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By Marlene Prost

When you're as cutting-edge as Tesla Motors, using social media is as natural as breathing.

Yet when it comes to benefits communications for its 1,700 employees, including factory workers, engineers, artists and administrators, the company's primary approach is one-on-one, to sell employees on smart health care choices.

"While technology is great -- we have a large population that have smartphones -- we are extremely hands-on," he said. "For example, we have new-hires orientation every Monday," he said. New employees also personally meet the CEO and the heads of finance and technology.

"That gives you a flavor of our philosophy," said Randall. "A lot of companies are relying on next-generation ideas. ? This electronic stuff is definitely great. But you can't replace good old-fashioned (tactics). Everybody knows 'Nate.' "

Electronic tools and social media are fast becoming best practices in benefits communications. But that doesn't mean every HR director or risk manager is jumping on the bandwagon. A company should choose communications tools based on its goals, as well as the makeup of the workforce. Mix it up, say experts. There's no reason you can't send tweets reminding employees about open enrollment and explain benefits face-to-face at a brown-bag luncheon.

"We feel strongly it has to be a multichannel approach: Different things work for different people," said Jim Hoff, principal at Aon Hewitt's communications practice in Chicago. "A nice mix (of the Web, print and social media) is helpful. ? Some of the channels that are tried and true are still relevant."

As an example, Hoff points to a client that used posters at a fair to remind employees of open enrollment. The posters had a QR (Quick Response) barcode for employees that, when scanned with a smartphone, took them to a mobile benefits site.

It's not just the media that have changed. Benefits strategy has as well. Today, benefits communication is no longer about educating the workforce, say experts. It is about marketing.

"Benefits communication, for years and years, was focused primarily on education and compliance," said Hoff. "Legal compliance is still critical. But there's a move to marketing, to behavior change and outcomes ? motivating people to do something, rather than educating them."

Companies have made all the cuts they can to their benefits programs. Now, they want employees to help them save money -- by, for example, encouraging workers to choose preventive wellness programs, or driving them to enroll in a consumer-directed health plan, with lower premiums and higher deductibles.

"At some point, (companies) are thinking of employees as customers of these benefits," said Hoff. "You have organizations spending quite a bit of money on these programs, whether wellness or retirement. We have to market and sell them. We're no longer benefits communicators. We're benefits marketers."

The goal, they say, is to help employees better understand their role in managing costs while maintaining -- and improving -- their own health.

A "Clunky Medium"

Meanwhile, employees feel overwhelmed and under-informed about their options, according to recent surveys of employee attitudes toward benefits.

The 2012 Aflac WorkForces Report found that 76 percent of the 2,200 adults surveyed admitted making mistakes about benefits decisions during open enrollment. Forty-two percent say they wasted money because of mistakes they made, while 74 percent say that they only sometimes, rarely or never understand everything covered by their major-medical insurance-coverage plan.

Employees want information tailored to their needs, according to a 2011 survey of more than 3,000 employees and their dependents by Aon Hewitt, The Futures Company and the National Business Group on Health. Half of those surveyed want a personalized plan that recommends specific actions they can take, up by 9 percent from 2010. Forty percent prefer a wellness website, and 35 percent want personalized health tips and reminders.

"The reason people don't engage with benefits information now is they get all the information at once (at open enrollment)," said Jennifer Benz, founder of Benz Communications in San Francisco. "If you push it out a little at a time and make it available when questions come up, you get people engaged."

Benz recommends a three-pronged approach: First, make use of best practices in electronic media by breaking through the firewall and setting up a "branded" benefits Web page. Second, engage employees year round rather than just during open enrollment.

Finally, "work smart," Benz said. "It's about using every tool at your disposal to communicate to everyone. ? You can't make any generalizations anymore about who uses the Internet; everybody does. If you're providing good tools, everyone will engage online."

In an era of instant electronic access, open enrollment and the summary plan description are no longer doing the trick, said June Mara, founder and CEO of XL Communications in Wilton, Conn.

How many people read summary plan descriptions? "It's not an effective communications vehicle," Mara said. "Once a year, a few weeks before open enrollment, employees are expected to make decisions and understand the material. I equate it to getting the textbook the night before the exam."

Company intranets are clunky mediums, compared to sophisticated websites with Twitter feeds and videos.

"The intranet is inside the firewall. You can't access it from home. Family members can't share [information]. ? What I find about the intranet, it becomes a massive amount of information, generally not presented in a way that's easy to find," said Mara.

Best Practices Online

While most companies rely on their intranets to communicate benefits information, Ardent Health Services in Nashville, Tenn., maintains an eye-catching benefits page online, complete with a busy Twitter account and a wellness-oriented blog.

Melanie Miller, vice president for compensation and benefits at Ardent, which operates hospitals and health care systems with about 9,000 employees, said the company has an intranet but that benefits managers also want the information to be available to employees' families as well. "We are trying to reduce the amount of information mailed to people's houses," she said. "We found that people were not necessarily reading all the information we sent. "This way, the information is available all year round. Most people think about benefits one time a year; then, six months later, they're not sitting at their desk when they have questions."

Twitter and Ardent's blog are "cost-effective" ways of keeping the Web page dynamic, said Miller.

Recent tweets had links to "30 ways to stretch your Fruit & Veggie budget" and a study on children consuming too much sugar. Recent blog updates included a reminder about open enrollment and the winners of a contest to improve their body mass indexes.

HR still sends home mailings, such as postcards for wellness screenings. As for emails, they may have outlived their usefulness. The problem, said Miller, is getting an email address for everyone.

Ardent, however, decided not to create a benefits Facebook page because of lack of control over negative comments.

"I don't see a lot of companies doing (Facebook). ? I see it as a better tool for wellness than for benefits," said Mara.

Mobile access to benefits information is considered important by about 60 percent of HR decisions makers, yet fewer than half provide such access at this point, according to a recent survey by Roseland, N.J.-based ADP, which queried 501 HR decision-makers on employee-benefit tools.

"It's a heavily growing trend. We market to a lot of clients who know they need them," said David Marini, ADP vice president and managing director of strategic advisory services. At this point, many companies are using apps that allow employees to get data, but don't include a process for entering data, he said.

Hoff said he feels strongly about mobile technology. "We've seen organizations using text messaging," he said. "Some are really unique (text messaging) campaigns. For example, an email may guide employees to text to enroll for weekly reminders about upcoming open enrollment."

Mixing It Up

At Tesla Motors, Randall describes the "super-scrappy and old-school campaign" HR put together to encourage enrollment in the company health plan.

First, HR sent out one or two emails. Then they left flyers in company bathrooms, "the bathroom scrawl tack." Randall also visited all facilities to enroll hundreds of employees. The result was that only 15 failed to enroll. The biggest incentive was probably the plan itself: health care at Tesla is completely free to employees -- no premiums are taken out of the paycheck, and there are no copays for preventive care or prescriptions.

"If you're only talking to people once a year, it handcuffs you," said Randall. "You need a slow drop of information." At the same time, "HR needs to understand employees don't have time. Their main goal is to do well at their job. If I'm sending email after email, letter after letter, that don't have anything to do with them, at some point they're going to turn off."

Randall is taking a slow approach to introducing social media. The company is developing an external portal and a blog, and is talking to a health care provider about putting together a mobile app.

"We don't want to go out and buy the latest technology and then nobody uses it," he said. "We want to test it, measure the data and find what value we're adding."

Tesla also prefers to partner with other start-ups.

For example, six months ago, it did a slow rollout of a social-media platform called BetterWorks, which offers perks and rewards with an emphasis on wellness.

"We tried it one way with a soft rollout and not a lot of fanfare. We got moderate utilization and great feedback. Now we're changing course," Randall said. "We phased it in. ?We wanted to make sure employees would use it and value it."

The important thing is to engage -- and educate -- employees, whatever medium is used, said Audrey Boone Tillman, executive vice president of corporate services at Aflac in Columbus, Ga., which has 4,200 employees.

"You can't have one mechanism," she said. "You have several types of people. If we get a majority responding that they want electronic (communications), we recognize we're not going to reach everybody."

Some employees will say, "I want to hear it for myself. I don't want to get email,' " Tillman said.

Aflac relies on a "broad-spectrum approach" leading up to open enrollment. Along with a companywide email campaign, human resources publishes an attractively printed benefits guide with personal stories and scenarios, aimed at engaging decision-makers at home.

Emails are used for teaser campaigns and to drive employees to an Intranet benefits portal, where they review and update personal data before open enrollment and access current benefit-coverage information.

Premium costs are posted on the portal, along with other information on topics like generic drugs and health care reform. Finally, HR holds lunch-and-learn sessions to run through offerings and answer questions.

For some companies, communications isn't about educating workers. Some businesses are using a sophisticated "cost transparency" approach to give employees highly personalized information about health costs to help them manage their own health expenses.

Two years ago, First Horizon Corp., a self-insured bank-holding company headquartered in Memphis, Tenn., decided to reduce health care costs by limiting health plans for its 4,000 employees to a preferred-provider organization and a consumer-directed health plan.

Because the consumer-directed plan has a considerably higher deductible and lower premiums, First Horizon wanted to encourage employees to choose it over the PPO.

To sweeten the package, First Horizon bundled the consumer-directed health plan with a unique, innovative "cost transparency" program called Transparency Messenger.

Created by Change Healthcare Corp. in Brentwood, Tenn., Transparency Messenger sends employees regular email alerts about ways they can save money on medical, dental and pharmacy care. What's unique about these alerts is that they are customized for each individual employee. Change Healthcare has access to each employee's health claims records, in compliance with the Health Insurance Portability and Accountability Act, and analyzes the data to generate savings opportunities tailored to an employee, his or her network and local area.

"We spent a lot of time working with the HR team to understand the dynamics of the culture and to build tools, such as interactive videos, that explain the importance of cost transparency in health care," said Doug Ghertner, president of Brentwood, Tenn.-based Change Healthcare.

Ghertner's firm recently helped First Horizon encourage its employees to be more conscientious about saving money on health care via a tool called Transparency Messenger, which sends out regular alerts -- customized to each employee -- about ways they can save on medical, dental and pharmacy care.

The first step was educating employees at the time of open enrollment about the importance of cost transparency and helping them "take ownership of their own health care," he said.

So far, the program has been a success: After one year, the number of employees choosing consumer-directed health plans at open enrollment has gone from 10 percent to 25 percent, a 150-percent increase. The number of employees engaged in using Transparency Messenger rose to more than 50 percent in the first year, and remains at that level.

"Change Healthcare's proposal fit with our benefits strategy," said Kim Anderson, manager of total compensation administration for First Horizon. "We wanted to help our employees understand how they can manage both their care and expenses successfully."

First Horizon's approach is at the far end of the marketing spectrum, said Aon Hewitt's Hoff. "Ten to 20 years ago, we looked at 'targeting' as (identifying) average demographics. ? Nowadays, demographics still matter, but attitudinal data and behavioral participation are allowing us to tear a page from the marketer's book ? to ultimately change behaviors.

"On the other hand, there's more diversity," he said. "It used to be 'one size fits all.' Today, I think the basics are a multichannel approach. Make sure you're looking at all that as part of your toolbox."

MARLENE PROST is a journalist in Audubon, Pa. She can be reached at riskletters@lrp.com.

June 1, 2012

Copyright 2012© LRP Publications