Healthcare leaders understand their own organization’s insurance programs better than anyone else does. The challenge lies in effectively communicating a comprehensive description of the program to all parties, including the actuary, auditor, and broker. It is important for healthcare finance leaders to discuss with the actuary any changes to claims management, coverage or retention, financial reporting of losses, management goals, or other insurance or operational areas.
In this article, Richard Frese discusses the actuary’s role in providing and communicating independent estimates that can more accurately reflect the true exposure of an insurance program.
This article was published on hfma.org, the Healthcare Financial Management Association’s website.
With 2013 nearing it would be wise for employers to communicate changes in employee health benefits concerning Patient Protection and Affordable Care Act (PPACA) provisions set to take affect. Milliman’s Troy Filipek is quoted in this BenefitsPro article discussing “open lines of communication” between employers and employees.
Here is an excerpt from the article:
According to Troy Filipek, a principal and consulting actuary for Milliman, the best way to prepare for compliance next year is to employ contingency planning as well as develop open lines of communication with employees.
Filipek says employers need to be proactive for 2013 while thinking ahead for 2014.
“There are a lot of changes that are occurring, and there are things employers can benefit from just by considering these options. Talk to your advisors and obviously if you do decide to make a change, talk to your employees or your retirees because with anything you make changes to, it’s important that your people are well advised on it, why you’re doing it and how it’s going to impact them.”
Previously we’ve outlined valuable communications practices to help employers navigate healthcare reform. For additional information on effective employer-to-employee communication regarding health benefits, read here.
Employers face a challenge communicating how changes brought about by healthcare reform will affect employee health benefits. Denise Foster and Heidi tenBroek provide advice to help employers explain plan changes to employees in their new article.
Here is an excerpt from the article:
Employers who take a proactive approach to addressing [employee] questions can help guide choices in ways that are best for both employer and employee.
The role of personalized communication
What role will personalized communication play in future healthcare communications, if any? It may be a logical solution depending on the situation. Employers will need to determine if they will incur a penalty related to employee exchange subsidies, and to do that, they will need to know who is likely to be eligible for a subsidy. We can take that same information and create individual statements that clarify the subsidy amount for the individual, lay out the decision points, and clearly identify the options available to the employee.
Set the right course
We’re not entirely sure how employers will respond down the road. A number of our clients are working with our Milliman consultants to conduct a Healthcare Reform Strategic Impact Study, which determines how healthcare reform will affect their population.” The results of these discussions will influence the direction that their communication should take.
Employers will need to make strategic decisions about whether or not they want to offer employees affordable health insurance. If they do not offer affordable health insurance, they would be subject to a penalty if any employees receive a subsidy in the exchange.
Independent of the strategy that employers choose, they are best served by taking a proactive approach. It will be important to set a strategy to communicate healthcare reform changes and do it in a way that ensures employees have the right information at the right time and the overarching benefit program goals are met.