Using Employee Benefits Data to Create a Better Workflow

employee benefits data

How Are You Putting Employee Benefits Data to Work?

“Benefits” are more than just wellness products — they’re a cyclical process of learning for TPAs, employers, brokers, and plan participants. Employees and their families are using benefits ranging from medical plans to voluntary options like AD&D and life insurance. Employers are determining what benefits programs and products to offer employees during the next open enrollment. Brokers are meeting with employers to sell new insurance offerings. And you as a TPA are managing the details for all of them.

But along the way, none of these groups can learn the information that they need to move forward without an important piece of the puzzle — data. Throughout the health data life cycle, information about people and their benefits activity is being collected. But if that information doesn’t get into the right hands, those groups can’t hope to truly understand how employee benefits data should guide their next steps.

For example, employers review benefits programs annually to learn what offerings are the most popular and unpopular, how often they’re used and unused, and what the reasons behind both might be. Without an automated software solution, there is little hope of capturing that information efficiently or accurately. And without accurate information, discovering what their next best choice should be for the following year’s benefits programs will be next to impossible.

Keep an Eye on What’s Happening at All Levels

It’s important to use data to understand these long-term strategic decisions, but it’s also important to understand how shifts and changes on a smaller scale can still make an impact. For example, how might a change in an employee’s location make an impact on his or her benefits usage? Say you’re working with an employer that’s based in a downtown area where foot traffic is the more common way of getting around. Some employees drive into the city, while others reside downtown and simply walk.

One employee relocates from downtown to a suburban neighborhood. Previously, the employee would catch an Uber from her downtown apartment to the office building. This was a reimbursable expense through her FSA. However, now that she’s living further away, she’ll be driving her own vehicle to work. The expenses for this are no longer reimbursable. While she may continue to use her FSA elsewhere, transportation was her primary use of the FSA. Unless she is expecting to relocate again or have other out-of-pocket expenses, it might not make sense for her to keep the FSA next year.

Organizations’ employees experience a number of changes that may result in changes to benefits offerings over time. But you as a TPA and an organization’s HR department may have difficulty identifying and acting upon changes to employee circumstances that have an impact on benefit programs. This is where a software solution can prove its value over and over. Built to identify these changes, automation can help you ensure greater accuracy in reporting and in understanding benefits usage. Armed with that information, you produce better reports for your employer clients and make more informed recommendations for the following benefit year.

Increase Efficiency with Workflows Built to Support Change

While you should expect a change in how plan participants use their benefits throughout the year, it can be difficult to know what to do next. And if you and your team do know the next best step, it can be even more difficult to find the time to do it. People are becoming more and more proactive with their health. Simultaneously, rates of certain conditions are increasing. That means more appointments, procedures, and healthcare expenses, which in turn means more EOBs for you and your team.

To ensure you’re able to manage this workload efficiently, workflows must be at the top of your priority list. Whether you’re already using a workflow automation platform or still process EOBs manually, it’s important to define the steps that need to be taken for both standard operations and unique situations. 

If you’re using an automated software solution like TPA Stream, this can be defined and implemented quickly — ensuring you’re able to keep moving forward with your workload while reducing the overall amount of time needed to do it. If you’re manually processing EOBs, a defined process shared with all internal team members is a good first step. However, strongly consider adopting a software solution to take advantage of automation. The benefits of this cannot be overstated.

Remember, It All Comes Around

When it comes to employee benefits data, the more you can learn throughout the year will only go to help you, your employer clients, your broker partners, and even the plan participants when next year rolls around. Better upstream data leads to better downstream decisions and outcomes, which are then turned into insights for a better benefits strategy later.

Consider where you stand now with your understanding of employee benefits data and whether there’s room for improvement. If you could benefit from more automation, deeper reporting and analytics, and an overall stronger platform that makes you more appealing to new prospects, TPA Stream is here to help. Contact us today.

Why TPA Stream

TPA Stream is a thriving, innovative insurance technology company committed to empowering better benefits by connecting systems, transforming data, and helping TPAs unlock more revenue.

Learn more about TPA Stream here.

Let's Connect