What I Learned: My True Story of HDHP Panic and Confusion

Bob Armour Benefits Communication

Houston, We Have a Problem

One afternoon last week, I got an unsettling voice mail from my wife. Let’s call her Carrie, because that’s her name.

“Hey,’ she said. ‘I’m at the pharmacy and they’re trying to charge me $100 more for a prescription. Call me!!’

Happy she was not.

After the message stopped, I felt nervous. I’d been at Jellyvision for about six weeks – and this was the first time either of us had tried to get health care on our new plan. What I thought I knew for sure was that the plan – an HDHP with an HSA – was going to cost us a lot less overall than the traditional plan I’d had at my previous employer. In fact, I could vividly remember Carrie saying: ‘Wow, your take-home pay is going to be so much more!’

But suddenly I wasn’t so sure it was the deal I thought it was. Had I screwed up the math on this? Were we doing it wrong?

Needless to say, as I dialed Carrie back, I was starting to sweat.

The Phone Conversation

Carrie picked up, clearly exasperated. We’d always paid just $20 on our old plan – and now they wanted six times that?! There must be some kind of a mistake, right? Could I call our HR department to fix this?!

I could, I said, but first I wanted to look over my benefits handbook again. I found it in my desk, located the appropriate section. And sure enough, the pharmacist was right. The price we’d pay now was $120.

‘But I thought this new plan was supposed to better,’ she said. ‘This isn’t better at all. This is worse! It’s going to cost us a fortune!’

Fast as I could, I kept reading, as Carrie waited in line for reassurance. And eventually, all the pieces of the puzzle fell back into place.

Relieved, I explained to Carrie (and to myself) that we’d have to pay more up front now…but the funds we were putting into our HSA would cover that stuff until we met our deductible; that’s what that card we’d gotten in the mail a few weeks ago was for. Plus, I reminded her, don’t forget how much we’re already saving because of our lower premiums.

“Basically,” I said, as I dabbed away the flop sweat from my face, “it feels like everything’s really expensive right now, but it’s not. It’s just a different way of doing things.”

‘Alright,’ Carrie said, at last. ‘I think I get it now. It’s all good. Disaster averted.’


What This “First Time” Experience Taught Me…And How It Might Help You

After my wife and I got off the phone, I had two thoughts: 1) I’d done a pretty lousy job communicating to Carrie what to expect when she tried using our new plan and 2) there must be thousands if not millions of unnecessarily stressful interactions going on just like this as HDHP newbies start getting the hang of their new plan.

Being someone who tries to make lemonade out of lemons whenever possible, I got to thinking about how my experience both as a employee with a new plan, and as the person in my household communicating about my plan to my wife might apply to the challenges benefits teams have communicating to their own slightly confused new-plan employees. What I came up with were these four recommendations:

1. Remind employees about their lower premiums and higher point-of-service costs at the same time

Soon after the new plan year begins–or in the case of new hires like me, a few weeks after orientation–package both ‘Remember that you’re saving money on premiums!’ and ‘Remember that you’ll be paying more up front and it’ll seem wrong but it’s not!’ into a single message, so neither reminder gets lost in the shuffle.

2. Repeat this message a few days after their plan materials are due to arrive

We’re more likely to absorb information at the moment we actually need it. So the week your employees’ various cards (plan, HSA, HRA) are supposed to arrive–i.e. at a point where plan questions are probably front of mind–consider sending a quick email reminder.

3. Walk through what a typical ‘first time’ health care interaction will probably feel like, beat by beat

By nature, the first time your employees with new HDHPs go to the drug store or get their yearly physical, is going to be stressful and disorienting. Their old health care habits don’t help them anymore. The game has changed. So why not demonstrate that you totally get how it’s going to feel for them…and walk them through “their first time” step-by-step in advance, via an entertaining email or handout.

Specifically, try organizing your advice by situation–for example, ‘Your First Trip to the Drug Store with a New HDHP’ or ‘Your First Trip to the Doctor with a New HDHP.’ Then, for each, lay out the exact actions they should take to complete their healthcare transaction like a pro, calling out where new plan-holders often feel confused or anxious and why they shouldn’t be.

4. Go the extra mile to make sure all that helpful HDHP info gets into the hands of the health care decision-maker in every employee household

As you well know, your employees often aren’t the primary healthcare decision-makers. So the next time you send an email with important new plan information, include a flashy call-out that says something like this: Got a partner or spouse who’s going to need to know how this stuff works too? Forward this email to them right now, before you forget. Seriously, I’ll wait. 🙂

In addition, if you’re already planning to send a reminder email with plan management information when your employees are due to receive new cards in the mail, consider snail-mailing a reminder postcard too. Doing so will increase the chances the information will land in the hands of the person who needs it most.

In summary: don’t underplay the “how to actually use the plan stuff” like I did with Carrie…and hope it all works out. Anticipate the questions your colleagues will have – especially about their “first times” – with communications that get to the appropriate people at the appropriate time…and have a human touch.