March 20, 2024

What do employees do when they have questions regarding their benefits?  Where can they go to find information?

One solution is a benefits navigation platform that summarizes all benefit plans within one app, providing on-demand help, whenever and wherever it is needed.  This allows employees to serve themselves at their convenience, right from their mobile phone or tablet.

From within the benefits app, employees and their families may have access to:

• Plan summaries
• ID cards
• Deductible and Out of Pocket Accumulations
• Provider Search
• Chat and/or Secure Messaging
• Virtual care

If employees need additional help, healthcare concierge staff can assist to:

• Find a specialist or facility and book an appointment
• Estimate health costs
• Review medical bills for accuracy
• Answer benefits questions

When employees are able to access the information they need, they have greater benefits satisfaction, lower healthcare costs, and improved wellbeing.

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February 29, 2024

At Watko, a focus on growth is a basic characteristic of our work culture. Having a growth mindset allows us to serve our customers better by learning new ways to improve practices, impact vendor performance, and make a measurable difference in a momentous way year in and year out in every relationship. Below are some examples of how we focus on this in our business:

• Growth by deepening the relationships with our existing customers, while recognizing that every customer is unique. Understanding objectives over time with a focus on listening and staying in touch is fundamental within our practice.
• Growth by keeping an open mind toward new solutions that meet typical challenges in a refreshing and new way.
• Growth by always seeking ways to introduce our services to new opportunities available in the market.
• Growth through proactive education and communication – Educating during open enrollment is the norm but sometimes not enough. There are tools to communicate benefits year round.
• Growth in benefits offerings – Millennials and Gen Z are now the majority of workers in today’s workforce, so plan designs and employee offerings should be updated and reviewed on a regular basis. Offering voluntary benefits can also help bridge the coverage gap and allow flexibility for employees to decide how to spend their discretionary income on products that may fit their needs.
• Growth by leveraging vendor capabilities – Vendors are always updating their plans and offering new features. Growing within your existing plan is fundamental and something many planholders forget to consider.

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February 15, 2024

For some employees, their annual open enrollment is the only time of year that they are engaged with their benefits. When employers place a focus on year-round benefits education, employees have the information they need to make informed decisions, and they will utilize their coverage more effectively.

Employee benefits aren’t always easily understood. Therefore, a monthly communication strategy can begin with topics such as health care terms (deductible, coinsurance and copay) or how to read a benefit summary.

As the year progresses, topics can include how to review medical bills for discrepancies, when you can conduct a telehealth visit, qualifying life events or how to conduct research in order to save on medical procedures.

Employers can tailor their plan communication based on their industry and the demographics of their workforce. Utilizing various methods (ex: emails, lunch and learns, texts, etc) can be helpful to maintain engagement.

Communicating about benefits year-round will certainly be helpful by the time the next open enrollment comes. Employees will be more confident and are more likely to examine their existing coverage and add coverage to fill gaps if their lifestyle or needs have changed. Overall, taking the time to provide benefits education can reduce healthcare costs for employers and employees in a time when healthcare costs continue to be on the rise.

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February 1, 2024

I watched the last night. If you haven’t watched it, there’s much to learn and it is very entertaining. His Yogi-isms and story in general are epic.  Makes me think a lot about the way we run our business. How many times are you advocating for your customer and it just seems to take much longer than it should to get the right answer?  “It ain’t over ’til it’s over” is a classic. The “always do the right thing” and “never give up” paradigms are timeless.

Which yogi-ism is your favorite?  Check out the link below.

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October 26, 2023

While it’s true that most self-funded health plans have over 200 employees, there are more creative self-funded plan options for smaller groups, including groups that have fewer than 10 employees.

In fact, we have experienced an enhanced level of stability for those employers that decide to implement a benefits captive strategy.  Being self-funded through a benefits captive provides greater stability on large claims experience, along with the advantage of participating in lower-than-expected claims experience.  Being able to leverage the marketplace based on Captive size also provides great advantages for smaller employers.  In addition, gaining transparency with Prescription rebates and financial assistance with Specialty drugs are other advantages of being self-funded vs staying fully insured.

There are various components of a self-funded plan.  Employers who are self-funded usually select an Insurance Carrier or Third-Party Administrator (TPA), a Pharmacy Benefit Manager (PBM), and a Reinsurance carrier (Stop Loss coverage).  There are pros and cons associated with every vendor in the market.

Remember that being fully insured does not mean less long-term risk for small to medium sized employers.

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October 12, 2023

Navigating the healthcare system can be confusing and time-consuming for employees and their families.  Member advocacy programs help people make better decisions about their care by combining proactive guidance, a streamlined experience, and compassionate service.

What can a healthcare advocacy program do?

• Find a high quality, low cost provider (doctor and/or facility)
• Provide cost estimates and comparisons of multiple providers
• Facilitate connection with a virtual care provider
• Book an appointment
• Answer questions about benefits and how they work
• Review medical bills and compare them to the Explanation of Benefits from the health insurance plan
• Explain medical savings accounts, such as HSA, FSA, and HRA
• Identify ways to save on prescription medications
• Help manage a new diagnosis or ongoing condition

Providing employees the help they need, when they need it, leads to greater benefits satisfaction, improved wellbeing, lower healthcare costs, and greater engagement at work.

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October 5, 2023

I would like to take the opportunity to thank our team at Watko for doing such a wonderful job supporting our customers while I was away on maternity leave.  The team we have here at Watko never ceases to amaze me.  Being able to take the time I needed to be with my family, knowing that our customers would be taken care of, is certainly something I will never take for granted.  I was able to lean on our Watko team and know that they would connect with our customers in the same manner that I would without skipping a beat.  Being able to accomplish this, especially during our busiest time of the year, truly speaks volumes to our team’s dedication and the way we embody working together to solve every customer’s unique needs.

Please welcome the newest member of our Watko family, Jace Hawkins!

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September 6, 2023

Every company is concerned about increasing costs across their business. Providing competitive benefits plans becomes more complicated as health costs increase. Many companies are spending as much as 50 percent of their health claims on prescription claims and in some instances have no awareness of this. In the next year, outpatient prescription drug costs are projected to grow 16%. A large portion of this growth is due to an increase in specialty drug utilization and prices. This growth is expected to be in behavioral health, cardiovascular, neuroscience, and oncology related services. Offsetting this growth is the continued uptake of biosimilars, which has increased over the last few years. 

Having a proactive approach to introducing biosimilars with patient incentives and patient advocacy can help stem this growth in costs. These strategies are difficult to implement or even consider in a fully insured health plan.  Having a strategy to address these challenges can help enhance quality and costs in plan sponsor benefit plans.

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July 28, 2023

The popularity of weight loss drugs, such as Wegovy, has reached an all-time high, leading to more individuals asking about these medications. As a result, employers are being faced with the difficult decision of whether or not to cover these expensive medications.

There is a range in cost for these medications, running from $300 to $1,600 per month, as well as a variance in effectiveness. When the drugs are paired with healthier lifestyle choices, long-term outcomes are more likely. However, some of these medications haven’t been on the market long enough for concrete outcomes and any potential side effects to be observed. There are concerns about whether or not the medications will lead to long-term weight loss and whether or not the medications will need to be taken for an indefinite period of time.

Meeting employee desires while mitigating Rx spend can be challenging. We are seeing more and more insurers and Pharmacy Benefit Managers cracking down on prescribing practices for these medications. Physicians should be accounting for age, body fat, satiety differences, individual medical factors and psychosocial factors when determining which medication will best support their patient’s health care needs. In addition, restricting access to individuals who need the medications the most will alleviate shortages and ensure they are able to access them.

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July 13, 2023

More of our customers are engaging in ways to enhance provider access while improving patient care and potentially lowering health costs.  This is the foundation of Direct Primary Care (DPC).  Provider access is a real issue as witnessed by the amount of time it takes to get an appointment with your primary care physician.  When a DPC Clinic has a provider to patient ratio of 1 to 500, same day visits are attainable and patients experience an enhanced relationship with their provider.  We have also seen chronic condition health management be managed in an orchestrated and “as needed” strategy through DPC.  This has significant potential in improving care while lowering costs.  Last, integrating a DPC solution can be done in a variety of plan settings whether fully insured, self funded with a carrier or through a benefits captive.  For more information, contact us at info@watkobenefit.com.

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