Employers have discovered that they’re bound to pay one way or another. It’s often better off to deal with the predictable costs of offering coverage, rather than the hidden costs of not offering it.

In the late 1990s and early 2000s, the trend was for employers to eliminate dental (and vision) coverage as a way to offset the rising cost of primary health plans. Employees were encouraged to use medical flex accounts to offset the cost.

Two problems: Employers still paid the cost through lost productivity – an employee scrambling to find a dentist for himself/herself or a dependent is an unproductive employee that day.  And apart from routine yearly checkups, dental costs are notoriously hard to predict when employees budget their FSA contributions for the year.

Familiar ideas

The good news: Many of the strategies that help control traditional healthcare costs also seem to work for containing dental costs. These two familiar approaches are gaining popularity, according to the Segal Company’s 2008 Survey of Dental Benefits:

• DPOs and DMOs. Similar to PPOs and HMOs, these are managed care plans for dental bennies. As with an their primary health plan counterparts, the idea is to make sure employees are steered to the most cost-efficient level of care for their medical needs, and
• Self-insurance. This approach significantly lowers overhead and stop-loss coverage for catastrophic dental claims is often more affordable than for other types of claims. Another option: You can lease an insurance company’s dental plan.

The survey finds that 85% of companies either offer dental coverage – or are considering it. If it’s not in the budget to offer a fully or partially company-paid plan, voluntary plans remain a popular option. In the end, the most expensive option is to leave employees to fend for themselves.

Studies show that when it comes to choices about when, where and how to seek out care, most people make emotional decisions, not rational ones.  When people ask their doctors questions about their care, it’s far more likely to fall along the lines of “Will I be OK?” rather than “How much will it cost?”

There’s also a tendency for people to follow their doctor’s recommendations. Think about how long it’s taken to educate employees to ask about the availability of generic drugs and teach them that  generic provide the same benefits as name brands (especially ones that are advertised on TV).

When cost of care does enter into people’s minds, it often arises in ways that employers DON’T want: avoiding care altogether out of fear of not being able to afford out-of-pocket costs (i.e., deductibles).

Most employers are aware of these obstacles. The problem has been overcoming them. Usually the employee education burden falls directly on the shoulders of already overstretched HR/benefits managers.

It used to be that employee education meant teaching employees about the health (and other) benefits available to them and how to access them.  Today, the task also includes the responsibility of teaching folks how to research their own care and interact with their doctors. Finance types rarely appreciate just how difficult this chore really is.    

Sensitive subjects

Here’s an example of the difficulty HR/benefits faces in playing the role of teacher:  When discussing the need for preventive care (one of the hallmarks of consumer-driven healthcare), is it your responsibility to discuss potentially sensitive subjects?

Much like medical benefits themselves, medical practices constantly evolve. In the last couple years, several medical boards and regulatory groups revised their guidelines for preventive healthcare. One of the most controversial changes in the guidelines: providing routine sexually transmitted disease (STD) screenings for adolescents.

Not every carrier has elected to add STD tests as a standard preventive-care benefit for employees’ dependents. But, among others, many Blue Cross plans now provide first-dollar coverage for the screenings.  What should YOUR role be in teaching employees that the benefit is available to their dependents? Do you:

• simply pass the info along, without further context or explanation, in an e-mail or memo?
• rely on employees who need the info to find it in the benefits newsletter the carrier sends out?
• deal with the discomfort of telling employees to talk the sensitive issue over with their teenage kids and their doctors?

Any of these approaches has the potential to backfire. From a purely financial/consumerist point of view, we know that the first two options rarely work.  But what employer wants to risk resentment (or worse) from employees by recommending they tell their teenagers to get tested for STDs?  

Bottom line: It’s easy for the bean counters to stress the cost-saving advantages of preventive care. It’s easy for social advocates to say this sort of education is part of corporate responsibility. These people aren’t the ones who deal directly with your employees.   Frankly, we’d love to see one of THEM volunteer to lead a discussion on  STD screenings at your annual health plan meeting.

Some workers barely pay attention, ask few (if any) questions and then hurry to leave the room. Others seem overwhelmed by the info presented.

Almost inevitably, in the days following the presentation you find yourself answering the same basic questions from employees on the very issues that had been addressed during the presentation.

One company in Northbrook, IL, found a simple, but effective way to break the cycle and get folks to pay attention: a contest for employees.

Rewarded folks who paid attention

The HR manager put together a 20-question quiz cribbed from handouts from the presentation. There were 10 true or false questions, eight multiple choice and two fill-in-the-blanks. He distributed the quiz at the end of the presentation.

The employee who got the most questions right received a $20 gift card. In case of a tie – usually, several people got all 20 questions right – they drew a random winner.

The contest was a hit, and served two valuable purposes.

First of all, it successfully got employees to be more engaged during the session. Secondly, the quiz results helped point to areas where employee knowledge was particularly weak and helped HR better target its future benefits education efforts.

A pretty good investment for $20, wouldn’t you say?