Important conversations to have between employers & TPAs: A Q&A with Jim Hayes

The relationship employers have with TPAs is important to maintain, but it’s also important to ask questions and address the problems that affect employees. Jim Hayes, executive client partner at Alegeus, a market leader in health care payment solutions, explains what important conversations employers need to be having with their TPAs.

How has the conversation between employers and TPAs shifted as it relates to employee “whole health” after the pandemic? What has changed?

The conversation continues to shift towards strategies for implementing a holistic approach, meaning one that addresses the physical, mental, financial and emotional wellbeing of their employees. Driving engagement and measuring outcomes of benefit solutions is also top of mind, as many employers are investing in benefit offerings that aren’t being highly utilized.

How does a focus on “whole health” translate to retaining employees?

A holistic approach supporting employees’ whole health enables employers to create a workplace culture that promotes wellbeing and contributes to employee engagement, productivity and overall satisfaction. When done well, this holistic approach to mental, physical, emotional and financial health creates an organization that will retain employees because they are happier, healthier and feel valued.

Given recent market conditions, how are employers and TPAs coming together on conversations with those newest to the workforce? Are they focusing on near-term financial wellness, retirement, both?

Employers are focused on strategies to educate and provide benefits that meet the expectations and needs of those newest to the workforce. TPAs have an opportunity to support employers by creating education aimed at the newest members of the workforce who often need more support picking health plans or aren’t familiar with 401ks or Health Savings Accounts. TPAs can also provide solutions that meet these newest employees’ experience and expectations. An example is offering a robo advisor or the ability to pick individual stocks or ETFs in their Health Savings Account or 401k.

Alegeus data has found that employees feel that employers are responsible for their health care financial wellness in 2023. How have HR and their TPAs responded to that responsibility, or how should they be responding, in the year to come – especially in light of health care cost concerns?

Employers and TPAs we talk with feel responsible for supporting their employees’ health care financial wellness and are frustrated by the challenges of doing it well. The most successful employers and TPAs we see partner on the following:

• Ensuring their employees go through active enrollment every year to maximize opportunities to educate and support their employees’ health care decisions
• Creating plan designs that are easy to understand
• Offering fewer plans that employees have to choose between
• Providing specific recommendations on the dollar amount employees should be contributing from each paycheck to budget for health care in their HSA/FSA
• Driving engagement with tools to help employees find high-quality, affordable care
• Giving employees best-in-class investment solutions to grow their Health Savings Accounts for near-term and long-term expenses

Related: Humira biosimilars are finally here: What brokers and TPAs need to know

Beyond health insurance, should employers and TPAs be considering third-party benefactors of benefits programs, i.e., the dependents of their employees, and how benefit offerings impact their “whole health? How so?

Absolutely. It is challenging to show up at your best at work when anyone in your family is struggling. We recommend looking at some of the top stressors dependents of employees face and determining if your benefit offerings have solutions to help employees meet those challenges. This could include everything from counseling, caregiver benefits, time-off considerations, financial coaching and more.