How to Build a High-Performing Benefits Plan in 4 Steps

Most HR teams spend their time fighting fires instead of building something better. They're stuck in manual processes, drowning in compliance questions, and watching employees make expensive healthcare decisions because nobody taught them how their benefits actually work.

Here's what we've learned from working with employers across multiple states: high-performing benefits plans aren't just about spending less money. They're about making life easier for HR teams while helping employees get real value from their benefits.

1. Electronic Enrollment and Administration

You'd be surprised how many employers still handle benefits enrollment with paper forms and spreadsheets. If you're manually entering employee data into carrier systems, you're already behind.

High-performing plans use benefits administration systems that automatically feed enrollment data to carriers. This eliminates data entry errors, reduces processing time, and frees up HR staff to focus on more strategic work.

Consider consolidated billing too. Instead of writing separate checks to each carrier, you write one check that gets subdivided automatically. Less reconciliation, fewer headaches, more time for what matters.

2. Compliance on Autopilot

State-specific benefits legislation is moving faster than ever. National requirements keep shifting. The employers who perform best aren't trying to track every change themselves – they've built systems that handle compliance automatically.

This means understanding your specific obligations based on your company size, employee locations, and benefit offerings. High-performing plans don't rely on hoping someone caught that email alert about new regulations. They have processes that ensure compliance happens without constant manual oversight.

3. Employee Education That Actually Works

The best-performing plans have employees who understand their benefits and use them wisely. This isn't about sending more emails or hosting annual meetings that nobody attends.

It's about helping employees make good financial decisions. When employees understand how their benefits work, they spend healthcare dollars more thoughtfully. This matters especially for self-funded employers, where every dollar saved stays with the company and can improve benefits or pay rates.

Tell your employees you're self-funded. Explain how much the company pays before reinsurance kicks in. Help them understand that healthcare spending affects the entire organization's ability to provide raises, better equipment, or enhanced benefits.

4. Incentives That Drive Better Decisions

Some employers struggle to get employees to use lower-cost options even when they're available. The solution isn't more communication, it's better incentives.

One employer couldn't get staff to source prescriptions at lower-cost pharmacies despite offering the option for free. They started offering 50% of the savings as a payroll bonus (up to a maximum amount) for employees who used the preferred pharmacy. Usage went up immediately.

Direct contracting with providers creates similar opportunities. When employees choose contracted providers, you can waive their cost-sharing. Better outcomes, lower costs, happier employees.

The Credit Card Analogy

Think of health insurance like handing every employee an unlimited credit card. Because that's essentially what it is – a card with an insurance logo that lets them spend company money on healthcare.

You wouldn't give employees unlimited spending power anywhere else in your business. Why would you do it with healthcare? High-performing plans put guardrails in place while still giving employees excellent benefits.

Building Your Plan

High-performing benefits plans reduce administrative burden for HR teams while helping employees become better healthcare consumers. Every year brings new opportunities to improve in these areas.

The employers seeing the best results work with consultants who understand these four areas and can help implement changes systematically.

It's not about doing everything at once, it's about making steady progress toward better performance.

Small improvements in these areas can make a big difference for both HR teams and employees.

If you have questions about implementing any of these changes, connect with us on LinkedIn.

We enjoy talking through these challenges with other benefits professionals.

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