Are You Getting The Service You Need?

Group health coverage is not just about the benefits themselves – it’s also about the service that accompanies those benefits. Service is what impacts the day-to-day interactions with the plan and it’s what most affects the plan experience for everyone. Having great benefits is only part of the total equation – you also need great service alongside them.

Plan Design

The service you need must begin at plan inception. Your provider needs to take the time to understand your needs and then work with you to develop a plan that meets them. Great service means you and your provider have open communication and are both on the same page.

Your provider should help you identify goals for the plan, so they can tailor their recommendations towards them. They should take the time to understand your workforce, so the plan best supports your employees.

For example, if your workforce is largely comprised of millennials or Gen Zs, your provider should tailor the plan towards a younger, tech-savvy demographic. This may mean including things like virtual healthcare or individualized fitness coaching (such as LIFT).

When it comes to plan design, the service you need and want shouldn’t stop after the plan is in place. Great service means your provider will regularly check in with you. They’ll suggest ways to tweak or improve the plan in order to keep it relevant for your organization. It’s an ongoing process as your organization will change over time, and so should your benefits.

Cost Containment

The service you need should embrace cost containment as an integral part of the benefits plan. Cost containment doesn’t mean cutting corners; it means finding creative ways to support your employees with the benefits they need, while limiting unnecessary costs.

Sometimes, the service you need means your provider creates products that balance great benefits with cost control. Other times it means they partner with organizations to find the right balance of cost control and support.

  • Smart Rx Solutions – Smart Rx Solutions are a suite of products that GroupHEALTH created in response to rising prescription drug costs. These products support employees with prescription drug coverage, while trimming waste from plan costs. Smart Rx Solutions incorporate managed drug formularies and/or central dispensing pharmacies. This is a great example of cost control that still supports employees. For many employees, having their prescription drugs delivered to their door is an added benefit, not a hindrance.
  • Disability Management Services – Targeting disability benefit costs while also supporting employees and your organization is the essence of disability management services. This is the type of service that you need. Disability management services are provided through a third-party organization (we use Disability Management Institute), and they are aimed at helping employees get back to work as soon as they’re able.
    A disability management worker supports the ill or injured employee with organizing medical appointments, filling out paperwork, developing a return-to-work plan and much more. They also provide non-confidential updates to you so that you can effectively plan for your employee’s absence. Getting an employee back to work as soon as they are able is great for your benefit plan costs, but it’s also great for your employee. Research shows that the sooner an employee returns to work, the more likely they are to return to pre-disability health.
  • Education – When it comes to cost containment, education is key. The service you need means you’ll have support from your provider to educate your employees about benefits and benefit plan costs. Your employees need to know that how they use the benefit plan impacts the sustainability of the plan. It means teaching employees to be smart consumers, so they help contain plan costs. If you educate employees about things like prescription drug dispensing fees they may choose to purchase from a pharmacy with lower fees, in order to help contain costs.


One of the most important things you should look for in a benefits plan is support – support for you (the Plan Sponsor) and support for your employees. The service you need means great support for both of you.

You should be receiving systems support that helps you easily administer your benefits plan. That means training on how to use the systems, and access to real people who can troubleshoot with you if you encounter any obstacles.

At GroupHEALTH we provide initial training on our WEBS online administration system, as well as recorded training sessions and ongoing training for new employees or new elements of the system. We also have accessible staff to help with claims issues, systems issues, or anything else. This is the kind of service you need.

Good advice is key

While you may be happy with the benefits you are providing your employees, you should also be happy with the service you are receiving. The service you need and deserve extends to all areas of the plan, including plan design, cost containment and support. If you aren’t getting the service you need, it’s time to make some changes. Review your options with one of our licensed advisors on the phone or in-person or contact us for a comparison quote.

Whether you’re looking for extended health and dental coverage, disability coverage, or life and critical illness coverage, GroupHEALTH has affordable benefit packages that work as hard as you do.

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