Health Plan Design & Strategy
Health Plan Design & Strategy
Health Plan Design & Strategy is the definitive course for benefits professionals who want to master the art and science of designing health plans that control costs, improve outcomes, and attract and retain talent. Across 15 modules, you will learn every major plan design strategy — from HDHP+HSA and Value-Based Insurance Design to Direct Primary Care, Centers of Excellence, behavioral economics, and emerging benefits. Built for advisors who want to be indispensable strategic partners in plan design.
What You Will Learn
Learning objectives for this course.
Who This Course Is For
This course is designed for the following roles.
Course Modules
15 modules · 75 lessons
Health Plan Design Fundamentals: Structure and Strategy
Build a solid foundation in plan design — understanding how every design element affects cost, access, and member behavior.
5 lessons · 45 min
HDHP and HSA Strategy: Consumer-Directed Health Plans
Design HDHPs that genuinely reduce costs without shifting financial risk onto employees who can't absorb it.
5 lessons · 45 min
Network Strategy: Narrow, Tiered, and Reference-Based Networks
Evaluate network options beyond the standard PPO — and understand when narrower networks deliver better value.
5 lessons · 50 min
Value-Based Insurance Design: Aligning Cost-Sharing with Clinical Evidence
Apply VBID principles to reduce cost-sharing for high-value services and increase it for low-value care.
5 lessons · 45 min
Multi-Plan Strategy: Offering Choice Without Adverse Selection
Design a multi-plan portfolio that gives employees meaningful choice while protecting the plan from adverse selection.
5 lessons · 45 min
Dependent Coverage Strategy: Eligibility, Surcharges, and Spousal Rules
Optimize dependent coverage design to reduce costs while maintaining competitive benefits.
5 lessons · 45 min
Ancillary Benefits Strategy: Dental, Vision, Life, and Disability
Design a comprehensive ancillary benefits package that supports recruitment and retention without overspending.
5 lessons · 45 min
Open Enrollment Strategy: Communication, Decision Support, and Engagement
Design an open enrollment process that drives informed decisions and reduces adverse selection.
5 lessons · 45 min
Telemedicine and Virtual Care: Plan Design Integration
Integrate telemedicine and virtual care into plan design to reduce costs and improve access.
5 lessons · 45 min
Maternity and Family Planning Benefits: Design and Cost Management
Design maternity and family planning benefits that support employees while managing one of the highest per-episode costs.
5 lessons · 45 min
Behavioral Economics in Plan Design: Nudging Better Decisions
Apply behavioral economics principles to plan design and communication to drive better member decisions.
5 lessons · 45 min
Benefits Benchmarking: Staying Competitive Without Overspending
Use benchmarking data to design a benefits package that wins talent without paying more than necessary.
5 lessons · 45 min
Retiree Benefits Strategy: Medicare Integration and Cost Management
Design retiree benefit programs that coordinate with Medicare and manage long-term cost obligations.
5 lessons · 45 min
Plan Design Renewal Strategy: Annual Review and Optimization
Build a systematic annual plan design review process that continuously improves cost and quality.
5 lessons · 45 min
Plan Design Advisory Practice: Positioning and Deliverables
Build a plan design advisory practice that commands premium fees and delivers measurable value.
5 lessons · 45 min
Earn Your Certificate
Complete all modules, pass the module quizzes, and score 80% or higher on the 50-question final exam to earn your certificate of completion and 5.0 certificate hours.