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Plans and Services
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Who We Serve
Who We Serve
- Small Businesses (2-99 employees)
- Small to Midsize Businesses (100-499 employees)
- Midsize to Large Businesses (500-2,999 employees)
- Large Businesses (3,000+ employees)
- Hospitals and Health Systems
- Higher Education
- K-12 Education
- State and Local Governments
- Taft-Hartley and Federal
- Third-Party Administrators
- View all business types
- Health Insurance for Expats
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- Multinational Businesses
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White Paper | January 2020
The 5 Steps to Creating a Healthy Benefits Strategy
A step-by-step guide to help you improve health, engage employees, and lower costs.
So, what is a health care benefits strategy?
A health care benefits strategy is a plan that helps your business contain the costs of health insurance, increase employee satisfaction, and maximize the efficiencies of your health plan.
Many employers are looking for ways to contain health care costs. With the average cost of insuring an employee hovering around $14,000 a year1, health benefits represent one of the most significant overhead line items facing employers. But while many businesses are putting an increased emphasis on cost reduction, many simply may not know how to consistently reduce costs, year-after-year, without impacting outcomes and the satisfaction of their employees. Many times, short-term discounts are appealing, but they may not reduce the Medical Cost Trend in the long term.
That’s why creating a health care benefits strategy is critical.
A holistic health care benefits strategy attempts to find the best balance of cost and care for your business. An effective strategy should also focus on improving employee productivity, attitude, and overall job satisfaction.
This guide will walk you through what you need to create a health care strategy and give you the guidance you need to execute it.
Health care benefits strategy at a glance
The 5 essential steps:
- Define objectives and goals
- Assess the population
- Establish a performance benchmark
- Create an engagement plan
- Define a measurement plan
Long-term building blocks:
- Year 1: Biometric assessment
- Year 2: Increase participation
- Year 3: Expansion to family
Step 1: Define objectives and goals
Like any other part of your organization, a health care benefits strategy’s primary purpose is to impact the bottom line. A major challenge to effectively implementing a health care benefits strategy is getting commitment from your organization, starting at the top. The leaders and key decision makers in your company need to be active and vocal supporters of the plan in order for it to work.
How do you get the organization to buy in? By setting simple, achievable goals that show how the health care strategy will help the business. Every business is different, but these goals are common across industries and should provide a good place to start.
Set health-specific objectives that will help you reach your business goals
The goals for your health care strategy should focus on measurable, health-specific factors that ladder up to your business goals. It’s critical to take a holistic approach and consider the different variables that will ultimately add up to a successful plan.
Ask yourself a few key questions:
- Do you want to improve overall employee health?
- Do you want to use health benefits as a recruitment or retention advantage?
- Do you want to address a specific benefits challenge?
Common business goals for HR department:
- Reduce benefits expense
- More effectively forecast overhead costs
- Successfully recruit experienced senior leadership positions and attract key talent
- Increase talent retention and employee satisfaction
- Improve productivity and the health and well-being of employees
These 3 goal categories will help you set goals that address both the symptom and the source of the challenges your organization may face from a benefits perspective.
Better health:
Better engagement:
Better savings:
Step 2: Assess the population
It’s important to have a firm understanding of the needs, usage, and risks of your employee population when it comes to creating an actionable health care strategy. This phase of the strategy development is all about gathering the right data. There are a number of ways to gather this information, but one of the best starting points is to have your employees fill out a Health Risk Assessment, to gain more insight into your population’s health and lifestyle.
Key data points
These are the data points to focus on that will help provide the best representation of the needs of your population.
General Health Status
Are most employees generally healthy and live active lifestyles? Does your population have a high number of chronic conditions?
Attitudes Toward Health
How do your employees feel about healthful decisions like regular preventive care or healthy eating?
Health Care Utilization
How is your population utilizing their current health plan? How often do employees fill prescriptions or receive treatment? Are there any trends in claims?
Demographics
What is the average age of your employees? Are there concentrations in particular generations? Do many employees have children?
Population Trends
Are there any indications of prevalent chronic conditions, like high blood pressure or high cholesterol?
Click here to download our tips for conducting an Employee Benefits Satisfaction Survey.
Why you should host a worksite biometric screening
A biometric screening is a quick test that identifies risk for heart disease, stroke, diabetes, and these key health metrics:
- Blood pressure
- Total cholesterol
- Body mass index
- HDL
- TC/HDL ratio
- Glucose (blood sugar)
Step 3: Establish a performance benchmark
Benchmarks help you understand what normal is for your industry. Obviously every business is different, but as a general baseline, benchmarks can help you set smarter, more achievable goals. The benchmarks listed in the next section are designed to help you get started, but remember that the metrics for your goals may be slightly different, depending on what you’re trying to achieve.
Common Benefits Strategy Benchmarks
- Cost per member per year
- Preventive care utilization
- Chronic condition prevalence
- Health engagement
- Out-of-network utilization
- Claims analysis
- Specialty pharmacy usage
Key Health Care Benchmarks by Industry
|
Industry
|
Spend Per Member Per Year
|
Health Maintenance & Health Improvement Engagement
|
Chronic Condition Prevalence
|
|---|---|---|---|
|
Insurance |
$5,018 |
43% |
39% |
|
Financial Institutions |
$4,764 |
41% |
35.2% |
|
Retail Merchandise |
$4,559 |
38.3% |
33% |
|
Oil and Gas |
$4,543 |
38.1% |
32.2% |
|
Law Firms |
$5,986 |
36.7% |
38.5% |
|
Manufacturing |
$4,784 |
34% |
38.5% |
|
Pharmaceuticals |
$4,834 |
32.9% |
41% |
|
Hospitals |
$5,553 |
32.1% |
39.7% |
|
Technology |
$4,396 |
31.2% |
33.6% |
|
Car Dearlerships |
$4,339 |
26.6% |
28.8% |
|
Retails Food and Drink |
$4,586 |
24.3% |
38.6% |
|
Trucking |
$4,393
|
22.8%
|
43.1%
|
Step 4: Create an engagement plan
This is where the rubber meets the road. It’s important to work with your broker or insurance carrier to turn your strategy into an operational plan with specific programs and initiatives that are designed to help you reach your goals.
For example, if you have an employee population with a high rate of diabetes, it’s important to get them involved in specific health improvement plans.
Or, if you have issues with out-of-network spend, it could be a reason to find a network or plan design that better suits your needs.
Remember, employee engagement is one of the biggest challenges to implementing an effective health care strategy successfully. Emphasize the importance of preventive care, including annual checkups and access to health programs. Be proactive to reinforce your organization’s commitment to the health and wellness of its employees.
How your carrier can help
-
Care management: Outreach programs to identify and engage individuals with potentially dangerous risk combinations to help lower the overall risk of your population.
-
Wellness initiatives: Discounts on health and wellness products3, one-on-one coaching and support, and personalized health plans for employees.
-
Chronic care: High-level, individual attention to employees with chronic conditions such as diabetes, asthma, depression, back pain, cardiac, and oncology conditions.
-
Health risk management: Support for at-risk individuals, incentive programs to help you motivate behavior change, and the ability to measure progress.
Jerry Berwick,
Cigna HealthcareSM Leader, South Texas Region
Step 5: Define a measurement plan
Just like any other part of your organization, it’s important that your health care strategy is able to prove that it’s working. Ultimately, the ROI of your strategy is based on whether you experience lower health care costs. However, each phase of your plan should be measured with a key metric for success. Make sure that each stage of your plan is measurable and actionable to reveal short and long-term opportunities for optimizing engagement.
Remember to measure regularly. It’s easy to fall into the trap of only reviewing health care performance reports during renewal season, but regular pulse checks are critical to maintaining an effective strategy. Monthly and quarterly reports are key to ensure you’re still tracking for success. If you are, great. If you’re missing the mark, stop, assess, and reset.
Here are a few sample goals and metrics:
|
Example Goal
|
Example Metric
|
|---|---|
|
Assess health of population
|
Percentage of employees who complete a biometric screening
|
|
Increase preventive care
|
Percentage of employees who had an annual physical
|
|
Educate employees on the plan
|
Percentage of employees connected to myCigna™
|
|
Reduce risk of high risk employees
|
Percentage of employees enrolled in clinical coaching programs
|
Ask your employees what they think
Assessing employee satisfaction with health care benefits is a must. Surveys can be easily sent out via email and should be straightforward and easy to understand. The questions should be targeted and ask about specific aspects of the benefits plan. For example, are you satisfied with the number of plans available? Are you satisfied with the access to doctors and hospitals in the network? Your carrier should be able to assist you in developing and administering the survey.
To help improve the success of your health benefits programs, major shifts or changes should be clearly communicated to the broader employee population—typically from your CEO or higher-ranking management. Reinforce and repeat at the organizational level. If employees aren’t communicated to or incentivized, they likely won’t participate. Plain and simple.
To download our guide to conducting an employee survey, click here:
Download survey guide [PDF]
You’re on the fast track to a better, more effective health care strategy!
You’re set for success. You now understand the value of actively managing your health care benefits strategy. With these tools, you can begin implementing it today.
Remember, your carrier should be your partner in this journey and provide support and guidance every step of the way.
Download this white paper [PDF]
Discover how Cigna Healthcare can help your organization
Ready to plan your benefits strategy for next year?
Contact your broker or connect with a Cigna Healthcare representative to learn more about how we can work together.
Learn More About Our Services
Related Topics
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1 Employers to Spend about $10,000 on Health Care for Each Worker.” O’Brien, Sarah, CNBC, August 9, 2017. https://www.cnbc.com/2017/08/09/employers-to-spend-about-10000-on-health-care-for-each-worker.html
2Analysis included all clients within the given industry in Cigna Healthcare book of business across all segments and client sizes for 2016 benefit plans.
3A discount program is NOT insurance, and the member must pay the entire discounted charge. If your plan includes coverage for any of these products, this program is in addition to, not instead of your plan benefits. Discount programs are separate from your medical benefits. Some programs are not available in all states and programs may be discontinued at any time.
Product availability may vary by location and plan type and is subject to change. All group health insurance policies and health benefit plans contain exclusions and limitations. For costs and details of coverage, contact a Cigna Healthcare representative.
All Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company (CHLIC), Cigna Behavioral Health, Inc., Cigna Health Management, Inc., and HMO or service company subsidiaries of The Cigna Group. Policy forms: OK - HP-APP-1 et al., OR - HP-POL38 02-13, TN - HP-POL43/HC-CER1V1 et al. (CHLIC). The Cigna Healthcare name, logo, and other Cigna Healthcare marks are owned by Cigna Intellectual Property, Inc. All pictures are used for illustrative purposes only.
882168 © 2018 Cigna Healthcare. Some content provided under license.
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Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of The Cigna Group Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT). The Cigna Healthcare name, logo, and other Cigna Healthcare marks are owned by The Cigna Group Intellectual Property, Inc.
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