Choosing the Right Preventive Care Benefit for Your Organization
Healthcare costs keep climbing; KFF put the average 2025 family premium at $26,993, up 6 percent. Preventive care benefits help employees catch problems earlier and stay healthier, but only if people use them.
Key Factors to Consider
ERISA compliance, integration with existing plans, employee engagement potential, measurable ROI, and administrative simplicity. Start with those.
ERISA Compliance Matters
Any supplemental benefit you sponsor generally falls under ERISA, which sets standards for plan documents, fiduciary duties, and reporting. Look for solutions built for compliance from day one, not retrofitted later.
Integration With Existing Plans
The strongest preventive care benefits work alongside ACA-compliant major medical coverage and get used first. Employees shouldn't have to choose between plans; the two should complement each other.
Engagement and Administrative Simplicity
Engagement follows the reward design. When rewards appear in an account after a verified preventive action, people use the benefit. Participation-point programs sit unused. On the administration side, look for a benefit that adds to your current plan without rip-and-replace.
Measuring Success
Look for programs that give you clear metrics: participation rates, completion rates for preventive care, claims reduction data, and overall cost trends. WellthCare delivers those metrics through its patent-pending Readiness Index™, which analyzes real usage data to project savings. Without those numbers, you can't demonstrate ROI to leadership.
This article is for general information only and is not legal, tax, or medical advice. Employers should consult their own advisors.