3 Flexible and Creative Employee Benefits Solution Case Studies
By: Benefits by Design | Thursday May 31, 2018Updated : Wednesday July 22, 2020
An employee benefits plan is like a balance scale – with benefits on one side and employees on the other. If employees use too much of a benefits plan, the scale tips unfavourably. If employees don’t have enough benefits coverage, you’ll see them suffer to keep themselves healthy and well.
As an employer, what can you do to keep the scale balanced?
Below are 3 real-life example case studies of Benefits by Design (BBD) Inc. groups that have implemented creative solutions to solve just that.
Case #1: Controlling Massage and Other Paramedical Spending
Paramedical coverage is one of the most popular benefits offerings in Canadian employee benefits, both in how sought-after it is by employees and how prevalent it is in group insurance plans today. That increased usage can sometimes translate to significant cost, as was the case here.
The Problem: Increasing Paramedical Usage and Cost
A large Extended Health Care (EHC) spending problem was driving up this company’s benefit plan rates. Upon further investigation, the culprit was identified as employees spending too much on massages.
Traditional benefit plans are built on a flat-rate based on employee demographics (age, occupation etc.) and can generally be quite costly. Rates are often subject to go up, especially if a group has a lot of claiming activity. For this company, the overall cost increase to their benefits plan meant that the company was entertaining terminating their benefit coverage entirely.
There’s been a lot of discussion around whether or not massage therapy is a worthwhile benefit to include in a benefits plan. This employer felt it was important and wanted an easy way to carve out their organization’s healthcare plan to be used solely for massages.
The Solution: A Health Care Spending Account for Massage Claims Only
In this case, the company still wanted to offer massage to their employees who wanted it, but needed it removed from their EHC coverage to keep rates reasonable.
So we set them up with a Build Your Own (BYO) Standalone Spending Account for massage claims only.
The company offered their employees $500 per year with a co-pay option of 80%. This means that the employer covered 80% of each claim and the employee covered a fixed 20%.
Not only did this lower the amount of claims that were coming through for massages, it also helped employees become increasingly aware of how much they were spending.
Case #2: Providing Orthodontic Coverage
Orthodontic coverage is generally embedded in an Extended Health Care (EHC) benefit, but depending on the Insurer and the level of coverage, may not be quite what you’re looking for. This was the case for our next group.
The Problem: Providing Comprehensive Orthodontic Coverage
A company offered a very comprehensive orthodontics plan to its employees. They wanted to ensure their employees (or families) who required orthodontic work would have the means to cover it.
Traditional benefit plans have a minimum number of employees required in order to keep a current plan design. In order to sustain their current plan design, this company needed a minimum of 10 employees. Unfortunately, this organization did not have enough employees to keep enrolled in their current plan and would therefore lose their orthodontic coverage.
The Solution: A Health Care Spending Account for Orthodontic Claims Only
In this case, the company chose to set up a Standalone BYO spending account solely for orthodontic claims. Since our Standalone product has no minimum life requirements, this organization who didn’t have enough employees for a traditional plan, had the flexibility to provide this coverage.
The Results: Maintain Coverage and Control Cost
The group was able to maintain the orthodontic coverage that they wanted, despite not having enough employees for traditional coverage. Additionally, by the very nature of a HCSA, they were better able to control the cost of orthodontic spending! Bonus.
Case #3: Setting Spend for Medical Cannabis
Medical Cannabis has become a hot topic in the benefits world. Organizations are putting drug and alcohol policies in place for their workplace to protect themselves and ensure the safety of their employees at work.
The Problem: Medical Cannabis Isn’t Covered
Although medical cannabis has been prescribed to treat ailments ranging from critical illnesses to managing chronic pain, a number of insurance carriers do not cover medical cannabis through traditional benefits plans. This organization wanted to ensure that their employees could access medical cannabis if it was prescribed by their physician.
The Solution: A Health Care Spending Account for Medical Cannabis Only
This company chose to setup a Standalone BYO spending account for medical cannabis purchases and further defined the spending account to only include medical cannabis purchased from a licensed carrier.
The Results: Controlled Cost and Medical Cannabis Coverage Made Possible
The employer was able to ensure that employees could access medical cannabis if they needed it. And the best part?
If no one does need it, no charges are made to the employer, so they’re not paying for a benefit that no one is using. That’s just how an HCSA works!