PLAN DESIGN OPTIONS

In many ways plan design is the most important aspect of your benefits program. Most of the frustration associated with benefits stems from plan design. Employees’ satisfaction is dependant on how effective the plan is. Poor plan design can lead to abuse if the proper guidelines or restrictions aren’t in place, therefore costing more money. A poorly designed plan will not have maximized the efficiency of the premiums spent, especially if you are investing in benefits that are not utilized or valued. Even beyond the obvious plan design options there are nuances which can enhance or diminish your plan depending on if they are utilized or not.

Example: Most brokers will suggest including Paramedical services (Chiropractor, Psychologist etc.) in your plan design and establish a maximum per practitioner. As a response to an increase at renewal they might suggest you lower the overall maximum as a cost containment measure. This is a typical “solution”. Gowan Consulting approaches this issue by studying your employees’ usage patterns to determine which cost effective solution will least negatively impact your employees. Per visit maximums, maximum number of visits per practitioner, and maximums on specific paramedical services and not others, or doctors’ notes for certain services that are more prone to abuse than others such as massage therapy are some of the cost containment measures that can be tailored to your plan’s particular usage patterns.

This is one small component of one part of one benefit. Imagine if someone analyzed your entire program with this much detail.