The Essential Elements of a Strong Benefits Advisor and Benefits Administration Vendor Partnership, Part 2: The Solution

Without benefits advisors, many employers would struggle to implement employee benefits strategies with the right tech solutions and an effective approach to benefits communications and engagement. Your role is essential, and you should count on your benefits administration partners to help you make the most of each opportunity to serve your clients.

This 2-part series discusses how a benefits administration partner can help you deliver maximum value to your employer customers. The first installment explores the “softer” side of a successful partnership and what defines a healthy vendor/advisor relationship. Here in the second part, we take a look at the technology behind the relationship and what to expect from a solution that drives success for you and your clients.

Part 2: Leveraging Technology to Drive Results

Approach to Data and Technology

In today’s benefits industry, data is critical… but it can be difficult to access and use in a meaningful way. Accurate, current, and properly understood data should underpin every major decision an employer makes about its benefits program — including which benefits to offer, how to structure them, when and how to communicate with employees, and how to track ROI.

Since most organizations don’t employ data experts, employers lean heavily on brokers to support this process. However, brokers can only do this effectively if they have access to the necessary data. To support this, a benefits administration vendor should provide:

Data management

A valuable benefits administration partner provides technology that supports the effective collection, analysis, and reporting of benefits data. Of course, this is much easier said than done. As more solutions and programs enter the benefits ecosystem, customers need efficient ways to access and analyze data spread across multiple systems and formats in order to truly understand what’s going on with their benefits.

At a minimum, a benefits administration tool must be able to ingest and rationalize this diverse data and provide the customer with insights to help them understand their full dataset — for example, making it easy to measure and track the ROI of benefits initiatives.

Actionable data insights for brokers

In order to serve as trusted advisors, brokers need access to each customer’s data along with tools and smart insights designed specifically for their needs. A technology experience geared solely for employers will not provide the control and insight brokers need to play this role. If brokers use employer-focused tools to support their employer clients, they can inadvertently underserve those employers, as they will miss out on expert advice and guidance from their broker partners.

Interoperability

As more health plans, TPAs and employers move away from paper-based processes and adopt digital systems, it’s increasingly important for benefits administration platforms to include robust connectivity.  

Similarly, platforms should integrate seamlessly with point solutions to ensure employers and brokers have total access to and control over data across a benefits program's entire scope. Needless to say, the specifics of which systems and tools require integration will differ by employer — however, a benefits administration partner should, at a minimum:

• Provide a robust range of integrations out-of-the-box, and
• Support new integrations within a reasonable time period for new and existing customers.

Employee Experience  

Consumer-driven health care has permeated the benefits market and practically every employer has adopted some form of it. Employers and employees grasp the concept, and HDHPs/HSAs are now a popular choice for the management of health care and dollars. Research suggests that over half (53.6%) of U.S. private-sector workers were enrolled in HDHPs in 2022.

But… the concept has been around for a while now, and, as explained by Mercer, there really aren’t any more costs that can be shared with employees. Instead, employers are increasingly looking for ways to offer their employees choice. Rather than forcing employees down the route of HDHPs and HSAs — or watching them fall back on traditional plan types because ‘that’s what they’ve always done’ — employers want to empower employees to make the right decisions for their personal situations.

This is a prime example of an area where brokers — supported by the right benefits administration partner—can add huge value for their customers. To help your customers maximize their employees’ experience, look for a benefits administration partner that can offer the following services.

1. Enable optimal benefits selection and utilization

Every player in the ecosystem wins when employees make good decisions about benefits and become better, more educated consumers of health care. However, historically, many employees have struggled to understand the benefits available or navigate their care experiences.

When employees are directed to their next best action and don’t have to figure it out themselves, they are far more likely to avoid poor decisions. An effective benefits administration tool can remove the barriers that prevent employees from making smarter benefits decisions and engaging with their benefits by guiding them in a simple and logical way through their benefits experience.

This ultimately means the potential for better health and financial outcomes for employees, along with clear benefits for employers. Successful employee outcomes are hugely important for effective talent attraction and retention, maximizing benefits program ROI, and maintaining employee health and productivity.

2. Manage and integrate point solutions

Many employers have adopted point solutions to support employees’ specific health needs, such as diabetes, heart health, behavioral health and the like. These can be tough to manage, administer and communicate to employees — and challenging for employers to evaluate for ROI. In many cases, employers retain point solutions without knowing whether they’re moving the needle on employee health.

This is another area where a benefits administration platform can help employers — and also help brokers play their trusted advisor role. By helping employers determine the cost, utilization, and improvements in outcomes associated with a point solution, a partnership of broker and benefits administration platform can dramatically improve the cost-benefit ratio of any benefits program.

3. Help employees navigate their care journeys

A patient’s choice of doctor is an important decision when it comes to health care costs and outcomes. However, most employees aren’t health care experts and may not be in a position to make an informed decision without support. Often, employees choose doctors based on convenience — perhaps for their location or because a friend or primary care doctor recommends them. Since most people don’t have ready access to objective quality and performance metrics, it’s tough to make informed decisions.

Steering employees toward doctors who consistently perform well and don’t engage in wasteful practices (e.g., sending patients for unnecessary procedures) can have dramatic cost and outcome implications for both employees and employers.

An effective benefits administration platform should offer data-driven navigation tools that allow employees to find top-performing providers within their network, directly from their benefits portal. This feature alone can reduce health care costs, not to mention providing peace of mind for employees and their families while simultaneously maximizing the likelihood of positive health outcomes.

Beyond this, care navigation functionality can support employees in identifying the most appropriate type or source of care for their needs—for example, avoiding a costly trip to the ER when a telemedicine visit would suffice or selecting a covered, in-network doctor instead of an out-of-network provider.

4. Provide data-backed decision support

Access to the right benefits is central to employees’ ability to enjoy positive health and financial outcomes. However, choosing the right benefits is far from easy, particularly when an employee’s circumstances change over time. Many employees become so overwhelmed by their benefits decisions that they simply choose the same — and possibly suboptimal — options year after year.

Sophisticated benefits administration tools provide decision support capabilities that leverage data from an underlying health care analytics platform to suggest the ideal combination of benefits for each employee’s unique circumstances and needs. This results in employees benefiting from optimal benefits selections that help maximize coverage without overpaying for unnecessary services.

Building Long Term Relationships

At Benefitfocus, we provide the solutions brokers need to deliver outstanding service. That includes tools that help employers make better decisions about the benefits they offer and empower employees to choose and use benefits optimally to help maximize their health and financial outcomes.  

Want to learn more? Explore our end-to-end benefits solution for you and your clients.