Individual medical questionnaires, personal health questionnaires, health risk surveys, enrollment forms with health questions…..No matter what they are, they are designed to do two things:
- Help an Insurance Company or a Self-Funded plan appropriately price your plan for the known risks
- Help a plan to identify areas where a particular service or treatment can be sourced for less money
Both you as the employer and almost all of your employees hate the idea of Individual Medical Questionnaires (IMQs). They feel intrusive, ask for too many details, are time-intensive, and employees don’t want to pay more or have their conditions excluded.
But, on the flip side, if neither you or your insurance vendor can price for the financial risks of your health plan, your company becomes subject to an increased rate to help cover the unknown. And no one likes inflated, overpriced, costly health insurance. You don’t like offering it coverage at higher prices and your employees don’t cherish it as a wonderful experience.
So what do you do? You explain the process and put in privacy filters and protocols. Or you get lucky enough to leverage your current plan’s data so you and your employees don’t have to go through this exercise.
If you have between two and 35 employees on your health insurance plan, the IMQ exercise is going to be worthwhile. If you are lucky to live in Texas where you can get some level of health insurance claims data all the way down to two employees, I suggest using it as a litmus test to see if you are “winning” or “losing” as the Premiums Paid vs. Claims pPaid out on your behalf. Unless the numbers are horribly adverse–do it. Even as a spot-check against your current plan, it is part of being a good steward to your company and? to your employees’ paychecks.
If you have between 35 and 100 employees, I’m still an advocate for the IMQ process. Sure, there are vendors that will use your current claims data and also some kind of predictive modeling like GRx (a software that turns your census data into a risk score), but the IMQ is often a better tool at this size to price your coverage correctly. I love the idea of just using GRx and getting prices that are 35% lower than your current health insurance costs, but I hate getting a 49% renewal in year 2 that puts you right back where you started. Using the IMQs, along with additional scoring tools like GRx, puts us on a much better track to design a 3 to 5 year strategy.
And, if you have 101 to 300 employees, this one is a toss-up. You may have great claims data at your disposal, or you might fight the same plight as the 35 life group. Hopefully, you have great claims data and we can use that to find a baseline price for fixed insurance costs. Then we can leverage that same data to start to purchase your healthcare at a lower fee–saving both your insurance costs and your employees’ pocketbooks.
Over 300 employees — don’t even think about it. Leverage what you have or use predictive modeling only. And, if your claims data isn’t good enough, go ahead and leverage a new vendor who will provide you with better data and better reporting. You hold the keys to the kingdom once you have enough meaningful presence to dictate what you deserve.
How to position it to your employees?
First, we suggest using a secure, electronic collection method that is done by a 3rd party so your company has an arms-length distance from viewing the private employee health data.
I know collecting a paper form or pdf is sometimes easier than forcing an employee to create yet another unique login and password, but this level of security is important so your organization can build employee trust.
Here is the verbiage we use with our clients:
Dear XXXX,
In order to provide you with the best value possible from our health insurance plan, every employee needs to complete a Personal Health Questionnaire (PHQ). This questionnaire’s sole purpose is to help potential health insurance carriers assess our risk as a group and determine appropriate premiums. Please complete your health questionnaire by 5 pm Friday XX date.
Your privacy is of utmost importance to XXXXXXX, which is why we are using an outside 3rd party service to gather this information. XXXXXXX employees will NOT be able to view this information at any time. This includes employees in human resources and finance who administer the health insurance plan for the company. Also, completing a questionnaire is NOT a commitment to enroll in benefits; you can waive benefits later when it’s time for open enrollment.
Please complete the personal health questionnaire by 5 pm Friday XX DATE. Click the link below to get started immediately:
-Link to IMQ service-Code to use when registering: EXXXXXX
