Picwell Blog

How to Build the Right Health Insurance Plans to Satisfy Employees & Meet Employer Needs

Jun 30, 2020 8:48:39 AM / by Picwell

As a benefits professional, one of the most important parts of your job is to design and offer health insurance options that fit your organization’s needs. But, designing the right set of medical plans is always a challenge. Your organization’s goals will differ from those of your employees and on top of that, each and every employee has different preferences, health risks, and budgets. 

A well-designed health insurance offering is integral to organizational success

It’s true. Well-designed medical plans can serve multiple purposes. They can keep your current employees happy (and healthy!) while also helping to attract new talent to your organization. When an offering is designed with both the employees and the organization in mind, it can become a way to improve employee financial wellness, drive employer cost savings, and increase employee engagement.

With the right data, it’s possible to design plans where everyone wins

While designing the perfect benefits offering (and satisfying everyone) might seem impossible, it can be easier than you think. However, in order to do this, you will need to start by gaining insights into your employees’ health risks and preferences. This type of analysis requires you to know:

  • The health risks each of your employees face
  • The level of risk your employees are willing to experience when it comes to unexpected medical needs and out-of-pocket costs
  • How much your employees can afford to pay in the case of an unexpected medical bill

Understanding the answers to these questions will allow you to truly consider plan design from an employee perspective.  It’s possible that two or three plans may provide enough options to meet your employees’ needs and preferences. It’s also possible that you may need to add another plan option with slightly different characteristics including different premiums, co-pays, co-insurance, deductible amounts, and out-of-pocket maximums.  In a perfect world, employees would have access to custom health plans that fit their needs as perfectly as possible (hang tight - we’ll come back to this thought in just a minute!)

You can’t consider employees’ needs alone. You also need to understand how various plan offerings may impact your organization’s bottom line. In doing so, you’ll probably find yourself asking questions like:

  • How will our employees choose from amongst these options?
  • How will offering additional plans impact our bottom line when employees make decisions at open enrollment?  
  • Are we likely to save the organization money or will this cost more money?

The right partners, including the right  benefits decision support technology companies, can provide insightful analytics to show you what your employees value most as well as which plans and contribution strategies would best support your organization’s strategic objectives. Gap analysis reports are essential when creating effective benefits plans as they will help you see where your current offerings might be lacking.

Introducing Picwell’s Pre-Enrollment Insights 

Picwell’s Pre-Enrollment Insights are a type of gap analysis that allows us to illustrate what would occur if employees made “rational” medical benefits decisions. We do this by simulating what Picwell medical decision support recommendations will look like for each employee based on the specific plan designs that your organization offers. Then, we compare the recommendation to their current enrollment plan. Basic pre-enrollment reports include the following analyses:

  • We’ll compare your employees’ current enrollments to the elections that they would make if they selected either the lowest cost or highest scoring plans.  
  • We’ll show you how many employees are already in the best plan
  • We’ll show you how much they could save by picking the recommended plan
  • We’ll show you how Picwell will rank your plans across your employee population
  • If you offer an HSA eligible plan, we’ll show you how HSA contributions could change if your employees follow Picwell recommendations
  • We’ll show you how your employer premium contributions could change if your employees follow Picwell recommendations


When you offer the same plans as last year, these metrics can help you understand how your current offerings align with your employees’ needs and identify the impacts of improved enrollment selections within your current set of benefits.

Whether you are considering a different set of benefits or changing your HSA and/or premium contribution strategies, enhanced pre-enrollment reporting can help you understand how these changes will impact your employees.  In addition to those listed above, Picwell’s Pre-Enrollment Insights include these analyses:

  • We’ll estimate the actuarial value of your current and proposed medical plans.
  • We’ll compare recommendations across plans under your current and proposed medical plans (or contribution strategy)
  • We’ll compare employee costs and employer costs under your current and proposed medical plans.

So you’re probably thinking… “This sounds great, but what can I actually do with this information?” Picwell’s Pre-Enrollment Insights can help you with your medical plan design in a few different ways.

Pre-enrollment Insights help fine tune your benefits communication strategy

Besides providing you with the ability to adjust plans based on employee needs, pre-enrollment reporting can also help you fine tune your benefits communication strategy. By giving you a preview of what certain decision support recommendations might look like, you can use this information to communicate value to your employees. An effective communication tactic would be to explain to your employees how much they can save on average by using Picwell’s decision support solution and following the recommendations provided therein (pssst, on average, people who enroll in Picwell recommended plans save about $1000 more per year than people who don’t follow Picwell recommendations!)


Pre-enrollment Insights allow you to compare current and proposed plans

In addition to providing information on your current plans, Picwell’s Pre-Enrollment Insights can also provide analyses on plans you’re actively evaluating to see how they might impact your employees and your organization. You will be able to easily compare plans and contribution strategies, and employee and employer costs under both your current and proposed plans. This will show you which plans just aren’t good matches for your employees, while also giving you the ability to simulate alternative offerings. 

Similarly, if you’re considering changing your contribution strategies, you can see how that change will impact the relative value of different medical plans to your employees and then you can communicate those changes. Using pre-enrollment reports to play around with options provides you with commitment-free guidance on what plans would fit your organization best.

Below is a sample of what this might look like for an organization.


Pre-enrollment Insights alert you to gaps in benefits offerings

Picwell’s Pre-Enrollment Insights report will help your organization quickly identify potential gaps in your current or proposed medical plan offerings. This can also show you how decision support tools like Picwell DX can help you and your employees save money by guiding them into the best-fit plans.

Combining Pre-Enrollment Insights with our benefits decision support tool, Picwell DX, will ensure that you are not only designing the best medical insurance plans possible but that you are also helping your employees understand why they are the best options.

As we mentioned earlier, employees need health plans that will fit their needs as perfectly as possible. In order to make sure they’re enrolling in the best-fit plans, you need to provide hyper-personalized guidance, and Picwell DX does just that. When you use a decision support tool like Picwell DX, you can ensure you are putting your organization and your employees in the best positions to remain both financially and physically healthy for the upcoming year. 

But, don’t take our word for it. Click here to download a full sample of Picwell’s Pre-Enrollment Insights and then schedule a demo to see for yourself how Picwell can keep your employees satisfied and engaged while still supporting your organization’s strategic objectives.

Topics: Benefits Decision Support, Health Insurance, HR Tech, benefits advisors, employee benefits, benefits professionals


Written by Picwell