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Designing & Customizing Group Benefits Plan

Understanding and Identifying Employee Needs

Small and medium-sized employers would never launch a new product or expand their business without first understanding the marketplace and current business environment. Similarly, employers need to understand what their employees and organizations are looking for before making any decisions about their benefits plans.

As with general market research, there are several simple steps that employers can take to determine what type of benefits might be best for them and their employees:

  • Conduct a benchmarking exercise to determine what benefits other employers in the same/similar sector are offering. General information is often available from Chambers of Commerce and the Conference Board of Canada
  • Conduct an employee survey to determine the health needs, preferences and expectations of their workforce; and
  • Review the demographic profile of their employees and previous claims experience (if available) to identify the needs of the workforce and to determine options that will meet the requirements and expectations of the largest number of employees.

These steps are something Wescan Insurance Brokers benefits advisor can assist and advice you with.

Asking the Right Questions

After establishing a benchmark for employee expectations, employers need to understand the role and cost of providing or changing the benefit coverage they provide. Answering a few basic questions can help provide this understanding:

  • What is the reason they offer/plan to offer a benefits plan?
  • What will the program’s primary goal be? (Competitiveness, retention/recruitment, increased
    productivity, provide protection to the employee)
  • Will/does coverage meet the needs of the current workforce?
  • Will coverage meet the emerging and changing needs of future employees? (Demographics, health
    needs, age, diversity, expectations)
  • What should the annual budget be for providing coverage?
  • Do/will employees understand their benefits and what is being offered to them?
  • How often should plan design/cost be reviewed to ensure that it meets the needs of a changing
    workforce and rising health care costs?

While some of the answers to these questions may require the assistance of an advisor, the exercise of working through these questions will allow employers to start to develop a group benefits strategy

Develop a group Benefits Strategy

Once the Employer has asked themselves the right questions and understand what role the group benefits plan plays/will play within the organization, small and medium-sized employers can develop a strategy for establishing their group benefits plan. During this process, employers will find that it is their view of benefits, not their size, that will dictate their strategy and what type of group benefits they offer.


Research Analysis

  • Determining the Employee Coverage needs, Affordability & Long-Term sustainability of the Benefits plan are the key factors to think about when designing an Employee Benefits plan.
    • It is easier to have a conversation telling employees you’re going to INCREASE coverage, rather than a discussion to DECREASE coverage.
    • Your plan is shared across all employees and should be designed from a group’s perspective. EHC (Extended Health Care) & Dental rates/premiums paid are based primarily on group’s plan utilization & demographics – which applies to most group insurance plans. If your group has someone who uses the plan heavily, the group collectively pays for this high user. Whether high users are employees who require expensive drugs regularly OR employees that max-out visits to the chiropractor, massage therapist and other professional practitioners – the group collectively pays for abnormal high usage.
    • A poorly designed plan will increase the amount of time you spend administrating the plan. With a poor plan design, renewal costs continue to rise and spiral out of control. This means more of your time will be dedicated to re-configuring the plan design, researching the market for best pricing and going through the enrolment process all over again.
  • One of the biggest mistakes we see with small businesses is to design a benefits plan from the perspective of a large corporation. This influence may be due to some of the employees that come from large corporations or general expectations of what a group benefits plan should provide employees. In either case, implementing a small business health insurance plan based on a large corporation type plan design, or general expectations of a few employee/s what employee benefits / health insurance plan is supposed to look like, shall likely not work out for the long run.

There are different solutions available depending on your past group experience, group demographics, etc. We can show you ways to make a few subtle modifications to the plan design and shall guide you through the process of plan implementation. By implementing this modified group insurance solution, you shall be able to address the changing Employee Coverage needs, plan affordability & long-term sustainability.


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