Audio Transcript: The Health Plan Edge 004, Getting Your Plan Up and Running

Steve Strauss:  Welcome to the Health Plan Edge, the podcast that makes it easier for small businesses to navigate health insurance. I'm your host Steve Strauss, USA Today small business columnist and author of the Small Business Bible. In each episode we share real small business stories and strategies that make health plan decisions easier for you.

  [00:00:30] With me today are Will Berigan, founder and CEO of Shamrock Wealth Management. Shamrock is a three year old financial services firm in St. Paul, Minnesota with five employees. Shamrock offers all of its employees both individual and family coverage, and interestingly, Shamrock pays 80% of the premiums up front and puts the remaining 20% in a health savings account.

  Also with me is Robert Horton. Robert's been helping small business owners design plans that [00:01:00] work for them for over 20 years, while working at UnitedHealthcare. Robert, let me start with you. Can you just tell us, what is open enrollment?

Robert Horton:  Yeah, Steve. Simply put, open enrollment is that annual period when employees have the option to enroll or update their medical coverage. It's when small employees will distribute plan materials to their employees, and they have the opportunity to ask questions about their employee benefit choices. They also might [00:01:30] want to add a dependent or delete a dependent, or select a different plan, or even add new offerings, such as dental or vision benefits.

Steve Strauss:  When does this typically happen? Is there a certain time of year it has to happen, or is it more open than that?

Robert Horton:  One of the things that we've seen, really since the Affordable Care Act, is we've seen a lot of small business that have migrated their renewal dates to sync up with either December first or a January first plan effective date. [00:02:00] We see about 60% of small businesses that hold their open enrollment in that November to December time frame, but the rest are spread out throughout the year.

Steve Strauss:  Will, let me ask you how this fits in with you. Tell us a little bit about your business and how you decided to cover so much of your employees' healthcare.

Will Berigan:  We deal with families and small business, helping them organize all of their financial matters and asking the basic question [00:02:30] of, "Am I headed in the right direction, and is this all going to work?" That's the essence of our business. Our business is really, it's small, there are five of us, and one of the key reasons why we do what we do relative to the premium and the health savings account, is I spend all day dealing with families who wonder the basic question, "Am I going to be okay?" And kind of preparing for this abstract, "What if something bad happens? Am I okay?" [00:03:00] I certainly can relate that to healthcare, so I just thought, "You know what? There's nothing that makes me feel better with a young family knowing that if all my healthcare coverage is taken care of and it's good, I'm going to be okay." That's really philosophically the reason why we do it the way we do it.

Steve Strauss:  Fantastic. I know that for most employees, their health benefits are really their favorite benefit that they get. Do you find that your employees really appreciate [00:03:30] the generosity of coverage that you're giving them?

Will Berigan:  I think they do. It hasn't been an explicit conversation at this point, because the way we started, we did it together. We were all in it together. I helped make the decision, but wanted to do it in a way that they felt like, "You know, I'm stepping into something that's really great." So I know they're grateful, we just haven't had a lot of explicit talking about it, [00:04:00] but every year it comes up. We're doing it right now, and the prices are going up, and we're still doing what we're doing.

Steve Strauss:  That leads me to my next question. When is your open enrollment period, and has it always been the same?

Will Berigan:  It's right around this time, so unlike a larger organization, we don't have to have a real detailed and strong communication plan, because it's like a family. There's five of us, and we can just walk out into the hall and start having a conversation. [00:04:30] But we began that last week, and we'll continue. Our plan year is really January first to the end of the year, so we've got some time. We get everything done in advance, so at the end of the year we're pretty much finished with that.

Steve Strauss:  So you do it about two months in advance of the plan you're starting.

Will Berigan:  Exactly, yes.

Steve Strauss:  Robert, that brings me to a question for you. How do life events affect open enrollment? Somebody gets divorced, or somebody gets pregnant [00:05:00] and is going to have a baby, or has a baby. Does that change the open enrollment period, or how does it affect it?

Robert Horton:  The good news is, if you have a qualifying life event, you do have the ability to make some changes to your medical plan, whether it's adding a dependent or deleting a dependent. There is a time frame or a time period that you must submit that change to an employer, so that they can submit it to the carrier. Generally that's 30 days, if you want to make an addition or [00:05:30] a deletion. For example, if you have a child, you have 30 days to get that child added to the policy. If you get married, you have 30 days to add your spouse, but if you happen to miss that deadline, then that person is going to have to wait until the next open enrollment period, so it's important to make sure that you pay attention to the insurance aspect of that very exciting life event of either getting married or having a child.

Steve Strauss:  What about other best practices? Are there other things people [00:06:00] need to know with regard to open enrollment?

Robert Horton:  I think what's really important is providing time and communication. As individuals, we don't want to feel like we've been forced into a particular decision. Sometimes it might take folks a little bit of time to determine in which direction they want to go with an employee benefit decision, so having two to three weeks, even maybe upwards of 30 days to make that decision, I think is something that would be a best practice. [00:06:30] Then really communicating to the employees around what's different this year, around the plan that's ended. It might have been from previous years.

  Also have to remember that in a lot of situations, while the employee may be the one that's quote, enrolling, in the plan, the decision-maker, the one that drives all the healthcare decisions for that employee might be the spouse at home. It's good to make sure that there's some materials out there that they can take home, either [00:07:00] physically or electronically, to share with that decision-maker so they can make the best possible decision for that entire family unit. And then, it's also important to leverage your broker. Most small employers have an employee benefits broker that helps guide them through the process, and they can be a great resource, as it relates to providing information around the open enrollment period.

Steve Strauss:  Will, how do you do the communication with the family? You obviously, [00:07:30] as you said, talk to your employees really easily. Do you give materials for them to take home and share with the family?

Will Berigan:  We do, but to the point that was made earlier, the broker is a key piece of that. We really rely on our broker to help us with material that's being produced from the insurer themselves, because for us to produce original material for five people to go out, and to have an email or some kind of web portal for [00:08:00] them to go on is way too much. We really rely on the broker to help us craft that message, get a document prepared, and get that done. In running a small business, there are so many things to do, to have a broker help with that is critical for us. We're not experts, either. I'm not. It's so clear.

Steve Strauss:  Working with an expert like a broker is just so smart. Good job.

Will Berigan:  It's critical, because again, when one knows just enough to be dangerous, [00:08:30] they end up being dangerous.

Steve Strauss:  Right. I'm wondering, Will, if you have any anecdotes you could share about open enrollment from your staff.

Will Berigan:  I do. There's one member of our staff who's not actually on our plan. She's on her husband's plan, and she's at a stage of life with her husband that they were looking at retirement last year. Maybe that would happen. There's a gap between where they are now and [00:09:00] Medicare, and said, "What can be done for me about health insurance on this plan, since I'm not currently on it?" So that's just one of those life-changing events where we said, "We'll make sure that you get 30 days to kind of get it done." But again, the first phone call I made was to the broker, right?

Steve Strauss:  The broker.

Will Berigan:  Right. That's the communication that came back, but it turns out he hasn't yet retired, [00:09:30] but it's coming. So now she's prepared. It kind of takes some of that worry away, because she's wondering, "What do I do about health insurance?"

Steve Strauss:  Great. Will, I'm wondering how you have your staff actually enroll in their plan. Is it online? Is it just a form they fill out, or what?

Will Berigan:  Great question. Because of our size, and working with an intermediary and not necessarily working directly with a provider, ours are all paper. [00:10:00] We get a pre-populated form for each employee. We fill it out and sign it, and scan it back, and send it to the broker, and then they take it from there.

Steve Strauss:  It's a pretty good ...

Will Berigan:  Yeah, basically, whatever open-ended question there is about our healthcare, my first answer is, "Our broker." "Jim, what do we do? Where do we go? How do we do this?" I don't mean to make it sound like it's flippant, because healthcare is so important, but it literally is [00:10:30] the key for us.

Steve Strauss:  All right, well, it looks like it's time for us to wrap up. I think we've learned a lot today. I hope we've answered your questions about the timing of open enrollment. Will, Robert, thank you so much for being with us today.

Will Berigan:  Steve, thank you.  A pleasure being here.

Steve Strauss:  My pleasure. From all of here at the Health Plan Edge, thank you for listening, and thank you to UnitedHealthcare for making this recording possible. If you enjoyed today's show or if you have any questions about health insurance and your business, head over to [00:11:00] to check out their free resources for small businesses, to listen to another episode, or to continue the conversation. We look forward to hearing from you.