Benefits Planning Now: 5 Unanticipated Changes HR Should Brace For

Tips to effectively manage the current and upcoming challenges

Even as companies prepare to reopen, HR leaders are continuing to keep their attention on how they’re responding to the COVID-19 crisis. But it’s also critical to start planning now for the challenges ahead. Planning for employee health benefits for the rest of this year and into 2021 should be on the top of that list. Why? Because data on employee health and plan usage points to likely unanticipated changes in the months ahead, including a surge in health complications and costs. 
 

The first half of 2020 has obviously been far different for HR and benefits leaders from any year before. The second half is bound to be equally challenging. But, if you have the full picture of today’s challenges, and clear insight into how they’ll affect the road ahead, you’ll be better able to optimize plan management and confidently make the necessary changes as frequently as needed.

Because of Gaps in Care Today, Look for an Uptick in Complications Tomorrow

The restrictions and regulations in response to the coronavirus have likely created a sharp drop in the number of health claims. Many healthcare providers delayed appointments for preventative visits, elective procedures, and routine checkups.

Our data bear this out:
 

• Eleven percent of all members at companies in the Springbuk Health Intelligence platform have a gap in care. These members are failing to follow their normal routines of medications, physician visits, or regular tests and screenings.

The resulting lack in preventive and regular care might cause employees and their enrolled family members to develop chronic conditions. Among the most common:
 

• Diabetes
• Hypertension
• COPD
• Asthma

On top of that, 6 in 10 Americans already suffer from a chronic illness; they could develop increased complications and comorbidities because of a gap in regular healthcare.

As stay-at-home orders are pulled back and people resume their regular health activities, employers may very likely see an increase in health complications and new diagnoses.

Your Health Costs May Be Down Now. But Will That Last?

Current overall health costs for employers are likely down due to the aforementioned reasons.  However, the second half of 2020 could make up for that lull, thanks to the potential for imminent complications directly tied to COVID-19. 

HR leaders are likely grappling with who to believe on the future cost of healthcare as pundits have been pontificating a wide range of extreme highs to extreme lows. Of course, the best way to get reliable forecasts for your organization’s costs is by analyzing your specific benefits data and circumstances. There are many micro-trends that need to be considered ranging from when your state opens, where your employees are located, your current population, and the various healthcare issues that have now risen due to COVID-19.

Layoffs (and Not Only Your Own) Could Change Member Demographics

The pandemic has increased unemployment by the millions. The numbers may continue to climb as businesses feel the rippling impacts of decreased revenue. This huge shift in the workforce landscape may affect your organization in one — or all — of four ways: 

1.    Layoffs (requiring mass offboarding and decreasing plan members)
2.    Furloughs 
3.    Reduced hours (which may affect benefits enrollment, depending on the policy)
4.    New dependents (due to employee spouses and children experiencing layoffs)

The last point — new dependents among your enrolled members — may be the most surprising. As people experience layoffs, furloughs, or reduced hours where they work, they might choose to enroll in the health plans of their spouses or parents. This means that traditional spousal carveouts may not be as useful as in a more full-employment economy. The volatility in the workforce will likely generate a set of costs employers didn’t plan for when they were designing their benefits plans for 2020. These new entrants will also bring their own health issues, which you won’t have historical data on to help you plan.

Watch for Mental Health Problems as a Result of Isolation

The CDC reports that even before the pandemic, 1 in 5 Americans had a mental illness. Their conditions could worsen because social distancing or quarantining may have limited their access to management resources. The same challenges could also cause new mental health issues for people with no previous diagnosis. Why? Because among the most common triggers for new mental health diagnoses are the threat of infection, economic instability or job loss, financial hardships, or social isolation, fear, anxiety, and stress.

The strain on employee mental health could, meanwhile, also lead members of your workforce to seek help from mental health professionals, or company-sponsored or covered well-being services. If you don’t already have an EAP, now may be the time to consider one. 
 

• According to the Substance Abuse and Mental Health Services Administration (SAMHSA), there has been an 891% increase in calls related to substance abuse and mental health.
• Athenahealth reports an increase of 66% in the share of primary care visits with first-time ADHD diagnosis for kids and teens, as well as steep increases in first-time anxiety diagnoses for adults.

Our Employee Health Trends study found that mental health conditions — and especially the high rate of people who have mental health and chronic physical conditions — cause extremely high costs for employers and employees. If your organization and your workforce and their families are already feeling the weight of the economic downturn, these additional costs could be especially burdensome. 

The New Bottom Line: A Likely Influx in Claims and Employee Requests for Health Services

Your plate is already incredibly full of responses to the crisis: communications, midyear plan changes, and other pandemic response needs. It’s a challenge that HR is likely to endure long-after life and business return to “normal.” You will — or already are — managing:
 

• Administrative burdens of potentially surging claims.
• Unanticipated onboarding and offboarding of employees.
• The implementation of new offerings like EAP or telehealth solutions.

Now, HR will also likely be juggling plan changes and plan design for 2021. 

Your employees and their family members will also have plenty of questions and requests for support, even as the year goes on. Due to a high level of economic uncertainty and fear, they may even feel dissatisfied or nervous about your organization’s decisions and responses to the pandemic. They may even question the company’s future. 

These trends and this uncertainty mean that clear communication and strong support for employees in the coming months will be more critical than ever. 

Prepare Now: 5 Critical Actions for HR Leaders Today

It may feel daunting to look at the continued changes over the next year. But neither should you overlook all the problems you’ve already overcome. With the right planning and insights, HR can lead organizations to effectively manage the current and upcoming challenges.

Here are five key actions that HR leaders can take to prepare:
 

• Identify gaps in care. Examine your organization’s population data to identify which segments are not getting the care they need. Consider applying targeted communication strategies, telehealth opportunities, and even disease-management solutions to help your members stay or get back on track.
• Consider plan changes. Monitor your claims data to see how these trends are affecting your population and consider whether midyear plan changes are necessary to account for cost changes throughout 2020. Consider redesigning your plan to match gaps in care by promoting good health and proper adherence to medical standards.
• Prepare for population changes. Start monitoring your data now to forecast costs and administrative needs due to changes in enrollment, and to accurately prepare for your 2021 plan design. Although you may not know the actual number of new dependents your plan will add, your analytics data can be used to forecast potential unknowns.
• Support mental health. Communicate consistently with your members to help them feel connected, supported, and aware of any resources available to them, such as an EAP or well-being services.
• Equip your teams. Start preparing now for increased workloads or added responsibilities for HR and benefits managers by setting up any tools and processes your team may need to work even faster, more nimbly, and more efficiently.

Now more than ever, employees and organizations need HR leaders who can take proactive, preventive steps to protect their health and financial well-being. By considering not only the current difficulties, but the ripple effects down the line, HR and benefits leaders can improve their plans for supporting employees and maximize their organization’s investment.

Rod Reasen is the Co-founder and CEO of Springbuk.   Connect Rod Reasen Follow @reasen2