Midyear Health Plan Check-In: Are You on Track?
A midyear review today can prevent coverage issues tomorrow.
We’re halfway through 2025—an ideal moment for SMEs to pause and evaluate: Is your current health plan performing as expected? Are your employees using the benefits? Are you getting value for your investment?
A midyear check-in allows HR and business leaders to spot trends, make adjustments, and realign benefits with your workforce’s needs—before renewal season.
Why Conduct a Midyear Benefits Review?
✔ Prevent underutilization of available health services
✔ Identify gaps in coverage based on emerging employee needs
✔ Measure return on investment in real time
✔ Fine-tune communication strategies to boost engagement
Being proactive now can save costs and improve satisfaction later.
Key Metrics to Monitor
1. Utilization Rate
Are employees using their outpatient, inpatient, APE, or mental health benefits?
Low usage may indicate poor communication or accessibility issues.
2. Reimbursement Volume and Types
What kinds of claims are being reimbursed?
Frequent out-of-network claims may signal limited provider access or unawareness of the accredited network.
3. Sick Leave & Absenteeism Trends
Compare sick leave trends from Q1 to Q2.
Has absenteeism dropped since implementing your current HMO plan?
4. Employee Feedback
Run a short survey: Are your employees satisfied with their current coverage? Do they know how to use it?
5. Mental Health & Preventive Care Engagement
Are staff making use of mental health consults or wellness screenings?
If not, consider reintroducing these benefits through awareness efforts.
What to Adjust if You’re Off Track
Reintroduce underused benefits via internal campaigns
Simplify access by using SmilePH or reminding staff about Doctor Anywhere
Add optional coverage (e.g., dependents, dental, mental health) to meet new workforce demands
Prepare to scale or downgrade tiers depending on actual use and team growth
Stay Ahead with a Midyear Plan Audit
Book a midyear audit with Purple Cow to review usage, satisfaction, and alignment—so your health plan keeps delivering value for your SME.
