by admin | Mar 7, 2023 | Employee Benefits, Hot Topics
Health care is expensive but there is good news: Most insurance plans come with free preventive care and benefits. There is a lot of confusion around what is and isn’t preventive care – and why it matters. Here is what you need to know.
What is Preventive Care and Why Is It Important?
Preventive care is routine health care that includes screenings, services and counseling to help prevent illness, disease or other health problems. It is care that helps detect or prevent serious diseases and other medical issues before they become worse.
When you subscribe to a health plan—regardless of whether it’s one offered by your work or one you purchase in the marketplace—most plans will include an array of preventive care services free of charge if you use an in-network provider. Due to the Affordable Care Act (ACA), plan providers are required by law to offer basic preventive care services to you and those covered by your plan with no additional copay, coinsurance, or requirement to meet a deductible.
So why should you go to the doctor when you’re healthy? The simple answer is that preventive care can help you stay healthier and, as a result, lower your health care costs. It can also help identify health problems earlier like diabetes, high blood pressure, or even cancer, when these diseases are most treatable.
Preventive Health Care Examples
- Annual Checkups – This is when your primary care physician checks your overall health. These visits are a great opportunity to bring up anything you may be worried about with your doctor.
- Immunizations – These include Tdap (Tetanus, Diphtheria and Pertussis) boosters, and immunizations against Pneumococcal Conjugate and Shingles. Your annual flu shot is also covered.
- Cancer Screenings – Most people don’t experience cancer symptoms when it is in the earliest, most treatable stage. That’s why it’s important to have regular screenings throughout your life. Preventive screenings for women include pap test and mammograms. It’s also recommended that both men and women begin colorectal cancer screenings starting at age 45.
- Tests and Screenings – These include tests for blood pressure, cholesterol, diabetes, obesity and depression
- Pediatric Screenings – These include screenings for hearing, vision, autism and developmental disorders
- Colonoscopy – 1 typically every 10 years, usually after the age of 50
- Mammogram – 1 per calendar year, usually after the age of 40
Unfortunately, most people in the United States are not taking advantage of preventive care. In fact, one study from 2018 found that only 8% of adults 35 and older received the preventive care recommended to them. Today, the vast majority of deaths in America stem from preventable chronic diseases and 90% of the nation’s $4.1 trillion in annual health care spending goes for people with chronic and mental health conditions.
The U.S. Department of Health and Human Services has provided lists of preventive services that must be covered by most health insurance plans. Lists are available for adults, women and children. Click here for the lists of covered preventive care services.
Preventive health services offer significant health benefits and are covered by most insurance companies. In other words, participating in preventive care usually won’t cost you anything. So, go get those freebies – and improve your health – while you’re at it!
by admin | Feb 6, 2023 | Employee Benefits, Health Insurance
Getting sick can be expensive. Even minor illnesses and injuries can be very costly to diagnose and treat. Health care coverage helps you get the care you need and protects you and your family financially if you get sick or injured.
We’re breaking down the health insurance basics. Because, when you understand it, you’re more likely to get preventive care, make better health decisions and even reduce your costs.
55% of people can’t answer basic health insurance questions and younger generations struggle with understanding the fundamentals of insurance even more. 69% of millennials and 64% of Gen Zers admitted they’ve opted not to seek care due to uncertainty about their health insurance.
Put simply, health insurance is a way to pay for your health care. Your health insurance protects you from paying the full costs of medical services when you’re injured or sick. And it works the same way your car or home insurance works: you or your employer choose a plan and agree to pay a certain rate, or premium, each month. In return, your health insurer agrees to pay a portion of your covered medical costs.
How Health Insurance Payments Work
Your premium, or how much you pay for your health insurance each month, covers some or all the medical care you receive – everything from prescription drugs to doctors’ visits. Most people choose a health insurance plan based on the benefits and medical services the plan covers, as well as on monthly cost. But there are other factors to consider as well, like what you will be required to pay when you see a doctor or a health care facility.
These out-of-pocket payments are important to understand and know the differences between them:
- Deductible – A deductible is the amount you pay out of pocket on healthcare costs before your insurance company starts to contribute to your healthcare costs for the year. Generally, a plan with a lower deductible will have a higher monthly premium than a plan with a higher deductible.
- Co-pay – A co-pay is a set fee you pay for a doctor visit. For example, if your policy lists a co-payment of $20 for a doctor visit, you pay that amount each time you see the doctor. Keep in mind that the co-pay will differ for different services. What you pay for a trip to the emergency room will probably not be the same as a co-pay for a visit to your primary care physician.
- Co-Insurance – Co-insurance is the amount you pay for covered health care after you meet your deductible. This amount is a percentage of the total cost of care – for example, if your co-insurance is 20%, your insurance covers the other 80%. Co-insurance levels vary by plan, as do deductibles.
- Out-of-Pocket Maximum – An out-of-pocket maximum is a limit on the amount of money you have to pay for covered services in a plan year. After you spend this amount on your deductible, co-payments and co-insurance, your health plan pays 100% of the costs of covered benefits.
Knowing how your insurance and healthcare costs are structured is an important part of your personal finances. When you choose a plan, look at your typical healthcare needs and costs so you can make the best decision for your health, and your wallet.
by admin | Jan 23, 2023 | Employee Benefits
A hot labor market that has seen scores of employees leave their jobs for new and better opportunities has HR and benefits leaders planning to up the ante when it comes to benefits that sway workers to stay. But at the same time, employers also are aware of soaring costs and inflation concerns and are looking to make sure any benefits investments are worthwhile.
For 2023, employers are uniquely positioned to offer more than just a health care plan, including perks and resources that today’s workers are seeking.
Voluntary Benefits
You can please some of the people some of the time, but you can’t please all the people all the time – unless you embrace voluntary benefits, that is. Voluntary benefits are optional perks that are offered to employees at a discounted group rate which their employer has negotiated with providers. While employees still need to pay to use these benefits, the amount is usually far less than it would be without company subsidies.
These types of benefits give employees the chance to customize their benefits packages to best suit their particular needs. Whether it’s affordable veterinary insurance for pet owners, subsidized pre-K childcare for parents, or student loan repayment programs, offering these types of policies can directly improve the quality of life for employees who choose to take advantage of them.
Financial Wellness Benefits
Employees worry and stress about their finances especially today due to record-high inflation and are searching for financial wellness education and guidance. Nearly 80% of employees say a financial wellness benefit is an important part of a comprehensive benefits package. Some of the popular financial wellness benefits are:
- Retirement Plan Options with Matching Contributions
- Health Savings Accounts
- Flexible Spending Accounts
- Financial Planning Assistance
- Flexible Paydays
- Employee Discount Program
- Financial Reimbursements (Ie. student loan repayment plans, child-care support funds and professional development stipends)
Family-Friendly Benefits
Employers are increasingly looking to expand their family-friendly benefits for employees in 2023.
- Paid family leave is not guaranteed by law in the U.S. but it is a highly sought-after perk. A parental leave policy – one that considers both parents and accounts for adoption and fostering in addition to childbirth – can show your employees you care about supporting their home lives.
- Childcare assistance supports working parents facing rising costs of living. While some larger employers may offer on-site childcare, smaller business can show their commitment to working parents by helping to subsidize the cost of childcare through employer contributions or pre-tax deductions.
- Fertility assistance supports employees who are going through costly infertility treatments, surrogacy, and IVF.
Inclusive and Flexible Care
The diverse workforce of 2023 is prioritizing a better work-life balance. It’s important to develop a benefits package that recognizes a healthy environment for your employees.
- Mental health benefits are in demand since mental health is a crucial part of overall health. Offering an employee assistance program (EAP) is a great way to support workers in tough situations.
- Work flexibility includes not only remote or hybrid work options, but you can also consider flexible start and stop times, a four-day work week or unlimited PTO to attract top talent and increase retention.
Overall, your benefits offerings for 2023 should reflect your organization’s values. Remember, your company depends on being able to keep your employees happy, healthy, and productive. Benefits that show respect for employees and promote a strong, vibrant culture are worth the investment.
by admin | Oct 11, 2022 | Employee Benefits, Open Enrollment
Choosing the right benefits during open-enrollment season is so important and can help save money. It can also give individuals and families broader support with their health. Benefits like medical coverage are particularly important with high inflation having such a big impact on people’s budgets.
A survey by UnitedHealthcare found that nearly 40% of employees devote less than one hour to the open enrollment process. It is crucial to carefully analyze your benefits during open enrollment as any decisions you make will likely be locked for the year until the next open enrollment period. Don’t rush into open enrollment without carefully considering your options!
Here are some tips to ensure you make the most of your open enrollment:
Be Prepared
Open enrollment typically lasts for a short period (2-4 weeks) so knowing what you need to do ahead of time can be a big stress reliever. A good starting point is to consider how your needs have changed since last year. For example, maybe you got married or received a raise. These changes may require a change in coverage, whether it be for life, health or disability insurance, and it is important to consider how these or any other expected life changes will impact your insurance needs.
Review Any Changes Made by Your Employer
It is common for employers make changes to plans and premiums to keep up with the times. When you receive your open enrollment packet to review plan options, it is important to consider all aspects of coverage and the total cost of coverage. The total cost is impacted by the deductibles, premiums, co-insurance and maximum out-of-pocket expenses.
Take note of whether your employer made any changes in providers. If this happens, your current physician or dentist may be out-of-network which will result in out-of-network costs or denied claims.
Review Your Insurance Options
The largest portion of employer benefits is health insurance so it is important to choose the plan that is best for you and your family. Important questions to ask are: how often do you have medical expenses? Are lower premiums or lower out-of-pocket costs more important to you? Do you take expensive prescription drugs? Can you afford hefty out-of-pocket costs if there is an emergency?
There are 3 main plan types:
- Preferred Provider Organization (PPO)
PPO’s are a popular choice since they allow you to see any doctor or specialist and don’t require a referral from your primary care physician (PCP) to see a specialist. However, PPO premiums are usually much more than other plans. To help reduce costs, remember that using in-network providers and specialists who are part of your PPO network will save you money.
- Health Maintenance Organization (HMO)
HMOs have lower premiums than PPOs but they require you to stay in-network. You will also need a referral from your PCP to see a specialist. The idea is that the PCP coordinates your care.
- High Deductible Health Plan (HDHP)
Another low-cost option is a high-deductible health plan. What sets HDHPs apart from other plans is their low premiums and high deductibles. That means you won’t have to pay as much each month for premiums but you will need to pay more of the healthcare costs when you need services. To help you pay for the bigger deductible, employers usually pair an HDHP with a health savings account (HSA), which allows you to save for medical expenses, including deductibles and copays.
Learn How FSAs, HRAs, and HSAs Differ
Many employers offer accounts that help you save for medical expenses:
- Flexible Spending Account (FSA)
You decide how much pre-tax money to put into the employer owned account through payroll deductions and then you can use that money to pay for out-of-pocket medical expenses. You lose that money if you change jobs or don’t use it by the end of the year.
- Health Savings Account (HSA)
Connected to a HDHP, an HSA lets you set aside money on a pre-tax basis to pay for qualified medical expenses. The account is yours, so you keep it if you change jobs. The money rolls over each year so you don’t have to worry about “using it or losing it.”
- Health Reimbursement Arrangement (HRA)
An HRA is similar to an HSA except that the employer owns the account so you can’t take it with you when you change jobs. You’re able to contribute money for medical expenses just like an HSA or FSA. Money can also be carried over to the next year like an HSA.
Open enrollment is an important time of year and is worth investing some time and energy to decide what is best for you and your family. Health insurance is one of the most important purchases you make. By doing your homework and taking the time to carefully consider your options, you’ll find the plan that is right for you!
by admin | Aug 30, 2022 | Employee Benefits
Inflation is a silent budget killer- it causes everything to go up, from your groceries to your gas, as the purchasing power of money decreases. Americans are feeling the pinch as the U.S. experiences the highest inflation level in 40 years.
Inflation has been particularly frustrating for Americans who are struggling to pay for items such as housing, food, energy, and vehicles. However, consumer goods aren’t the only thing that have increased – employee benefit costs are also on the rise. With rising inflation rates, many employers are struggling with rising healthcare costs. A survey of large employers from the Kaiser Family Foundation found that 96% of respondents agree that the high costs of offering healthcare to their employees are excessive.
With inflation increasing, you may be tempted to cut benefits packages, but now more than ever, a generous benefits and perks package is crucial to retaining employees. In fact, 63% of companies say that retaining is harder than hiring them. Amidst the Great Resignation, HR is having to figure out how to alleviate the increasing benefit costs without passing those costs on to their employees and facing even greater turnover. Fortunately, there are some strategies that employers can use to remain competitive in today’s market while still providing quality benefits for their employees:
- Foster a Healthy Workforce – The healthier your employees are, the less likely they are to have extensive healthcare costs. Wellness programs are a great way to promote a healthy lifestyle. A cost-effective way to provide wellness benefits while helping employees through periods of high inflation is through a wellness stipend. With a wellness stipend, you reimburse your employees for their wellness costs such as gym memberships, home exercise equipment and wellness apps.
- Encourage the Use of Virtual Medical Services – With telemedicine, employees can schedule an appointment with your health care provider or specialist. They don’t have to drive to the doctor’s office, park or sit in a waiting room. They can see their doctor from the comfort of their bed or sofa which makes it easier to fit into a busy schedule. Telemedicine appointments are usually short visits, so employees can get back to work more quickly.
- Supplement Your Group Plan With a Group Coverage HRA – One strategy employers can implement to lower costs while extending coverage is to add a high deductible health plan(HDHP) to their group plan offerings and supplement it with a group coverage HRA (GCHRA), also known as an integrated HRA.
- Eliminate Benefits that Employees Don’t Use – Take a microscopic look at all the benefits you provide. Do you see any that aren’t being utilized enough to justify the cost of providing them? A great way to learn which of your benefits your employees are and aren’t using is by sending out an employee benefits survey. Your company can then invest the money from underused benefits to something that your employees value more.
While it may be tempting to simply reduce your benefits offerings during periods of inflation, it doesn’t have to be that way. Comprehensive benefits attract better employees and retain them for the long haul—meaning employers benefit from a more productive and satisfied workforce.
by admin | Jun 7, 2022 | Employee Benefits, Human Resources
Companies spend a large amount of time and money creating valuable benefits plans for employees. But after all that work, they often get low participation. Good benefit choices require an effort from employers to ensure that employees have help in understanding their benefits options. To make things even more complex, employers are having to consider options for a span of 4 generations in the workplace which can look very different. Providing benefits for a multigenerational workplace can be challenging but it is important for employers to simplify the process by delivering education through the right channels while avoiding a one-size-fits-all approach.
Understanding your audience and how to effectively communicate with them is the first step in creating your benefits messaging. For example, what are the demographics of your workplace? Do you need to provide multiple messages across various channels? Does your workplace speak English, or will you need bilingual messaging?
A recent survey indicates that 83% of employers believe that communication, employee education and engagement are key for employee participation.
Here are 5 tips on educating your employees about their benefits to encourage benefits participation:
- Break Down Health Insurance Options
- Distribute a simple guide that explains the key things employees should know about their health insurance and basic terminology
- Explain in simple terms about provider network, covered prescriptions, monthly premiums, deductibles, and additional plan benefits, if applicable
- Have an efficient way for employees to manage benefits and ask questions
- Automate the Process
- Make Plans Customizable
- Provide plenty of benefits options including medical, dental and vision from leading carriers
- Offer a lifestyle benefits program that allows employees to personalize their plan according to their needs
- Consider offering perks like commuter benefits or health club memberships to reduce financial burdens and encourage a healthy lifestyle
- Provide Multiple Communication Strategies
- Offer educational tools and channels preferred by employees so they can stay informed year-round to make better purchasing decisions
- Utilize effective benefits education tools that include in-person and virtual meetings, digital communication or print media
- You can utilize a short video to explain key concepts; use graphs and images or create short quizzes for employees to ensure they have read and understand the material
- Make it Easy to Sign-Up
- Invest in updated HR and Benefits technology that includes easy message capabilities such as email, text message alerts, video support, and live chat integration
- Provide a Benefits mobile app
- Offer a benefits website which houses benefit information, HR information, and enrollment material such as “BenefitsEasy“
Although you may use one or more of the tips above, it is vital to keep the information flowing throughout the year. A fun way to do this is to pose a monthly trivia question to your staff related to the benefits and wellness programs you offer and award a prize to the person who submits the correct answer. Highlighting different features of your benefits or wellness programs each month will keep your employees engaged and informed!
