Wellness is a strategy that leverages behavioral modification programs to enhance employee well-being (physical, intellectual, emotional, social, spiritual and financial) to reduce the prevalence and severity of illness so employees can enjoy a better quality of life and help reduce their health plan sponsor's claims costs. Wellness programs can be effective with the right leadership, articulated strategy and support programs for changing behavior and environment. Without careful planning and strategic implementation, almost half of wellness initiatives fail to deliver on their desired outcomes.
Sibson works with plan sponsors to establish effective initiatives to help employees and their dependents maintain good health so that the organization can thrive. Sibson can help plan sponsors:
Sibson understands that employee productivity directly correlates to the success of the organization. We help our clients with the strategy, design and management of time off and disability programs, including paid time off.
Paid time off includes programs that many employees value, including:
Disability-related programs, which are integral to an organization’s effectiveness and overall health when properly designed and administered, include:
Employee support programs include many of the items mentioned above with the addition of employee assistance programs (EAP) and work/life benefits. All of these programs need to be managed within various constructs as illustrated below.
Through our Healthy Enterprise and Rewards of WorkSM research, we understand the important role that disability, paid time off and other leave programs play in establishing a healthy and effective organization where employees and the organization thrive. Sibson’s Healthy Enterprise Initiative creates a healthy environment for employees and their dependents, reducing workforce costs and enabling employees to more completely engage in their work and life. Sibson’s research indicates that successful healthy enterprise organizations experienced the greatest impact on workers’ compensation and extended absence, which included short-term disability.
Effective disability programs focus on rehabilitation and return to work of affected employees. This includes preventative measures such as safety, accountability and risk management, and efforts to promote health through personal and professional renewal.
Every organization has different issues that may affect absence and result in reduced productivity. Sibson conducts research on the many investments organizations make in their employees to better understand how these investments drive attraction, retention, commitment, motivation and engagement. Using our Employee Productivity Framework, we help our clients assess the factors that have the greatest impact on employee absence, health and productivity.
Employee Productivity Framework
The structure and communication of paid time off and disability programs play an important role in the shaping and supporting of an organization’s total rewards strategy. An organization does not need to be unique in all five areas of rewards, but it does need a distinctive value proposition (benefits, compensation, affiliation, work content and career opportunities) to set itself apart.
How Time Off Programs Supports Total Rewards Strategy (Example)
Sibson’s Rewards of Work research found that vacation time is the second most cost effective reward as illustrated in the following table:
Additional Reward Required to Induce 25%, 50% and 75% of Employees to Take the New Job
A good way to determine the success of your paid time off and disability program, and how it compares against other organizations, is through an assessment and/or audit of your current program. Using its Healthy Enterprise and Rewards of Work models, Sibson can help your organization experience positive outcomes in your paid time off, absence and disability programs.
Sibson Consulting works with employers to create health care networks that are cost-effective and comprehensive. We have experience with a variety of networks, including:
Our network analysis services include:
Sibson conducts scores of retrospective on-site claims reviews of private sector health plans administered internally or by third-party administrators.
Our consultants have extensive backgrounds in claims processing and review. This experience makes them uniquely qualified to evaluate established administrative procedures, suggest areas for improvement and ensure proper controls are in place for efficient plan administration.
Sibson can review your entire claims process:
Rising health care costs put a strain on every budget. Each year, employers must raise medical plan copays, deductibles, coinsurance limits and employee coverage contributions to help dampen the impact of higher costs. Beyond asking employees to pay more for health coverage and care, what can companies do? A Dependent Eligibility Audit can make a real, and immediate, difference.
Dependent Eligibility Audits help organizations realize substantial savings. Our experience shows that 8% - 12% of the dependents on your rolls should not be there — they simply do not meet your plans' eligibility criteria. Remove ineligible dependents and you can realize significant first-year savings. Use our savings calculator to estimate how much your company can save.
Our administration technology platform and client support model offer a flexible, complete Eligibility Audit administration and communications solution. Below is an overview of our Audit process.
We will discuss and determine the Audit approach that's right for your organization, and determine the details of your Eligibility Audit.
Dependent Eligibility Audit Savings Calculator
Rapidly rising prescription drug costs are driving overall increases in the cost of health coverage. Sibson Consulting can help you manage the cost of prescription drug coverage through a variety of services.
Sibson Consulting works to get the most from vendors for all the clients we represent. We make it our business to know a vendor's history, financial solvency and performance to date, and we bring that knowledge to the table on behalf of your organization.
It is critical that all renewal rates negotiated with vendors are reviewed and assessed to make sure they are competitive and appropriate given the experience and plan design of your organization. Sibson uses a fair but firm approach, based on our technical expertise as underwriters and actuaries, to ensure that you receive the right renewals from your vendors.
Our renewal and competitive bidding services include:
Some organizations with significant levels of cash reserves can reduce costs by self-funding their health plans or assuming more risk. But before doing this, you must carefully consider the ramifications and protect the plan against ordinary or catastrophic risks.
Sibson Consulting can help you determine if self-insuring or other cost-saving funding arrangements are right for your organization. We can also help plans that are already self-insured evaluate whether self-insuring is still the best choice.
Self-insured organizations can protect themselves against large claims or fluctuations in claims by purchasing stop-loss insurance, which secures insurer reimbursement for expenses above specific or aggregate limits. Sibson can help employers with:
View Sibson's infographic to see key medical and prescription stop-loss coverage facts.
To learn more about stop-loss insurance, read Sibson's recent Perspectives article, "Time To Take Another Look at Stop-Loss Insurance."
Sibson utilizes technology and analytical tools to measure, monitor and predict the costs of health and welfare benefit programs. Sibson has developed a number of pricing tools to help clients assess impact. We customize our technical resources for your specific needs, ensuring that we provide the high level of quality consulting that our clients expect. Sibson is on the cutting edge of health care industry trends and relevant legislation, and we update and revise our tools and technology as needed to provide maximum value to our clients.
Sibson can help contain health costs through diligent management of provider reimbursement. As experienced consultants to plan sponsors in the areas of health insurance, managed care arrangements and third party administration, we begin by identifying networks with strong overall provider discounts, efficient administrative systems and robust ancillary program services. From there, we can help reduce or contain costs by managing and negotiating vendor contract terms more aggressively. In Sibson’s experience, it is possible to challenge a provider’s proposed premium renewal after performing independent renewal projections using different methods and assumptions. Frequently, these alternative projections uncover carrier mistakes or non-competitive terms that the carrier will reconsider.
Sibson can help with the following:
Faced with the need for continued improvement in productivity and hampered by the tight budgets of the economic downturn, employers are taking a fresh look at implementing on-site and near-site medical clinics for employees and their dependents. The cost for implementing and operating these clinics has dropped, and clinics can now be set up on a smaller scale than in the past and require lower capital investments.
This renewed interest is also driven by a number of internal and external factors:
Adding on-site health clinics can serve several objectives for plan sponsors who want to take greater control of preventative care services, screenings and other primary care services. Sibson can help in many facets of your pursuit of an on-site or near-site clinic, including: