IPMA HR Successful Practice Communicating Benefits Changes

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1 Agency Information: Orange County, Florida Approximately 7,700 regular and temporary employees 51% Unionized Orange County Population: 1,072,801 Background/Overview: A comprehensive strategy for communicating complex medical insurance information to a diverse population of employees, dependents and retirees. Details: Up until 2011, the Orange County Board of County Commissioners offered a traditional HMO plan for its employees, dependents and retirees, as well as the employees, dependents and retirees of 12 other constitutional officers and municipal agencies. This totaled nearly 19,000 covered plan members as of the beginning of In 2010, the total cost of the plan was nearly $100 million with a projected 18% increase in 2011, and no sign of decreasing in the future. The County realized that without making significant changes to the plan design, the plan could not be sustained and the County would be facing a nearly $18 million budget shortfall in Given this challenge, the County considered a variety of options for the plan design change. It was ultimately decided that a Consumer Directed Health Plan (CDHP) model combined with a Health Savings Account (HSA) would close the budget gap, as well as change health behaviors of the plan members, which is believed to be the true solution to the problem of rising healthcare costs. This drastic change from an HMO with co pays, to a brand new plan combining a high deductible, coinsurance, an out of pocket maximum and a health savings account with an employer contribution, left a challenge for human resources in determining the best communication strategy to reach all plan participants. It was clear from the onset that employee education and communication would be key in achieving a successful transition process. The HR Benefits staff began by recognizing that the communication methods that worked in previous years would need to be reevaluated given the amount of information for the 2011 plan year. The learning curve in understanding how to use the 2011 plan, the diverse employee groups with different schedules and accessibility to computers across the County were major considerations in developing the communication strategy. In addition to these considerations, the timeline leading up to open enrollment was a factor that shaped the strategy as well. Considerations in Developing the Plan Employee Groups In order to determine the most effective communication strategy, a number of considerations needed to be factored in to come up with various methods of delivery. First, the various employee groups, locations, and schedules were evaluated to determine how the message would be developed. Each group of employees needed different types of communication since Orange County covers employees from utility workers, firefighters, and correctional officers to animal control officers and nurses. These employee groups have various schedules as well, not everyone is the typical 8:00 a.m.

2 5:00 p.m. office worker, so it was important to understand when the best timeframe to communicate would be for the various areas. Technical Capability & Accessibility In addition to considering the best time to reach employees, it was also important to evaluate the computer accessibility and technical capability of the employee groups. A large portion of the employees do not sit in front of computers during their workday, and have limited access to or the internet. Given this information, it was necessary to come up with varying methods of communication. Available Resources The next step in developing the communication plan was to evaluate the available communication resources of the County. The central HR Division s Benefits staff oversees a group of department HR Representatives called The Benefits Communication Committee. This group was reached out to in the development stages to ensure that each department s nuances were taken into consideration so all employees could be reached. The available resources across the County were identified and included a variety of media. The Benefits staff has a benefits address that could be used to generate outgoing messages to all County addresses. The County has a Graphics & Print Shop that can print professional looking flyers and brochures. There is an internal Intranet page that can be used to broadcast and store information, there is an external County website that can allow employees to access information from home, and additionally, a few of the departments have their own Intranet page. The Benefits Communication Committee is an available resource as well. This group answers front line questions from department employees, aides in open enrollment and gives presentations to department staff. One of the most unique resources available to Orange County is its Communications Division. This division includes a professional television studio called Orange TV, that is used to film board meetings, community events, and generate various County segments available to the public. There is also a monthly employee magazine called the Orange Spiel as well as the Orange Spiel Extra which is a countywide blast of information. In addition to the internal resources, external resources were considered as well. United Healthcare, the County s plan provider, and Express Scripts, the County s pharmacy provider, were also available for presentations and information. With all of these resources available, the strategizing could begin and a comprehensive communications plan could be developed. Broad and general communication began in February 2010 with a presentation to the Board of County Commissioners highlighting the budgetary issues, and laying out the considerations for the new plan design. This set the stage for early communications with employees. A follow up board presentation occurred in May which provided more detail on the specifics of the plan, why the change needed to occur, an explanation of health savings accounts, and proposed premiums. The final Board presentation occurred in June 2010 and requested formal approval of the proposed plan design. Between these meetings, discussions were held with the bargaining units, other covered agencies, department HR representatives and employee groups. Following the approval of the plan in June, the formal communication strategy was launched leading up to and beyond the October open enrollment period. The cornerstone piece in the communications strategy was the Open Enrollment Information

3 Video which was distributed via DVD to all Departments to show to their employees. It was also accessible through the internet and intranet for independent employee and spouse viewing. This video program explained all major plan components in an understandable fashion so that employees could begin to digest the information. Later in the strategy, other opportunities were given so that employees could get more personal interaction and also review more detailed information via other communication channels. Below is the communication strategy prior to implementation. Program: 2011 BENEFITS COMMUNICATIONS PLAN MEDIUM Videos DESCRIPTION Open Enrollment Informational Video Overview of the major changes, basic examples, and what s to come. This video will be distributed to all departments for viewing at staff meetings, fire houses, shift briefings, etc. followed by an HR representative fielding questions. HR in the Loop Webisodes HR in the Loop is a bi weekly webisode providing updates on all things HR, but especially benefits information during the time leading up to open enrollment. The format is a news desk with two anchors and additional correspondents to add detailed information. This tool was developed to reach all employees either at work or at home and is filmed by Orange TV. Scripts are developed by the Benefits staff. Recent episodes are on the external County website and can be found here: HumanResources/CurrentEmployees.aspx Print August Orange Spiel Magazine The Orange Spiel magazine is a monthly publication developed by the Communications Division with County news. The Benefits and Wellness staff will develop a 5 6 page spread discussing the benefits plan design change. It will include lots of examples, explanations on the 2010 plan vs. 2011, healthcare highway graphics, health expense tracker information and Wellness Screening Info. This will also advertise the new external website. Brochure Open Enrollment Info (Mailer) A paper brochure will be mailed to employees homes with specific information about the online open enrollment website, BenTek, as well as the enrollment process and a high level explanation of the major changes. Open Enrollment Packet A packet will be developed including a guidebook, handouts, summary sheets, and ineligible lists. This will also include comprehensive handouts from United Healthcare and the online open enrollment site, BenTek, with user guides. This packet is intended to be handed out during the United Healthcare training sessions taking place throughout the summer; additional packets will be given to the HR representatives.

4 Electronic Blast s The address will be used for sending out plan information, updates, and tips on an as needed basis. This will potentially be a weekly mailer given the volume of information. External Benefits Webpage An external webpage will be developed to provide information to employees, dependents, and retirees from home. This will store important documents, frequently asked question sheets, video recordings of provider sessions, benefits presentations, HR in the Loop webisodes, benefits packets, and any other information pertinent to understanding and using the plan. The page can be accessed from the main Orange County website: HumanResources/EmployeeBenefits.aspx Face to Face HSA Training Sessions Health Savings Accounts training sessions will be provided in partnership between United Healthcare and HR staff to focus on using HSA s and plan member experience. These trainings may be open to spouses if the department allows. Various dates, times and locations will be scheduled including some evening sessions to accommodate all work schedules. Q&A Open Sessions Providers & Benefits Open Sessions where employees can walk in and have their questions answered and be given guidance by HR Staff as well as the various plan providers. Intended to be held during the last few weeks leading up to open enrollment and will be placed at various locations across the county, as well as varied dates and times. Medicare/VA Eligible Employees Info Sessions For those employees who are Medicare or VA eligible, specific information will be provided on the interaction with the new plan. These employees will be targeted and given a short presentation explaining their options. Outcomes: The communication strategy has been considered a great success and is constantly evolving. The success of the strategy is difficult to quantify, however we have found a few ways to measure the program s effectiveness. United Healthcare, the County s medical plan provider, asked to use the communication strategy as a blueprint for other organizations that are going through a transition this drastic. Additionally, the County s communications efforts have received national recognition through an article on June 15, 2011 in Employee Benefit News. For the 2011 plan year, the open enrollment process was fairly complex and included various steps in order to receive certain additional benefits, as well as included steps in order not to be penalized. Specifically, employees and spouses had to complete a biometric screening, complete a health risk

5 assessment, affirm whether or not they are tobacco users, and open a health savings account. These steps resulted in the County making a contribution to the HSA and determining if the employee would be assessed a tobacco user surcharge. One way we ve measured the success of the communication strategy was by looking at the percent of employees who completed open enrollment and received the County HSA contribution and those who did not participate in open enrollment at all. We ve found 95% of employees seeking coverage successfully completed the process. Less than 1% did not receive the HSA contribution because of an error with their open enrollment; another 1% was not eligible or declined the HSA. This open enrollment was considered mandatory, however, approximately 3.5% did not participate in open enrollment and were therefore defaulted to basic coverage. Advice for Others: When developing a communication strategy for any message, but especially for detailed, complex and somewhat personal messages, it is important to be sensitive to the needs of the audience. This can be done so by varying the communication and using language that is understandable across the board (clear, concise, without jargon, and direct). Ensure that there is a diverse offering of explanations, presentations, examples, and media used for delivery. Use visual aids and graphics whenever possible to elaborate on the message. The strategy also needs to be adaptable. It is important to listen to the audience, figure out what areas are well understood, what questions keep arising, and modify the plan to meet the changing needs. Be open to changing the strategy to ensure that all concepts are being grasped and all areas of the organization are being reached. Additionally, communication needs to be consistent and constant. All presenters need to be on the same page with the message being delivered and they also need to be constantly available as new questions arise. Leading up to the plan change is huge for education purposes, but once the plan is implemented the application can cause new confusion and questions, so be sure staff is ready to assist employees on an ongoing basis.