MODULE EXAMPLE: Benefits Cost Calculator

Problem Objective Solution Results

Problem

The complexity of benefits management can be enormous for large organizations that try to give their employees the best options in benefits. This complexity, coupled with a sizable number of employees, results in high costs to manage benefits and help employees make optimal decisions.

Objective

A large energy company was in the process of implementing a new array of health care and prescription drug options and wanted to give employees and retirees a useful tool to help them make the best choices based on their personal circumstances and preferences. The organization needed a tool that would apply national statistics for costs of doctor visits, hospital stays, and other metrics to calculations as well as assist over 14,000 employees and retirees with decisions regarding their flexible savings accounts.

The company specifically stated these product requirements:

• Data/information must be presented in a user-friendly, easy-to-navigate presentation format
• Each employee/retiree must have their health benefits and costs calculated based only on the plans that are available to them (medical, dental, vision, prescription)
• An employee/retiree must be able to select how many dependents should be covered for a health plan
• For type of plan (medical, dental, vision, prescription), a comparison between all of the plans available to the employee should be shown so that the employee can determine which plan is best for them
• Each employee must be able to input estimates as to number of office visits, prescriptions, etc with their deductibles as well as out-of-pocket health and dependent care expenses so that the calculator can help determine the amount to place in their health care and dependent care spending accounts
• An employee/retiree must be able to view other documents during the time they are entering their elections. These documents could be details about the different types of plans, enrollment screens, etc.
• Details about each plan must be input each year by the HR Department (deductibles, in/out network, etc.)
• List of available plans and costs for the employee being processed must be obtained from SAP weekly
• General information about the employee must be obtained from SAP daily
• Multiple employees/retirees must be able to use the cost calculator at the same time and experience quick response time (especially during the enrollment period when a large number may be accessing the calculator at the same time)
• Since benefit plans offered to employees/retirees change frequently, support must be provided with rapid response time
• System must be available 24 hours a day / 365 days a week (especially during the enrollment period)
• Must be able to access the cost calculator via the Internet using either work or home PC's
• Product must be reliable and stable so that it is available at all times
• Plan information (availability and costs) to use in the calculations must be obtained from SAP weekly
• General employee information must be obtained from SAP daily

Solution

The PortBlue solution consists of a set of easy-to-use modules to meet the company's business objectives:

• Researcher Module: This module serves as the repository for data about the company's benefit options and national statistics to be used in calculations in the Employee module. Data in the Researcher Module is maintained by designated customer personnel.
• Employee Module: This module provides employees with secure, customized comparisons and solutions, unique to their profile and circumstances, allowing each employee the ability to evaluate the overall costs of various health care options available to them.
• Statistics Module (optional): This module tracks user responses and generates aggregate statistics for the company that can be used in evaluating its benefit options.

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Results

PortBlue's solution presented the following benefits to the company:

• Easy-to-use: The modules follow an intuitive outline structure, organizing different topics into meaningful pages and sections that can be navigated in recommended sequence or in user desired order.
• Customized: The modules apply an expert framework to unique employee/retiree data to generate customized comparisons and solutions for employees/retirees. The employee/retiree presentation is filtered and customized to individual profiles:
  • access to various plans (medical, dental, vision, prescription)
  • number of dependents for each/any plan
  • individual estimates (or recommendations from the Researcher Module) as to the number of doctor visits, hospital visits, prescriptions, etc used during a year
• Easy-to-Understand Output: Modules use intuitive tables and graphs to convey potential costs and savings of various employee/retiree alternatives
  • Quantitative results to
    • compare to the employee/retiree total annual costs (medical, dental, vision, prescription) and determine which plan is best for them
    • help determine the amount to place in their health care and dependent care spending accounts
  • Qualitative insights to describe unique features of various plans
  • Use of attachments for brochures and other documents that are accessible as the employee/retiree is using the module
  • Links to other relevant websites
• Accessible: Web-based technology allows all users to access and print the modules from any computer with a standard web-browser
• Easy-to-Maintain: The researcher module interface allows the company to maintain/update the module independently
  • Weekly and daily XML feeds from SAP automate most data processes
  • Changes to details about each plan can be input at any time by the HR Department (deductibles, in/out network, etc)
  • Minor modifications or enhancements to the module structures are included in PortBlue's monthly licensing, hosting, and maintenance fee