good generic drugs now in a lot of different categories. At one time, they were the big brand-name products, and they have not lost their efficacy just because they’re generic.

“Generics are so much less expensive than branded drugs that, where it is appropriate for people to switch—and of course, they should always check with their doctor—that can really save money for them and for their plan sponsor.”

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