For Employers: Help Your Employees Understand Their Benefits & Cost-Saving Tips

For Employers: Help Your Employees Understand Their Benefits & Cost-Saving Tips

October 10, 2019

Providing group health insurance benefits for your employees is a great perk to offer! The value health insurance adds to creating a happy and healthy work environment is enjoyed by everyone year-round.

As we enter the annual open enrollment period for your group benefits, now is a good time to make sure your entire team understands the benefits that you are offering to them.

In this article, we will discuss:

Communication can be critical when trying to get employees to take action. Be sure they fully understand the value of your benefits plan when working with everyone to get enrolled during this time of the year.

Educating employees on their benefits should be a year-round effort, but it's even more important of a task for a successful open enrollment period. It's the perfect time for you to educate employees on health insurance basics.

Employees have questions about their coverage and ways they can keep their medical expenses down. So take some time during Open Enrollment to ensure your employees' questions are answered.

We've assembled a tips to help employees choose the right plan, ways to save money and keep their medical expenses down as well as some common health insurance questions your employees may have about their coverage.

Tips to Help Employees Choose the Right Plan During Open Enrollment

Many people get tripped up when asked to select benefits for themselves and their families because these decisions can be complicated, and it is often easier to elect the same coverage that you had during the previous plan year.

However, last year's coverage may not suit you again, and there may be new plans that better meet your needs. Employees should follow these tips to make the best benefit decisions for you and your family.

  • Assess your health and the health of your family members before making any selections. For instance, plans with higher monthly premiums and lower copays and deductibles are best for those who will use a lot of health care services over the course of the year. Yet, healthy individuals and families may save a great deal by selecting a plan with low premiums and a high deductible.
  • Examine how you allocated benefits last year beyond just health care – retirement, dental, flexible spending accounts, etc. If you invested in some of these benefits in the past and did not use them, consider omitting this time around.
  • Attend all company meetings designed to explain new benefit offerings. These venues are great for learning the ins and outs of new plans and changes to existing plans.
  • Utilize plan selection and comparison tools. These resources can analyze your claims from the previous year and then determine which plan would be most appropriate in the coming year.
  • Before selecting a plan, verify that your doctor and hospital of choice are part of the network of health care providers that are covered. If they are not included, you will pay significantly more for their services.
  • Participate in wellness and disease management programs to not only become healthier but also to receive potential discounts on your health benefits.
  • Utilize tax-free benefits such as health savings accounts (HSAs), flexible spending accounts (FSAs) and dependent care spending accounts. These savings vehicles can provide tremendous tax advantages, as contributions are made with before-tax income. Reimbursements from these accounts are also tax-free. They can be used to pay for prescriptions, deductibles and health-related costs that are not covered by your insurance (braces, eyeglasses, etc.). HSAs are also a great way to save for future medical costs.
  • Are you saving enough to be comfortable during retirement? If not, change your retirement plan withholdings. Don't forget to take advantage of your company match in your retirement account. This is free money for the future.

The best rule of thumb is to make a list of your benefit priorities to determine which plan will serve you best. Then, let the selection process begin.

4 Ways Employees Can Cut Health Care Costs

Always use in-network providers, whenever possible. In general, if you visit an in-network provider, you will get your health care at a lower price.

Keep your drug costs down. Prescription drugs are a large driver of healthcare costs.

Consider using the following strategies to help contain your expenses:

  • Ask your doctor about generic or over-the-counter alternatives to brand-name prescriptions.
  • Shop around at local pharmacies to find the best price on your prescription.

Practice prevention. The Trust for America's Health predicts that there is a return of $5.60 for every $1 spent on preventive care strategies.

Take control of your health care. Asking your doctor the right questions, conducting price comparisons, reading doctor reviews and reviewing all medical bills carefully can help you save money.

Answers to Some Common Benefits Questions from Your Employees:

  • What is a Deductible?
    A deductible is the amount of money you or your dependents must pay toward a health claim before your organization's health plan makes any payments for health care services rendered. For example, a plan participant with a $100 deductible would be required to pay the first $100, in total, of any claims during a plan year.
  • What is Coinsurance?
    On top of your deductible, coinsurance is a provision in your health plan that shows what percentage of a medical bill you pay and the percentage a health plan pays.
  • What is an Out-of-pocket Maximum (OOPM)?
    An OOPM is the maximum amount (deductible and coinsurance) that you will have to pay for covered expenses under a plan. Once the OOPM is reached the plan will cover eligible expenses at 100 percent.
  • What is an Explanation of Benefits (EOB)?
    An EOB is a description your insurance carrier sends to you explaining the health care benefits that you received and the services for which your health care provider has requested payment.
  • What is a Preferred Provider Organization (PPO)?
    A PPO is a group of hospitals and physicians that contract on a fee-for-service basis with insurance companies to provide comprehensive medical service. If you have a PPO, your out-of-pocket costs may be lower than in a non-PPO plan.
  • What is Utilization Management (UM)?
    Utilization Management is the process of reviewing the appropriateness and the quality of care provided to patients. UM may occur before (pre-certification), during (concurrent) or after (retrospective) medical services are rendered.
    For example, your health plan may require you to seek prior authorization from your UM company before admitting you to a hospital for nonemergency care. This would be an example of pre-certification. Your medical care provider and a medical professional at the UM company will discuss what is the best course of treatment for you before care is delivered. UM can reduce unnecessary hospitalizations, treatment and costs.
  • What is a High Deductible Health Plan (HDHP)?
    An HDHP is a type of insurance plan that offers a low premium offset by a high deductible. Because of the low cost of the plan, the insurer will not cover most medical expenses until the deductible is met. As an exception, preventive care services are typically covered before the deductible is met. HDHPs are often designed to be compatible with health savings accounts (HSAs), which are tax-advantaged accounts that can be used to pay for qualified out-of-pocket medical expenses before the HDHP's deductible is met.

If you or your team would like our help explaining or presenting your group health insurance plan to your employees, please contact our office today.

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We have been working with local Houston businesses since 1936 to protect Texans. Along the way, we earned an industry designation as a Trusted Choice® Independent Insurance Agency.

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