Johanna Newsome

November 11, 2021

2 min

When evaluating a traditional employee health plan, employers and brokers typically focus on premiums, deductibles and co-pays, and the nuts and bolts of the plan’s coverage. Customer service is an afterthought. Historically, it has been enough that employees can call a toll-free number when they have questions.

Thankfully, the opposite is true when employers look at alternatives to these outdated insurance carrier plans. Instead of accepting the unacceptable status quo, there is growing demand for a significantly better member support experience. It’s about time!

A Better, More Compassionate Approach

There is no reason for employees to sit on hold waiting to speak with a random agent at a far-flung call center. Besides taking advantage of the many technologies available to connect and collaborate, members are better served speaking with a dedicated advocate who can guide them through the complexities of finding quality health care at a lower cost.

Health plans that prioritize the member experience help employees access more affordable health care, in all areas of care. Convenient and easy-to-use tools and personalized assistance ensure members (and employers) get the most value from their plan. This is as it should be, yet it is NOT what members get from a legacy insurance carrier.

Checklist for Better Member Support

Before renewing the current health plan, pause and seriously evaluate how well it meets member and employer needs. Apply these attributes to any plan under consideration and all stakeholders will be much better off.

  • Compassionate Advocacy
    Advocates are a member’s most important resource. Services should range from simple questions asked and answered, such as benefit verification, all the way to personal assistance in complex matters. When members need to access specialty care or find the physician or facility most capable of providing needed care, they deserve to work with a proven, trustworthy team that’s ready to jump in and advocate on their behalf.
  • Flexible On-Demand Access
    While there will always be traditional phone support, a truly great support experience includes multiple platforms to simplify communication between members and their support team. Options should include in-app and online member portal messaging capabilities, online document uploading, and secure text messaging. This will encourage more and better communication by providing members with the platforms they are most comfortable using.
  • Ongoing Education
    The more members know about their health plan, the more value they can realize. Most “education” takes place during the Open Enrollment period when members are inundated with flyers, fact sheets, and plan summaries. But it’s after enrollment that they really need help. Member-focused education provides readily available process guides, short “how to” videos, and regular communications throughout the year. It also highlights plan features to promote awareness and guidance on how to access them.

Members and their families benefit most from advocacy that supports them every step of the way. They deserve a trusted support team that is empathetic to their needs and is dedicated to removing barriers to needed health care

Comprehensive member support is a critical component of an employee health plan. And it’s what employers are demanding as they seek alternatives to legacy plans. With superior health plan alternatives available, isn’t it time to leave outdated insurance carriers behind and choose something better for both members and the business bottom line?

As Managing Director of the Client & Member Experience at Vitori Health, Johanna Newsome is passionate about nurturing positive, lasting relationships and building teams with a client-centric focus to collaboratively facilitate a positive member experience.

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