Health Plan Responsibilities

First, when it comes time to craft a health plan or revisit the current plan’s language every 2 years or so, it’s important to keep in mind the guiding principles of your organization. Think about your corporate philosophy. Great health plans reflect the philosophy of the organization.

Have you ever heard the old quote “Getting what you want isn’t really hard. Knowing exactly what you want is the real challenge”? Well, it applies in this case as well as countless others.

“Getting what you want isn’t really hard. Knowing exactly what you want is the real challenge”

Balance and Sustainability

Next, know what you want while being realistic. Each organization has to determine its own balance of costs and benefits with a nod to the reality of its own financial condition each year. Gauging the ebb and flow of needs over time and the specific requirement that are unique to your organization’s area of focus must be thoroughly considered. Review your corporate/organization philosophy and let those words guide you in making decision. in the details of your health plan. Make it specific to your employees needs and your corporate resources. This will guide the rest of you your benefit teams as they design and build your Health Plan, be mindful of Privacy considerations in regards to HIPAA, active involvement by your benefits department means some access to private details of your employees’ health.

Health Plan Level Up: See the Effects

Then, define your level of corporate responsibility. Does your company want to be an active participant in the promotion of your employees’ health or would you prefer to be passive by just supplying a range of options to your members? Doing so has been shown to help reduce costs while helping improve the wellbeing of members, which in turn boosts employee happiness.

Answer to Yourself

Also keep in mind that, most executives already believe that Corporate Social Responsibility (CSR) can improve profits. Consider if societal goals of a philanthropic or charitable nature important to your organization. Are they?

In essence, know who you are as an organization: Coverage limits, settlement authority COB provision clean? Primary vs secondary coverages. Reports? What percent of premiums do you cover? Employee contributions? If you know who you are, crafting your plan will come together naturally.


In conclusion, remember that your Health Plan says a great deal about your business/organization. It illustrates through the coverage provided, options, fees, and more, how exactly your organization see itself in the world and in relation to the plan members. Your Corporate Philosophy should actively guide decisions throughout the organization and the Health Plan is no exception. Balance is essential because without it a plan is not sustainable and requires higher levels or upkeep and costs.

A fit Health Plan addresses the needs of the members and in return, helps promote happy, productive employees.

Remember that, a 2017 Deloitte report indicates that ~80% of executives rate employee engagement as important or very important. In contrast, only 22% felt they were “excellent” at building a positive employee experience. Furthermore, 59 percent of respondents feel that their companies were under prepared to address the employee experience challenge. This is your time to do your part.

You can make your health plan a winner and improve employee satisfaction, reduce plan expenses and see a huge reduction in the number of phone calls and emails you receive from confused plan members.  If you have any questions or would like some additional information, we are always here to help. Call us to day. 1-800-813-4054

Vengroff Williams is an industry-leading Health Plan subrogation provider for Fortune 500 and Global 2000 firms.