DeWITT — The high cost of employee benefits suggests that using a strategic approach is both “obvious and necessary.”

That was the message that Neil Strodel, vice president of the Benefit Consulting Group, delivered to the Central New York chapter of the Society for Human Resource Management during a Sept. 10 breakfast meeting at the DoubleTree by Hilton Hotel Syracuse at 6301 Route 298 in DeWitt, near Carrier Circle.

It was part of his hour-long presentation entitled, “Health Care Benefits in 2014 and Beyond: A Strategy That Will Get You Through!”

Strodel discussed the Patient Protection and Affordable Care Act (the federal health-care reform law or ACA), talent management, costs, and opportunities in laying out the need for human resources (HR) professionals to become active in their firm’s health-care discussion.

Strodel went on to list some key points for HR professionals to consider when developing their strategic approach. 

The key points include the questions to ask providers, important areas to review, suggestions to keep health-care costs to a minimum, upcoming trends, wellness programs, prescription-drug programs, and how to develop a strategic approach.

“On the trends piece, it’s really going to more about trends that you’ve already seen and I think that are going to continue [to] become larger,” Strodel told the attendees.

Strodel’s presentation included a multi-page handout with several take-away ideas on the vital points from his session.

Questions for providers

The questions for providers should include what performance guarantees are in place; do they offer any additional services for members; how much savings are available on discounts; and is the generic prescription-drug program working well.

“I hear a lot of things about discounts, but a lot of companies really aren’t looking at what they’re saving on discounts and then really making that comparison out in the marketplace,” Strodel said.

Additionally, he advised the HR professionals to renegotiate their prescription-drug program for any savings available and to make sure they’re aware of any online tools available from their vendors.

As for the key areas to review about their firm’s health-care spending, Strodel suggests reviewing any and all data, along with trends in the use of prescription drugs (including cost per member per month and mail-order usage).

Strodel also suggests companies review the integration between their medical and  prescription-drug plans, and disease-management program.

“How is all that working? Are you looking at that?” he asked the crowd.

The key areas also include reviewing the employees’ preventive-care utilization.

In addition, Strodel believes companies should check to find out how their health insurer is handling high-dollar claims, referring to the ones involving “six or nine numbers.”

“They [the claims] should come under your scrutiny every year in terms of how they were handled,” he said, suggesting companies should ask their carriers about the length of any hospital stays and the type of care involved. 

Those key areas also include performing audits of health care and drugs and eligibility.

He also advises businesses to review their stop-loss and funding model.

“Take a look at that every year to say — are we happy with being fully insured versus self insured,” Strodel said.

Other areas to evaluate include the employee-contribution tiers for their health insurance, and an analysis of prescription-drug coverage with a firm’s pharmacy-benefit manager, if a company works with such an individual.

Minimizing health-care costs

Strodel also offered several suggestions to keep health-care costs to a minimum, which included taking a “strategic” approach.

“If you want to reduce your costs, you’ve got to have a strategy,” he said.

He suggests holding meetings to discuss best-practice approaches, issuing requests-for-proposals on benefits plans “regularly,” and conducting audits.

He also advises cost sharing with company employees.

“Not only your contribution is cost sharing but it’s also in terms of how much [people] are paying out of pocket. You’ve got to look at that piece. How much are employees really paying for their health insurance and adding those two numbers together,” Strodel said.

Strodel also suggests that businesses engage in plenty of education and communication with their employees on the topic of wellness and preventive care.

Companies should also conduct regular reviews of any data on health-insurance claims, he added.

Strodel advises companies to build trust with their employees so it’s easier to deliver messages about a firm’s health and wellness programs.

Contact Reinhardt at ereinhardt@cnybj.com