Russ Roland

Businesses large and small routinely face challenges in putting together health benefits programs that employees will value and appreciate. Health benefits politics are ever-shifting, and health insurance complexity is ever-growing. It’s a tough task, with many sensitivities, in even the simplest situations.

Irrespective of the size of the business, there are some common considerations for leadership teams that can make the decision-making process more manageable and more objective.

1. Make It Affordable

Health insurance plans are becoming more expensive and, concomitantly, offering fewer benefits. Cost is thus the most obvious and frequently-cited challenge for businesses providing health benefits.

Create objective cost targets—for example, basing a health benefits budget on total revenue as opposed to profit-margins, or as a percentage of labor costs—so that you can anticipate change and compartmentalize spending.

2. Consider The Industry Standard

Become familiar, if possible, with the health benefits benchmarks of your industry. In the smallest businesses with a higher percentage of low-wage, general-skill staff, benchmarks might have less generalizable value, but having objective data nonetheless demonstrates a necessary due diligence that objectifies reasoning behind decisions.

Look to trade groups for information, which can be specific to technical skills, or technology skills, or executive compensation. If nothing else, review general data, such as that available through the Kaiser Family Foundation, which gives averages and projections for health insurance plan premiums, employer contribution percentages and employee participation levels.

3. Keep In Mind Employee Perception

Putting a small number of plans into a fixed program for a diverse employee base with different socioeconomic backgrounds, different health priorities and different thresholds for medical uncertainty and pain(s) can quickly lead to frustrated employees and challenge HR teams.

Do your employees truly value the health benefits being provided? If the goal is to be offering a genuine benefit, and you are paying real money that affects an operating margin, it’s vital that you have a finger-on-the-pulse of employee perception. Otherwise, you might think you’re providing a great service while in truth you’re throwing money away.

4. Look At Your Corporate Culture

Be honest: For a given year, is it your business priority and bottom line to have a big heart? Consider this on a spectrum–not all-or-none–and allow that it can change annually. This approach can point out unintentional hypocrisies, such as offering bare-bones insurance and considering it overly generous, or offering robust insurance support while struggling to make payroll. It might also lead to actionable opportunities for improved cost-efficiency.

Dr. Bryan Fine, a local pediatrician, has been a physician for more than 15 years. In addition to practicing medicine, he has also been interested and engaged in health policy as part of his practice. In his opinion, it is becoming increasingly clear that his patients don’t fully understand their health benefits, which can have significant financial ramifications. He has also discovered that many physicians don’t understand their patients’ health benefits, which can lead to major expenses that could have been avoided.

“This is something I’ve been teaching my residents, medical students and colleagues for a long time,” says Dr. Fine. “I’ve given talks on it. I’ve written books articles about it. So I just decided to package it up better to be able to provide it to the masses.”

He started Percentric, a health benefits consulting firm that allows him to translate his bedside experience into opportunities for human resource managers to better engage and support employees while optimizing expenses. The company also strives to work with a company’s employees to access and fully understand their health benefits.

Getting both sides of the equation to understand what he’s trying to do and how it can help everyone has been Dr. Fine’s biggest challenge. However, he believes he is making good progress and as soon as all the light bulbs go on, he’ll be gaining some excellent traction with the growth of his business.

“In think an ongoing obstacle that I continue to work to overcome is the divide—the distance between healthcare and connecting that to how much that healthcare will actually cost somebody,” he says. “There are so many different variables and players, and there are so many different ways to point the finger at somebody else about who is responsible for something. That’s part of what I’m trying to do, to navigate that for the patients’ benefit and for the employers’ benefit.”

Part of the struggle is that the idea he is presenting is a rather new concept and one that can be difficult to understand. Fortunately, his background as a physician has been beneficial, not only from being able to make contact with other doctors and healthcare providers but also from a perspective of expertise.

“This is a pretty unusual theory for most people,” Fine says. “There are some doctors who are savvy about it but not many, not enough. But I haven’t found a previous model where a physician goes out and enters the world where health insurance brokers have typically tip-toed, and I’ve tried to bring that inside knowledge into the boardroom and make a point to emphasize it. Brokers may say that they provide some of the services that I’m presenting, but I bring something to the table others don’t, which is the practice of medicine. So I could, in fact, supplement what brokers do if they wanted to add value. I could work with brokers and offer these services to their clients, which provides a degree of employee support that goes well above and beyond what they currently offer.”

Knowing that running a business is a constantly evolving process, Fine is comfortable remaining small for now and building over time. “I’m happy staying small. I can grow while still being small for quite some time. I don’t have all the answers yet, but we’ve had some really good successes,” he says. “We’ve saved businesses money, and we’ve saved a lot of individual people a significant amount of money just by encouraging them to be educated, ask questions and advocate for themselves.”