Today’s world has become one of instant information and two-day delivery. We want everything quickly and conveniently—and this includes information about our health care benefits. For this reason, health care benefits administrators and health insurance companies offer access to employee self-service (ESS) portals. By creating an online account, health plan members gain access to information they can use to manage their health care benefits—on their own terms, whenever they need it, 24/7/365.
The COVID-19 pandemic has pushed the need for digital and virtual services forward, as health care support has moved out of the office and more toward telehealth and virtual office visits. In a recent study from CVS Health1, 57 percent of respondents indicated they had used a virtual visit to connect with their provider. On-demand and convenient health care information and guidance is now more popular than ever before, helping consumers feel safer within their own homes rather than making a trek to the doctor’s office. In fact, digital access to health care information has become the expectation of consumers, rather than the exception.
ESS portals, which can be accessed anywhere a plan member has an internet connection, continue this trend. Self-service functions make even a phone call to customer service unnecessary in many cases—it all depends if a plan member is finding what they need within portal.
What makes a good ESS portal great?
Health care benefits can be time consuming or even confusing for plan members to manage. So any resource that helps make this easier can help ensure members are getting the most from their benefits. When members make smart decisions like visiting network providers, scheduling preventive care services, and using spending account dollars to cover expenses, they’re taking steps to save on their health care costs. Plus, using available health care services helps them stay in good health, which can curb spending associated with chronic, unmanaged conditions.
Strong ESS portals are a win-win for both employers and plan members, and the more available features and convenience, the better. This can include:
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- Ability to access the portal from any desktop or mobile device.
- Real-time updates, so plan members are always viewing the most current information.
- Comprehensive access to all benefits plan coverage, including medical, dental, vision and wellness.
- Access to spending account balances for help tracking.
- A provider search function, making it easier to stay in-network.
- Forms and ID card downloads, for efficient use.
What works: tips for success
The best plan for ESS portals is to intuitively provide resources, information and materials that give plan members what they need to manage their benefits. This adds to their value and convenience, as well as plan member satisfaction with the portal. And it stands to reason that if a portal successfully provides the resources members need, they will continue to use it for management of their health care benefits and well-being.
Meritain Health is experiencing success with the ESS portal we provide for our plan members. Recent member feedback has been positive, with usage percentages increasing while calls to Customer Service have gone down. Translation? While we’re always working to enhance the tools we provide members, the data is showing we’ve been on the right track.
So, what does the Meritain Health member portal include?
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- Mobile-friendly display
- Mobile app technology that provides access to the live portal with real-time updates
- Claims, Explanations of Benefits (EOB), and out-of-pocket spending with progress towards the annual deductible
- Coverage information (dependent on what is offered, including medical, dental and vision)
- Online find-care search options
- Spending account balances
- Downloadable forms and ID cards, including the ability to send a copy of your ID card to your provider from your desktop or mobile device
- Ability by members to submit a claim for reimbursement
- Ability to update and submit other insurance information
- Ability to view visit limits/number used for services, such as chiropractic, acupuncture, etc. (if covered by the plan)
In addition, we’ve recently refreshed the look of our portal dashboard to give visitors access to key, frequently searched information in one convenient location, rather than buried behind menus. It’s just one part of our efforts to keep member resources fresh and valuable, continuing our mission to make health care benefits easy to understand and use as Advocates for Healthier Living.
Successful outcomes
It’s all in the numbers. By providing what our plan members are looking for, we’ve tracked several overall positive stats. These include:
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- 1 percent of members using the portal did not contact Customer Service within 48 business hours after use (this increased from 89.5 percent in 2020).
- Member utilization of the portal is quickly growing, with a recent 3 percent increase, and expanding beyond the 10 percent increase experienced in 2019.
- Mobile access continues to grow, as 32 percent of member sessions are accessed from a mobile device.
Boost your portal value to boost member plan use
By providing the health plan information members need, you can offer value through your ESS portal. This helps plan members access and use their benefits information for the best possible health outcomes, as well as savings for themselves and the plan sponsor.
About Meritain Health
Meritain Health is an independent subsidiary of Aetna and CVS, and one of the nation’s largest employee benefits administrators.2 We have the resources of a national carrier coupled with the unique flexibility and devoted service of a third-party administrator (TPA).
Our unique, fully customized plans offer simplified solutions for medical, dental, vision, FSA, HRA, HAS and COBRA administration, and much more. Plus, we provide the extras clients need to manage their benefits offering, centered around our core pillars: cost avoidance and prevention, access, payment integrity and actionable data.
We provide easy-to-access consultative solutions across all products, including trusted implementation specialists, multi-tier support teams, nationwide service centers, online portals and our mobile app for members. Our dedicated client advocates serve as a single point of contact for the client, providing proactive assistance and ongoing support.
- CVS Health: The 2021 Health Care Insights Study. 2021, page 12.
- Business Insurance; Largest Employee Benefit TPAs (as ranked by 2019 benefits claims revenue); May 2020.
