Digital data is allowing for new levels of integration and fresh insight across many areas of healthcare. This includes addressing how an employee's core medical benefits can work together with supplemental health and absence coverage to help employees get the most out of their benefits while helping employers manage costs of care.
Supplemental health plans include accident, critical illness, and hospital indemnity coverage. They are paid at the time of the incident and provide financial peace of mind by helping employees fill any gaps not covered by traditional health insurance, disability coverage, and paid leave benefits. Lump sum benefits paid by supplemental health plans can be used to cover out-of-pocket expenses like copays and deductibles, or to bolster income replacement benefits from paid leave or disability plans.
Increasing The Integration
Over the last few years, insurance carriers have made significant progress toward the integration of absence and supplemental health products. Many offer a package discount on core health insurance products when bundled with supplemental health and core disability and absence coverage. Additionally, some carriers are reviewing processes and healthcare data to find efficiencies and create a better experience for members by looking into ways to:
- Identify disability and leave claimants who also are enrolled in one or more supplemental health products.
- Utilize data provided for a leave or disability claim to pay a supplemental health claim, so the member doesn't have to submit the same information twice.
- Help those enrolled in supplemental health plans get the most from their benefits.
Improving Member Experiences
This introspection has led to process improvements like coordination across leave, disability, and supplemental health claims, along with sharing medical information across all claims. Carriers also routinely review existing leave and disability claim files to identify any additional coverage a member could benefit from and determine if existing healthcare data can be used to expedite the payment of supplemental claims.
Some carriers are taking an even more proactive approach and using medical claims data to remind supplemental health plan participants about their benefits.
These adaptations alleviate steps for employees, maximize the value of their benefits, and help them know what benefits are available. An integrated approach also enhances healthcare experiences, which is beneficial for employee satisfaction and retention.
This article applies to groups consisting of 50 or more individuals (100 or more in California, Colorado, and New York).