In terms of worries, benefits managers face a familiar concern: cost-conscious employers and a workforce worried about paying more and getting less bang for their health care buck.
According to its annual Employer Health Benefits Survey, the Kaiser Family Foundation and Health Research and Education Trust found that the typical employer contributed $12,591 to a family coverage plan in 2015. That figure represents a 54 percent increase from 2005, when the contribution was $8,167 per enrolled family.
Employees haven’t gotten off much easier. The same study found that the average employee paid $4,955 out of pocket in 2015, up a whopping 83 percent from 2005 when the contribution was about $2,700.
Costs are high; that’s no surprise. And employers are vocal about finding a solution. Many have turned to the idea of corporate wellness, said Bob Gevelinger, vice president of group field sales for Ameritas Life and Ameritas Life of New York.
“It makes perfect sense,” Gevelinger said. “Employers want to keep employees healthy so they aren’t filing claims and driving up costs.”
And while fitness bands and healthy snack options play their part, there are other less expensive benefits options that employers have at their disposals to help keep their employees well: dental and vision benefits.
“The connection between oral and vision health and overall health is clear,” said Stu Shaw, vice president of group risk management for the Guardian Life Insurance Co. of America. “Providing access to quality, affordable dental and vision care can keep employees more healthy and productive, helping to control health costs.”
According to Shaw, employees with dental and vision benefits are more likely to visit dentists and optometrists to receive regular treatment, which aids in the early detection of hypertension, high cholesterol, diabetes and even brain tumors — which typically require visits to specialists if the employee visits a doctor first.
In addition, the typical stand-alone dental and vision plans are considered excepted benefits and are not subject to the 40 percent excise tax known as the “Cadillac” tax, which has been delayed until 2020. As a result, some employers are adding them to soften the blow to employees as they cut back on medical offerings to save costs, Shaw said.
Benefits and HR consultancy Segal Group Inc.’s 2016 Health Plan Cost Trend Survey found that trends for dental coverage are expected to be lower for 2016 compared with 2015. Dental plans in particular are projected to decrease to 3.5 percent of an employer’s annualhealth care budget for fee-for-service plans and dental plan organizations. Vision costs are projected to remain the same — just 2.7 percent.
While it makes good health and fiscal sense to offer these benefits, insurance companies have had to adjust to give both employers and employees what they want in terms of information and ease of access in order to ensure that dental and vision plans capable of driving down costs and keeping employees well are given the opportunity to do so.
As employers’ health care costs have climbed, they have gotten savvier with their spending, Gevelinger said. Gone are the days where employers make benefits decisions “just because that’s what they’ve always done.” Now, employers want numbers to back every decision.
“We’re more data-driven than ever before,” Gevelinger said. “Employers demand more information. They want to be able to spot trends within a group to determine exactly who is using the benefit.”
Many employers want “score cards” from their providers. They work like baseball cards for a company’s benefits usage, Gevelinger said. Employers can break it down by department in terms of who is using what benefits and how often.
“This helps them make plan decisions that cut the fat and offer only what employees demonstrate they need,” Gevelinger said.
The desire only to buy plans their employees will use means that the plans themselves are changing. In the past, dental and vision plans were generic. Employers could choose to offer plans with 100, 80 or 50 percent coverage. Typically this included a $50 deductible with a $1,000 maximum benefit, explained Beth Bierbower, president of Humana’s employer group segment.
“The demand for data means that employers are coming back to us and asking for higher annual maximums and smallercopays more consistent with what our typical medical offerings look like,” Bierbower said.
In addition, paying closer attention to the makeup of a workforce means that employers want plans offering more frequent dental cleanings at 100 percent coverage for pregnant women and children, since dental exams are an early detector for gestational diabetes and early childhood diabetes, Bierbower said.
In the case of Ameritas, employers have requested that any funds left over in a dental plan account be allowed to be used to purchase vision coverage if the employee chooses.
“A more educated consumer means that we’ve been forced to change our plans or have employers look elsewhere for more flexible offerings,” Bierbower said.
Tantalizing with Technology
Last year Lukas Ruecker, the president of vision insurance provider EyeMed Vision Care, fell while climbing near a waterfall in India and lost his glasses. Even though he is the president of a vision company, it took three days before he was able to replace them.
And he admitted he is “as blind as a bat.”
In that moment of helplessness, he saw the challenges and a potential solution for a growing segment of the workforce: millennials.
“Millennials make up the majority of the workforce today,” Ruecker said. “And that workforce is becoming increasingly international. My situation provided firsthand insight into what it would be like to try and navigate the vision benefits world in a different country in a language you do not speak.”
That experience drove Ruecker to develop a mobile app that not only provides access to temporary, next-day adjustable eyewear, but also a list of providers that sell authentic frames. The app also provides translation services in more than 160 languages to help during the appointment.
In addition to this unique, international benefit, the app also stores insurance card information, prescription details and allows employee consumers to compare costs and reviews of in-network optometrists.
“We wanted to use technology to better educate and inform the employee in a day and age where employers put so much of the onus for health care on their employees,” Ruecker said. “If an employee has to make a decision alone, we want to make sure that they have easy access to the information to get the best care possible.”
Shaw said that as consumers become more astute health care purchasers, it’s important to ensure they have the most choice possible in their selection of dentists and greater control of out-of-pocket costs. “Better technology improves the speed and accuracy of that information in a way that will positively impact employee health,” he said.
Bottom-Line Value: A Healthy Workforce
Bottom-line value is the concern of every employer, and while insurance companies can offer low costs for dental and vision plans, the impact of that investment on employee health is more difficult to measure.
“It’s just like defending a corporate wellness program in a sense,” Bierbower said. “You can measure the low cost going in, but the results are more abstract.”
For evidence, she turns to the correlation between poor dental and vision health and the incidence rate of heart disease, cancer and stroke — three of the top focuses of many preventive wellness programs.
“More and more evidence continues to link cardiovascular disease and periodontal disease,” Bierbower said. “A new Humana plan recognizes the impact of periodontal disease upon overall health and allows for as many as four periodontal cleanings a year, while most plans offer just two.”
Insurers are confident that the right dental and vision benefits plan will keep employees well. It’s just a matter of choosing the right one for your workforce.
It is important to remember that the dental and vision care system is different from the medical care system, and carriers focused on dental have adapted accordingly to deliver cost-effective benefits that keep employees satisfied.
Many dental carriers have developed infrastructures that may help them pay claims faster. Some carriers subcontract dental, which could result in added administrative cost.
“Network is one of the most important considerations when choosing a dental or vision plan,” Shaw said. “It’s not only about the size of the network, it’s about making sure the network is made up of dentists and optometrists that the employees want to see.”