BEST PRACTICES: Strategic Health-Care Plan Design Flashcards
Plan sponsors should consider developing and formally adopting a long-term, strategic plan that includes guiding principles and key objectives for managing health-care costs and improving participant wellness.
What should plan sponsors develop to manage health-care costs and improve participant wellness?
A long-term, strategic plan that includes guiding principles and key objectives.
What are the goals of defining the plan sponsor’s overall objective for providing benefits?
Objectives may include keeping employees healthy, recruiting new employees, and employee retention.
How can plan sponsors develop a strategy for determining eligibility for health-care plans?
By articulating separate strategies for both active and retired employees.
What should a contribution rate strategy for health-care plans include?
A plan for both employer and employee contributions.
How should the role of the health-care plan be communicated in relation to the overall compensation package?
It should clarify whether these benefits are offered in lieu of other compensation elements.
What should be established and defined to manage health-care costs effectively?
Cost objectives using performance measures with a 3- to 5-year planning horizon for annual trends.
How can health-care sponsors use analytical tools effectively?
For predictive modeling, data warehousing, and measuring the plan’s efficiency ratio to identify cost drivers and health risk factors.
What are examples of cost-containment measures?
Auditing plan performance, eligibility and vendor management strategies, health-care management programs, influencing participant behavior, and cost-sharing measures.
Why might a plan sponsor consider aggregating health-care benefits?
To get better pricing through fewer vendors or by combining the purchasing power of several organizations.
What factors should be analyzed when evaluating the viability of self-funding for health-care plans?
Participant demographics, ability to accept risk, availability of stop-loss coverage, and financial viability projections.
How can plan sponsors integrate health-care plan design with organizational strategies?
By working with departments like human resources and considering health-care plan design during labor negotiations.
What role does ongoing education play in strategic health-care plan design?
Educating participants about benefit provisions, costs, and value, and developing education guides for stakeholders.
How should the provision of retiree health-care benefits be considered in strategic planning?
As a factor affecting the costs and sustainability of the overall health-care benefit package.
