by Lindsay Byrka, CFP® Vice President, Immix Group
When we first begin working with a new employer to review their benefits offering, it involves a bit of detective work. We need to uncover why you’re not fully satisfied with your benefits program, and why you’ve come to us for a second opinion.
Employers often sense that the plan needs adjustments but aren’t sure how to pinpoint the issues. Perhaps there are obvious areas where the plan falls short, but the solutions are unclear. And sometimes it’s as simple as not feeling the value is there, for the premiums that are being paid.
This is where Immix’s employee benefits audit comes in. Our goal is to uncover the answers to a range of key questions and to provide a clear, detailed review of your benefits program.
In this article, we’ll walk you through what it looks like to have an independent benefits advisor conduct a full audit of your employee benefits program.
Staff Satisfaction with the Program: Does your Team Feel it Meets their Needs?
We want you to love your plan. While this is one of Immix Group’s taglines, it’s a genuine sentiment! When we’re first speaking with an employer, we need to know:
- Have you surveyed employees about their benefits? Do people like the plan? Are there common areas identified as “missing pieces”?
- Is claiming easy or are they constantly running into problems?
- Do they understand what their plan covers?
- Have you quantified the value of the plan as part of total compensation?
Conducting an employee benefits satisfaction survey can be eye-opening. It’s very common for this to reveal a lack of understanding as to the scope of available coverage. These “ghost benefits” – which look good on paper but go unused- are often the result of communication gaps. The value of a benefits plan is seriously eroded if people don’t understand what they have.
Employee benefits education sessions go a long way, and the Immix Group recommends everyone in our Client Community take advantage of our offer to run these important sessions every year or so!
Employee surveys allow employees to be heard, and to assist employers and advisors in fine-tuning coverage to truly meet people’s needs. Staff feedback is incorporated into Immix Group’s benefits audit and helps shape our recommendations.
Plan Design & Coverage Flexibility: Is the Plan Design Effective?
Benefits programs need to evolve—not just to keep pace with inflation, but to address changing needs, emerging trends, and new coverage areas in health and wellness. And, they need to evolve as your business changes.
Reviewing the details of the coverage is an integral part of Immix Group’s employee benefits audit process. We review contracts and booklets line by line and will address (using benchmarking information) areas we feel are outdated or fall short against industry and competitive norms. As well, we need to know:
- What is the goal of the plan? Is it important to you that the program reflects the company’s values and philosophy? For example, do you embrace ‘one plan for all,’ or does it align more with your organization to implement benefits classes for different levels of staff?
- When the program was put in place, what was the process in determining the plan design?
- When was the plan design last reviewed in detail, and have changes been made to the coverage?
- Is the coverage set up properly from a tax perspective (in particular, the Long-Term Disability)?
- Are you offering employees flexibility and choice as part of the benefits offering?
Whether it’s addressing women’s health, fertility, or expanding access to mental health practitioners, the reality is that a robust benefits program today looks very different than it did a decade ago. Sometimes a simple tweak (expanding eligible paramedical practitioners, for example) goes a long way to improving employee satisfaction with the program. A detailed benchmarking report is a key element of Immix Group’s health benefits audit.
Claims Analysis: Understanding Exactly what your Employees are Claiming
Related to the program design is delving into the breakdown of claims. Immix Group emphasizes the importance of claims transparency—not just for financial reasons, but because ongoing analysis helps guide plan design and provides insight into the health needs and usage patterns of the staff.
Part of the Immix Group’s benefits audit report is an analysis of your historical claims experience, typically looking back 2-4 years. We break down:
- Which benefits are being used and not used?
- What takeaways can be made from the claiming patterns, and how does your group compare to industry averages?
- Are there areas where members are consistently maxing out their coverage?
- What is the average cost per certificate year over year? Is it rising? How does this break out by category?
- What are the key therapeutic categories and could these be strategically addressed?
Our benefits audit report lays out the information clearly, so you can gain a clear understanding of the claims composition for your group.
Financial Analysis of your Benefits Program
One of the most common reasons we are approached to conduct a benefits plan audit is to review the employee benefits plan pricing. A financial audit of your benefits program pricing by an independent benefits advisor can reveal whether you are overpaying for your benefits. This involves far more than simply requesting quotes from competing insurance carriers.
Our in-depth review of pricing seeks to determine all factors related to your bottom line:
- Review of the cost adjustments over the past several years, analysing the annual rate adjustments per benefit line
- Analysis of the rates for the pooled benefits, and whether they are accurate based on your demographics and plan design
- Detailed analysis of the expense factors on your plan (target loss ratio, admin charges, advisor commissions)
All of the above leads to the answer of the key question: Are you overpaying for your benefits program?
Employee Benefits Program Marketing: Obtaining Quotes from Competitors
Based on the results of our benefits audit, we usually have a clear sense as to whether the pricing is fair. Regardless, we may suggest marketing the program with alternative insurance providers to see the rates they will offer.
As well, pricing is just one element of a plan, and moving carriers can be desired for other reasons such as obtaining certain plan design features, better tech offerings, or a better service and member engagement experience.
As independent benefits advisors, we have freedom to survey the market and obtain quotes from a wide range of providers.
Service & Advisory Support: Are you Getting the Support you Need?
Are you totally happy with both your advisor and your insurance provider? Advisor roles vary significantly; some stay behind the scenes and only appear at renewal time. In contrast, the Immix Group takes the opposite approach, and we encourage our Client Community to see us as their benefits partner.
One of the nicest things to hear from our Client Community is along the lines of ‘you make my life so much easier’. This is music to our ears, because our role extends far beyond presenting the benefits renewal report. We handle the daily administration of the program, as an extension of your HR team.
When it comes to the Immix Group’s benefits audit, we want to understand:
- Are you receiving the support you need, from your advisor?
- Are they making pricing, plan design and other relevant factors clear and understandable?
- Is your insurance provider making it easy for employees to understand their plan, and adjudicate claims?
- Are they using modern technology?
A benefits program should never be ‘set it and forget it’! We want you to have a flexible benefits plan, that can shift to meet your needs. The Immix Group strives to be your partner in guiding you through this process, with an eye on both sides- the financial aspect of the program as well as the member and plan administrator service experience.
A Benefits Audit by an Independent Employee Benefits Advisor
The feeling that you are overpaying for benefits, that you are not getting value for the premiums, or that money is in some way falling through the cracks is something that keeps business owners awake at night.
While it’s simple to obtain a variety of quotes from competing carriers with a range of lower premium options, they don’t tell you much, other than the fact that another carrier is willing to buy your business with lower rates.
An Immix Group benefits audit goes far beyond basic plan marketing. As we said earlier, ‘We want you to love your plan!’ and we mean it. To us, this means every aspect from coverage that meets people’s needs, to a user-friendly claims experience, to transparency and fairness when it comes to the pricing of the program. If you’d like to have your own plan reviewed, we’re happy to help. Here’s what you can expect:
- Understandable snapshot of your program structure; benefits, administrative and financial
- Summary of key takeaways from plan members
- Benchmarking of plan design
- In depth review of claims usage
- Historical rate review/ analysis of costs
Quick Self-Assessment:
Before diving into the full audit, here’s a simplified checklist to help you uncover potential issues right away. Use it as a strategic snapshot of what we examine during our full Benefits Audit:
Key Takeaways:
- Survey staff and improve benefits communication. Surveys and education boost engagement and help tailor coverage to real needs.
- Update plan design for flexibility and relevance. Ensure employee benefits plan design reflects current health trends, offers flexibility, and reflects business goals and values.
- Analyze claims data to guide plan changes. Claims analysis reveals usage patterns and provides value insight as to beneficial changes.
- Review costs to ensure fair, transparent pricing. Pricing analysis that looks to historical rate adjustments and administrative costs helps answer the key question: ‘are we overpaying?”
- Ensure strong advisor and carrier support. Proactive, supportive advisors and modern service platforms ensure the smooth ongoing management of your program and a positive member experience.
Read More:
One size fits all? Not when it comes to employee benefits. – Latest News from Immix Group
8 Reasons for Increases to your Employee Benefit Plan Premiums – Latest News from Immix Group
Your Benefits, Your Way: The “101” on Health and Wellness Spending Accounts
Lindsay Byrka, CFP® BA, BEd
Vice President, Immix Group: An Employee Benefits Company
A Suite 450 – 888 Dunsmuir St. Vancouver V6C 3K4
O 604-688-5262
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