BI’s Article search uses Boolean search capabilities. If you are not familiar with these principles, here are some quick tips.
To search specifically for more than one word, put the search term in quotation marks. For example, “workers compensation”. This will limit your search to that combination of words.
To search for a combination of terms, use quotations and the & symbol. For example, “hurricane” & “loss”.
SAN RAFAEL, Calif. -- A new service provider pledges to help employers increase employee satisfaction with their health care benefit plans.
CareCounsel L.L.C., a San Rafael, Calif.-based company launched last year, started its health assistance program in February. A toll-free telephone counseling line offers a variety of educational, patient advocacy and coaching services that proponents say breed employee satisfaction through better understanding of workers' benefit plans.
When an employer contracts with CareCounsel, the service familiarizes itself with the plans offered and establishes relationships with representatives at those plans, according to Lawrence N. Gelb, president and chief executive officer.
Once the service is initiated with an employer, telephone counselors will help an employee understand all of his or her health plan options and guide that employee in selecting the most appropriate plan. The education and information aspect of this service also encompasses answering specific questions about coverage and the definition of terms used.
The counselors also will help an employee select a physician within a plan by providing data such as the doctor's educational background and graduation date, board certifications and primary and secondary specialties.
The advocacy role is aimed at helping employees resolve claims disputes with providers and investigate treatment delays and denials, among other service issues. CareCounsel also will help patients diagnosed with certain diseases find support groups or national associations that might help them understand and cope with their conditions.
"The whole concept is that consumers are confused as the health care system has become increasingly complex," Mr. Gelb said. "At the same time, with all the issues related to the managed care backlash, confidence that the health plan is going to do the right thing has dropped. There's a need for an independent, confidential resource to help people."
But Helen Darling, practice leader-group benefits and health care at Watson Wyatt Worldwide in Stamford, Conn., said the service "raises a lot of questions," chiefly whether an employer should delegate the role of advocate for its employees and whether some of the services duplicate tasks that the employer or its third-party-administrator already perform.
Employers pay $1.25 to $2 per employee per month for the service, depending on the number of employees and number of plans offered.
The calls currently are fielded by four counselors with health-related master's degrees or nursing degrees. About 65% of the calls fall into the education and information category, and 15% relate to problems with health plans or claims.
To date, CareCounsel has four employer contracts covering 12,500 lives. The company also has a contract with an insurer to offer the service to its policyholders.
One of the corporate clients is the Fritz Cos. Inc., a San Francisco-based international cargo logistics company. The service became available to the company's 4,600 U.S. employees in August, just prior to the September start of enhanced health benefit options.
Using CareCounsel is an added employee benefit that helps "make our program stand apart from other people's programs," which is important in maintaining employees, said John Sequeira, corporate risk manager responsible for the company's insurance programs.
"The primary responsibility for our benefit program and benefits communication is the company's," Mr. Sequeira said. But, he added, "any way you can better communicate what you're doing benefits-wise for your employees is totally an advantage."
CareCounsel periodically provides employers with analyses of the types of calls that come into the system, broken down by factors that include the callers' plan types and the specific services requested. Mr. Sequeira said the reports provide companies with the data "to make decisions on the future of the plan as it develops."
Each caller to CareCounsel also is asked to respond to a customer satisfaction survey, giving the employer feedback on the service.
The Fritz Cos. benefit consultant, Bernie Tillotson, area executive vp at Gallagher Heffernan in San Francisco, introduced the company to CareCounsel.
"Whenever we're introducing changes to a plan, there's always a worry about acceptance," Mr. Tillotson said. Part of employees' resistance is not understanding how the plans work. CareCounsel "gives them an avenue they can use" to augment benefit communication programs and support benefit departments, he said.