Benefits utilization training: Help employees be prepared

Too often, employee benefits are often not of interest until they need to be used. But we can help employees prepare for that time.

Perhaps there is no way to be fully prepared, but training and preparation create a framework that you can draw from as you navigate complex situations. (Photo: Shutterstock)

At the time, our house was at a T in the road. My husband at work, my oldest at kindergarten, my toddler, my baby and I were anxiously waiting. I want to say that I was prepared and trained for such a time as this, in reality, I was keenly aware of the chasm between what I ‘should’ know for this undertaking and what I knew. There, in the front yard, I held my baby and passed the soccer ball with my toddler when the social worker drove up. She popped out of her car, swung around, pulled out a car seat carrier, grabbed a diaper bag, and begun walking toward me.

I can’t recall much of what she said as we walked through the front door, but she was there a short time and then wiped her hands together; you know how people do when they are done and said ‘alright need anything’? I cannot remember what I said, but in essence, it must have been no because she left. My answer should have been yes, and I have a list of questions with a side of anxiety.

This was the scene the day my family received our first foster care placement. By now, we have had many, but I will never forget the borderline panic I felt as the case manager backed out of my driveway.

Most of us have been in situations where we feel unprepared for our circumstances. This example represents a situation; perhaps there is no way to be fully prepared, but training and preparation create a framework that you can draw from as you navigate complex situations. I am passionate about communicating and educating, and I believe it equips us to be prepared for times of transition and new experiences.

Related: Knowledge is power: Help employees understand their insurance coverage

In the workplace, it looks a bit different, but the idea is the same. Health care is complex, and employee benefits are often not of interest until you are immersed in the need for care. As an employer or benefit educator, we may not be able to equip employees for every scenario. Still, education on the benefits offered builds a framework on how to utilize your benefits.

In my experience, decisions about what employee benefits to offer are made at the owner/management team level, and many times, the plan design educating trails off. Not all the employees are on the decision-making team and, therefore, not privy to the pursuit that went into providing these benefits. Through that pursuit, the decision-making team developed an understanding of the offered employee benefits.

The chasm here is that the employees will need to use the benefits that are provided by the employer. Educating the employee of the benefits offered and how to utilize those benefits is an important and impactful way to provide training and development.

I fully acknowledge the obstacles to educating employees. Time is taken away from work, production, the bottom line. The question becomes, is this necessary? Will this utilization teaching provide real value? How can we offer this training that will genuinely engage the workforce?

There are numerous reasons that employee benefits coverage creates a ripe environment for education. Studies show differing percentages related to employees’ understanding of their benefits. One reason for the differences is that reporting an understanding of benefit coverage is different from taking a test to assess utilization knowledge. What I do know is that I have been working in the employee benefits industry for 20+ years and still get questions that I need to investigate.

Two items to consider when determining if the need outweighs the obstacles when it comes to benefits education:

First, often there is a lack of frequency for many employees using the health system to get care.

Lack of frequency, coupled with medical professionals, are not experts in benefits, plan designs, networks. Keep in mind the onus is on the employee turned patient to navigate the system to maximize the employee benefits and mitigate costs.

The second refers to the patient/employee state of mind. I want to be sure we do not gloss over this point. When you or your loved one requires medical care, you are likely not thinking at your highest level. You are experiencing at best an unfamiliar situation but can be so much as painful or traumatic. The environment may be new, you are meeting new people who are experts in medical care, and they are asking questions, giving you information, and perhaps touching and poking you. There may be new sounds while you are taking in crucial medical information, and you may be experiencing pain.

Your employee benefits may not have ever been significant, but they are now. You can think back to the educational training provided, the stories and examples, and the benefits counselor or online training offered to educate and review benefits. Now that was a framework of benefits education that you can anchor to and help you in this complex situation.

Medical facilities often have representatives that can assist with pre-certification and network checking, but that is no substitute for the employee turned patient understanding of the benefits. The employee needs teaching to provide the framework to ask better questions and the direction to know where to seek answers.

In my kitchen on the fridge, I have posted this saying: “if you wanted to, you would.”

Educational meetings and one-on-one enrollments are conducted in a myriad of ways. If you want to highlight the value of the benefit being offered, you will. Finding a creative, relevant and impactful way to teach your employees about the benefits being offered is only as far away as a reliable benefit educator.

Michelle J. Smith is a non-medical benefits sales specialist with Keystone Insurers Group.

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