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Savvy tools to help pick and choose

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Savvy tools to help pick and choose

As employers continue to shift workers to consumer-directed health plans and private exchanges, more are offering technology-based decision support tools to help employees build and utilize a tailored benefits package.

Selecting benefits traditionally has been confusing, but decision support tools aim to make it easier for workers to make an informed and accurate choice, experts say.

“Decision support always comes down to, ‘how can we help that individual get to the best mix of plans or programs that are right for their needs?’ ” said Scot Marcotte, Chicago-based director of talent and human resource solutions with Buck Consultants at Xerox. “We try to draw on what we know about the individual already, and then help tailor the options with the decision support.”

Decision-support tools often combine employee-specific demographic data, such as age and location, with personal preferences to produce a customized benefits package, including health plan and voluntary benefits.

Employers provide the demographic data and their employees’ past usage of medical benefits, if available, and employees answer questions online about their lifestyle and plan preferences, such as if they smoke or how many prescriptions they fill each month. Some decision support providers include national claims data as well.

The tools then use algorithms to recommend the plan and benefits that best suit the employee’s needs and break out the cost, including monthly premiums and out-of-pocket expenses.

Though decision support tools have been used for years on benefits administration platforms, they are becoming crucial as benefits choices grow, experts say.

The advent of private exchanges with their wide options has created a need to make benefit-shopping a “consumer-type experience, just like you’d go to Amazon and buy a book,” Mr. Marcotte said.

And as employers move toward private exchanges, the greater choice can increase confusion among employees, said Shandon Fowler, Charleston, South Carolina-based director of product management for marketplaces with technology provider Benefitfocus Inc. Including decision support tools in the enrollment process may increase understanding and effectiveness of the benefits offered, he said.

According to Aon Hewitt’s 2015 Health Care Survey, conducted from November 2014 to January, 11% of employers reported they were increasing their health plan options coupled with decision support tools. Four percent of employers said they planned to in 2015, and 39% planned to in the next three to five years.

Only 3% of employers offered benefits through a private exchange this year, and 22% plan to in three to five years, according to the same survey.

“If you put 150 health plans in front of a person, they’re going to have no idea what is the right plan for themselves,” Mr. Fowler said. In a “complex decision environment” decision support tools are a must, he said.

But even with a handful of plans, “research shows that generally speaking, people have no idea which plan is going to be better for their needs with the information that has traditionally been provided to them,” he said.

Decision support tools also have a holistic focus, helping workers include voluntary benefits as well as a medical package.

The real issue now is “how you consider the other products that you need … to have a complete picture of a financially secure and healthy family,” said Vinay Gidwaney, Boston-based co-founder and chief product officer of benefits technology provider Maxwell Health.

“It’s really more of a holistic look, rather than saying, ‘Let’s look at what medical plan this person should be enrolled in. Then let’s go look at the dental plan.’ Making each of those elections separately doesn’t end up with oftentimes the optimal elections for the employee,” said Rae Shanahan, executive vice president with technology provider Businessolver Inc. in Des Moines, Iowa.

Instead, using the demographic data and employee preferences, decision support tools help fill the gaps in medical coverage or supplement the employee’s plan with extra benefits to accommodate his or her lifestyle.

For example, Willis’ exchange platform, Willis Advantage, might recommend a high-deductible health plan to a low-risk, healthy 27-year-old who would need protection in the event of a catastrophe, said Rob Harkins, Boston-based practice leader for private exchanges with Willis North America Inc.

If that individual told the decision support software he hikes or runs often, the tool may also recommend an accident benefit in addition to the high-deductible plan, he said.

Maxwell Health’s decision support tool may even recommend a meal delivery service, a subscription babysitting service or a fitness device, depending on the employee’s demographic and what the employer chooses to offer.

Decision support tools help employees make the best use of their benefits, but they also relieve employers of many administrative duties, Mr. Harkins said.

Large companies often have to “staff up” during open enrollment to answer workers’ benefits questions, a process that can be time consuming and laborious, he said. Decision support reduces that need, he said.

And experts say decision support gives employees a more accurate and personalized recommendation for benefits than a benefits manager or human resources team can.

“It’s very atypical for a person at a benefits fair table to sit with someone and even have the resources to make a projection on their out-of-pocket expenses on half a dozen plans,” said Don Garlitz, Salt Lake City-based senior vice president with benefits technology provider bswift L.L.C.

White Plains, New York-based yogurt and dairy product maker Danone North American Cos. is rolling out the Benefitfocus decision support tool for November’s open enrollment. Typically, a two-person benefit team fields Danone employees’ questions, but the team often must provide “very broad and fairly generic” examples of how certain health plans work, said Tracy Beane, health and benefits manager with Danone.

The decision support tool will help employees make a “personal decision that’s more targeted on how they use a plan,” rather than based on impersonal examples, Ms. Beane said.

Though decision support is “not a perfect science” now, “there’s a lot of development going on across the industry … to make for a more appropriate and elegant process as well as a recommendation,” Mr. Harkins said.

And developers are getting creative. The next generation of tools may offer voice interaction, like the iPhone’s Siri, Mr. Marcotte said. “We’re seeing more of that possibility coming to play probably over the next year or two.”

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  • Tech tools help employees make smart decisions

    Technology-based decision support tools come in a variety of forms. At Chicago-based bswift L.L.C., the “Ask Emma” decision support tool uses national claims data and the employee’s demographic information, salary and number of dependents to determine the “most economical plan options” for the user, said Don Garlitz, bswift’s Salt Lake City-based senior vice president.