Effective plan design is the key to providing high-quality, cost-effective health care to your employees. Sibson Consulting has extensive experience in the design and redesign of all health benefit plans, including medical, dental, prescription drug, vision, behavioral health, short- and long-term disability, life, accidental death and dismemberment, and flexible benefits.
We use a number of strategies to enhance the health plans of our clients. These include:
Cost is an important consideration when planning any change in benefit plan design, as plan redesigns can have a significant fiscal impact on an entity. Sibson’s cost modeling experts and tools enable plan sponsors to make informed decisions about their plans.
Our knowledge allows employers to make decisions that maintain the long-term sustainability of their plans.
Proper budgeting and financial monitoring is key to sustaining a health and welfare plan.
Sibson Consulting is able to help employers with the following services:
Data mining gives employers valuable insight into plan costs and usage to improve decision making and financial analysis. Plan sponsors can determine the root causes of cost changes using data mining, which allow for targeted and effective intervention to manage future health care expenses.
Sibson Consulting's data mining services include:
Benchmarking is the process of identifying, understanding and comparing best practices across organizations. It is a powerful tool for an organization seeking to align benefit programs to the goals and strategies of the organization.
A competitive analysis of benefit programs serves as an important method to identify sources for program improvement, such as cost efficiency, recruitment and retention of employees. A benchmark assessment provides a unique and invaluable understanding of how benefit programs compare among competing organizations. Furthermore, a rapidly evolving industry makes it important for employers to understand not only the current benefit plans in place at key industry and geographic competitors, but also the future direction of the benefit initiatives competitors may undertake.
Providing health benefits for retirees presents employers with many challenges. Sibson Consulting can help you find solutions that work for your organization and your retirees. Sibson works with a variety of employers that offer Medicare and non-Medicare retiree coverage, including prescription drug, dental, vision and life insurance benefits.
Services we provide include:
A voluntary employees' beneficiary association (VEBA) is one option for organizations that are looking for a new way to handle the rising costs and obligations of retiree health benefits, especially when these benefits are collectively bargained or the company is in bankruptcy.
Sibson Consulting has experience with more than 25 retiree health VEBA clients — some of which have been in business for more than 25 years. This significant, in-depth experience in the creation, design, implementation, communication and administration of VEBAs is unparalleled. Our consultants are available to assist you and your attorneys in addressing the following aspects of a VEBA:
A consumer-driven health plan (CDHP) invites employees to become more involved in health care decisions and more aware of the true cost of care. An increasing number of health plan sponsors are turning to CDHPs in hopes of controlling costs.
The implementation of a CDHP involves a significant effort on the part of the plan sponsor and should not be done without considering the changes it would require from employees in terms of utilizing their coverage. In addition, deciding on the proper plan design — whether it be a Health Reimbursement Account (HRA)-based plan or an Health Savings Account (HSA) option coupled with a High Deductible Health Plan (HDHP) — and understanding the administrative and compliance challenges associated with each, can be confusing and challenging.
Sibson can help you determine the best way to introduce health care consumerism to your plan participants. This may involve implementing a CDHP, modifying your current plan designs to increase participant cost awareness, launching a communications campaign for conscious decision-making or some combination of these methods.
In our experience, employee contributions are one of the most visible and sensitive issues forming employee perceptions of health plans. Working with our clients we carefully evaluate employee contributions. We assist plan sponsors with outlining their employee contribution strategy by:
The strategy an organization develops and uses will send messages to participants that the plan sponsor will want to ensure are consistent with its strategic plan. Sibson can help develop new strategies and, if the new strategy is significantly different from the current approach, we can work with plans to evaluate a “phase-in” process for its implementation.
We can also integrate the employee contribution review and cost sharing analysis with a client’s communication strategy to help plan sponsors communicate the benefit offering to employees, emphasize the portion of the total benefits bill that the plan sponsor is actually paying and encourage the right employee behaviors and selection results.
Sibson has extensive experience designing and evaluating value-based benefit plan designs; we have worked with a number of clients to help develop custom value-based designs in order to help them achieve their health benefit goals. Introducing a nuanced benefit design that tailors cost-sharing for both high-value and low-value services helps to ensure clients are getting the most value for their health care dollars. By identifying and promoting the utilization of strategies and services, which have been found to be both clinically and cost effective, our clients have realized significant improvements in the overall wellness of their members.
Value-based plan design customizes plan design and management based on proven medical interventions, high-value therapies and efficacy, rather than providing a one-size-fits-all solution to coverage. These plans encourage treatments with evidence of clinical benefit and lowers financial and behavioral barriers to effective treatment. The plans also encourage participants to adopt healthy behaviors and help employers better manage plan costs. Examples of value-based plan design include:
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