HR Takes on Health Claim Help Responsibility

June 2, 2010 (PLANSPONSOR.com) – The majority of human resources professionals recently polled agreed with the notion that they have a professional responsibility to help employees sort out problems with their health insurance.

Sixty-six percent of those in the survey by the Society for Human Resource Management (SHRM) either agreed or strongly agreed with their responsibility assessment. A quarter disagreed and 9% strongly disagreed, according to SHRM.

In the poll, 6% of respondents said they have changed carriers in the past five years because of long processing times for health care claims. Eighteen percent said they had changed insurers in the past five years because of poor overall customer service.

Six percent of respondents have a provision in their contract with their health care insurer that provides incentives to decrease the time that it takes for claims to be processed, SHRM said. The most common incentive is performance guarantees.

“As a result of health care reform, we can expect to see more and more employers look to their health care providers for alternative ways to provide cost-effective health care options. Employers that provide health care to their employees may be more likely to expect better customer service and increased efficiencies from providers,” said Evren Esen, manager, SHRM Survey Research Center.

Half of the organizations participating in the survey are privately owned for-profit organizations. One-fifth are publicly owned for-profit organizations. The rest are nonprofit organizations, government agencies and other employers. Sixty-four percent have fewer than 500 employees.

The manufacturing industry is the largest sector among poll respondents, at 13%, followed in size by health care and social assistance organizations; professional, scientific, technical, legal, engineering and similar service sector employers; and by retail and wholesale trade organizations.

Three-fourths of the SHRM members polled February 4-11, 2010 work in U.S.-based operations; the rest are multinational employers.

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