Last week I attended the Benefitfocus Seller Place 2020 conference. Benefitfocus has repositioned itself from a software company to a benefits platform provider with solutions focused on engaging and improving the user experience while helping employers and employees make more informed decisions and reduce cost.

Benefitfocus has 25m consumers, serving 150k employers with 15.5m employees, partners with 700 brokers, 144 medical carriers, 50 voluntary suppliers, and has 1,700 associates. The BenefitSAIGE platform processes 42m transactions per week, worth $18bn between BenefitFocus and its ~100 payroll partners with a 99.9% first pass yield. 100% of data is delivered on time during open enrollment and 100% of payroll and enrollment files/data transmitted is encrypted.

Why Benefits Engagement Matters

The importance of engaging employees with benefits for attraction and retention of talent cannot be underestimated. Benefitfocus presented data showing that there is a 19.3% employee turnover rate in the U.S. Employees are spending more on benefits than all other expenses except for home mortgages and car payments, yet they are getting less value. Since 2009, medical costs are up 54%, deductibles up 162%, while worker earnings are up just 20%, and 74% of employees are confused by their benefits options. In 2018, $3.65 trillion was spent in the U.S. on annual health costs, 20% of the GDP. Family costs have increased 2x faster than wages in the last decade, and 64% have delayed receiving care due to the costs involved.

BenefitSAIGE Platform Notifications

Benefitfocus has made significant investments in its BenefitsSAIGE platform, including the use of AI. BenefitSAIGE is event-driven: instead of benefits being an annual event, you can enroll and change benefits when you need to. BenefitSAIGE engages with participants throughout the year, including participants receiving a proactive notification when something changes. Every person who comes to the BenefitSAIGE platform receives push messages on a weekly basis that will help them to make informed decisions and save cost. A dedicated content manager helps to ensure compelling content is delivered throughout the year. A few examples of notifications are:

• If an employee gets married, they will receive a message (email or text) on the top 5 things newly married couples needs to do regarding benefits
• If an employee moves, their auto insurance may change, so BenefitSAIGE will notify the employee to review insurance products that the platform recommends
• Personal reminders such as ‘today is your core strength training day’ or ‘it’s time for your doctor’s appointment today’
• Cost-saving notifications such as ‘the prescription you just filled can be $3 cheaper at the CVS pharmacy near you’.

Examples of Benefits Achieved

The following are examples of the type of benefits that can be achieved using the BenefitSAIGE platform:

• Ability to make a company HR admin a super-hero! For example, in looking at medical claims and trying to get a handle on costs, with one click you can get the top 10 categories driving cost and the dollar amount spent on (say) cardiovascular, with the number of claims
• ER costs have risen dramatically in the last 10 years. As such, you can identify the types of claims and diagnosis appropriate for alternative care. An example was given of a Benefitfocus client with high ER costs that implemented telemedicine communication and realized a $50k saving with a potential of $400k over 2 years
• Ability to run a report on zero cost claimants that are never going to the doctor (even for preventative physicals) and deliver messages to inform them they are covered for no cost for preventative annual visits and/or incentivize them to open a Health Savings Account and then see the impact it has
• A midsize employer with a lot of non-compliant prescription diabetics created member populations to track strategy effectiveness and realized a 24% increase in medication compliance, getting employees the right medication, and increasing employee engagement
• A large employer who was seeing double-digit pharma cost increases y/y, analyzed data and found improper billing/fraud and was able to reduce y/y spend by ~10%
• Open enrollment daily insights to HR admins including number of log-ins, elections, comparison of plans selected vs. last year, number and types of questions asked; allowing HR admins to proactively communicate anything that needs to be clarified
• Individuals enrolling in benefits are given insights; for example, ‘We recommend 2019 HDHP Premier as your medical plan, which can save you $3,822 on premiums compared to the PPO standard plan’. It will then provide further information on Total Risk and Savings Opportunity.

2020 Roadmap

Benefitfocus’ planned enhancements for 2020 include:

• Integrated case management capability to allow employees and employers to have full access to case history
• Email notifications will incorporate employer branding, including client logo and email styles
• In Q1 2020, in addition to email, text notifications will be made on mobile devices
• Increasing the number of broker partners from 700 to 1,000.

Outlook

Benefitfocus’ emphasis on using its BenefitSAIGE platform to provide proactive communication throughout the year gives it a unique position as a benefits partner in helping employers, employees, brokers and carriers to make more informed decisions, reduce company and employee costs, and improve engagement.

In terms of challenges, Benefitfocus needs to ensure that its notifications continue to add value and not lead to communication overload. But that can be overcome if the messages are short and succinct and help to make better decisions while saving money. Also, while there is merit in being a premier platform provider, Benefitfocus should let it be known that they are still a service provider with a Benefits Center and specialists able to answer questions on the phone when needed.

NelsonHall expects to see double-digit growth in Benefitfocus products bought and revenue generated in 2020.