The intersection of employee benefits administration and employee advocacy

Andrew Brickman

Recently the American Psychological Association (APA) published a retention survey that cited the reasons for employee loyalty. While enjoying one’s work and maintaining a good work-life balance ranked number 1 and 2 on the list, survey respondents identified their group employee benefits as the number 3 reason for remaining loyal to their employer. In fact, respondents ranked health and welfare benefits higher in importance than salary!

Because benefits are an important part of retaining talent, employers need tools to help their plan participants better utilize their health and welfare programs as well as mechanisms to bend the cost curve for this very expensive line item on the budget. With many organizations utilizing third parties to administer benefit plans, employee advocacy has emerged as an important component to drive value and lower costs.

Employee advocacy is a service where dedicated customer representatives or advocates resolve benefit issues for employees and dependents. Advocates answer general coverage questions, handle issues such as complicated claims problems, and assist with pre-authorizations or pre-certifications of tests, treatment and prescriptions. Some employee advocacy services also offer concierge-level
clinical support.

Advocates are a knowledgeable and caring resource to resolve group employee benefit challenges and help employees remain focused on their jobs instead of worrying about trying to solve issues on their own. Employees who receive this personal assistance develop quite a different perception of their benefits as opposed to those who must wait in line for help from the next available carrier representative or a staffer at a busy provider’s office.

The best employee advocacy program delivers peace of mind and elevates overall participant knowledge and satisfaction with benefits. A Corporate Synergies poll found that HR managers feel overwhelmingly that employees do not understand their benefits packages, and advocacy can help close this gap. In our poll, 84% of HR managers said plan participants don’t understand how their “lifestyle or utilization decisions” impact the cost of benefits. Just 8% of respondents said they felt their employees had a good grasp on how their decisions impacted the cost of benefits. A common underlying result of employee misuse and misunderstanding of benefits is frustration, which can be reflected on the employer.

In addition to advocacy, outsourcing benefits administration is a cost-effective way to offload tactical, error-prone and time-consuming program management tasks and to mitigate regulatory compliance risks. As with employee advocacy, third-party benefits administration expertise can help reduce benefit costs (efficient billing and reconciliation process are two good examples). These days, HR departments are required to do more with fewer resources, and outsourcing employee benefits administration is an efficient way to increase productivity and organizational effectiveness. Integrating employee advocacy with robust benefits administration relieves demands on HR and offers plan participants a single resource to address issues
such as:

  1. What are my benefit options?
  2. How do I use my benefits?
  3. Why did something go wrong when I tried to use my benefits?

While technology and outsourced employee benefits administration providers do a decent job of addressing benefit use, some offer little to assist the participant who needs a detailed explanations or who is having problems using their plans. That’s where employee advocacy can play a huge role. By competently addressing the questions above, advocates also have opportunities to coach employees on lower-cost care alternatives, such as using generic medications, or selecting primary care providers or urgent care centers over higher-cost emergency room treatment. They can guide participants on smarter ways to consume benefits like taking advantage of an available flexible spending account. Also, combining benefits administration with employee advocacy helps to proactively identify trends and correct unwelcome outcomes before they impact a broad portion of the workforce.

As the APA discovered in its survey, group employee benefits are an important part of retaining talent. If an employee has a negative experience with benefits or doesn’t understand the value of what you offer, your ability to keep and motivate key talent could be challenging. By combining the detailed plan knowledge of a benefit administrator with the industry experience of an employee advocate, employers can have a powerful tool to control costs, lower turnover and boost productivity.

©2015 Corporate Synergies Group, LLC. No part of this material may be republished or distributed without prior written consent.