Be a Health Insurance Advocate in Your Workplace
Conversations with employers about diabetes are difficult. In a recent survey conducted by No Small Voice, only 14% of respondents highlighted their employer as a contact they would go to for help when faced with insurance questions. The satisfaction of the information provided from the employer was rated second to the bottom, ironically only insurance companies were lower. Also, feedback to the employer was rated lowest on the list of potential services. Employees are concerned about the value the conversation will have verses the potential impact it could have on their job. Because of the limited dialog between employers and the employees, it is unlikely your employer is really aware of the challenges people with diabetes face when trying to work through insurance processes.
Advocating for yourself and for other people living with diabetes at work is a really important skill. I believe employers could improve the satisfaction with their insurance plans just by providing more information as insurance plans are being selected. 67% of No Small Voice Survey Respondents did not receive information specific to T1D to help them make a decision about the insurance plan they should select, and yet many employers are not aware that this is an issue. Having a conversation with your employer can help you to resolve short term issues and provide guidance for longer term improvements.
The first step in the process is understanding what changes you are advocating to be implemented. You might have an urgent need to appeal a denied insurance claim. You might be thinking about longer term requests for information like the availability of cost information when selecting an insurance plan or better access to new technology. You might also want to have a conversation discussing the high cost of insulin and ideas to minimize the cost while your deductible is being met. Depending on the size of your company, the urgent day to day support questions might be managed by a different group than the person who is managing the overall selection of your insurance plan. As you are thinking through the conversation you are going to have, it is also important to consider the audience and the timing. If you company just raised your deductible 20%, it is unlikely they will be willing to entertain a conversation associated with costs, but would be willing to help you navigate your denied claims.
Know who to contact
This person will vary based on the size of company where you work. In a large company you are most likely looking for a VP of Benefits in Human Resources. In a small company, it is most likely the owner who makes the decisions for health care coverage. Don’t be afraid to use all of your available resources to find the correct contact – online staff directory, LinkedIN, log a benefits ticket, ask co-workers, contact your HR resource. It may take a few conversations to locate the correct person. If you are having a conversation with the wrong HR person, remember to thank them for their time and ask them if they know who the correct person is.
Prepare for your conversation
Try to remove the emotion and focus on the facts. You may even need to practice the conversation a few times. Attend the meeting with a simple request such as I have 7 denied insurance that I am struggling to get approved or I would like to discuss getting more accurate information for people living with diabetes at the time of open enrollment. Be prepared with any documentation you may have collected through the process including copies of the formulary, cost information, people you have contacted, an overview of the efforts you have already made to resolve the issue, denial letters, research, etc. I use Track Communications at No Small Voice to track the efforts that I have made to resolve issues. So far this year, I have had more than 41 phone calls and emails to resolve our denied claims. Our HR team had no idea the length of time required to work through issues. It is important to remember that even though you have contacted your HR, many of these requests will still require engagement from the insurance company. I have found that faster progress is typically made when an employer is engaged in the conversation with the insurance company.
Start your conversations early
Finding your HR contact the week before open enrollment is way too late to make a change for that year, because the plans have already been selected for the upcoming year. In a big company, selecting the insurance plans is a lengthy bid process and making changes to the plan requires approval from HR as well as the insurance company. You would be able to request assistance in selecting the plan that would work better for you and understanding the cost. The length of time and request you are making will vary by company to implement, so be patient, persistent, and polite.
Additional support to help prepare you for your conversations:
DPAC – A set of worksheets to help you advocate for sharing the cost of insulin prior to your deductible being met.
JDRF – An insurance toolset including templates that can be used to email your HR contact to advocate for requesting support to select your insurance plan, cost information, or influence future insurance decisions and the technology selected.
NDVLC – Similar information to DPAC to advocate for sharing the cost of insulin prior to your deductible being met.
No Small Voice – Survey information to help substantiate challenges you may be facing with your insurance company.