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How to offer employees healthcare benefits

Businesses with at least 50 employees must provide healthcare benefits. Here’s what you need to know

Illustration courtesy of iStock

Healthcare benefits, for some small employers, may be considered optional. But for those with more than 50 full-time employees, group coverage or employer-sponsored healthcare benefits are of critical importance to the business. Under the Affordable Care Act (ACA), employers are mandated to offer health insurance if they have 50 or more full-time equivalent employees. 

Existing small- to medium-sized employers or newly formed businesses may struggle in establishing healthcare benefits for employees, as many employers have been forced to shift financial commitments in the wake of the COVID-19 pandemic

Regardless of business size, one of the main difficulties when providing benefits is selecting a health insurance provider that meets the needs of employees and their families, while providing the types of services employees expect, all for a reasonable monthly premium. 

Once an employer has selected a sturdy plan for its benefits package, it’s time to jump into the deep end and choose the right health insurance provider. Here’s what you need to know.

What to look for in a health insurance provider

In selecting a health insurance provider, small business owners might consider these four components that will directly impact employees:

1. Personalized customer service

One of the top priorities in evaluating health insurance providers is customer service. In preparing employees for open enrollment, consider evaluating the responsiveness and completeness of health insurance provider representatives in effectively fielding employee plan detail questions. 

In making changes to benefits coverage or submitting claims, does the health insurance provider have user-friendly systems with easy-to-access resources? Are customer service representatives readily available? Some great tools to look for in a healthcare insurance provider are online ones, such as online enrollment, mobile access, and support services, such as details on each plan’s member care management, customer service rank within each plan, and current customer testimonials.

2. ACA compliance

The Affordable Care Act aims to provide essential health insurance coverage to all individuals and small businesses with 50 or more full-time employees. Essential healthcare coverage includes coverage of prescription drugs, pediatric dental services, and pediatric vision care. When exploring healthcare plan options, ensure that these core benefits are included as part of the bundle or as an elective add-on. Business owners might consider additional coverage options, such as chiropractic, acupuncture, and mental health services.

3. Provider network size and strength

The best way to make sure that employees’ health care needs are being met is to find a vast network of quality providers. Some network considerations may include preferred provider organization (PPO) vs. health maintenance organization (HMO) options, specializations, business travel (e.g., out-of-state and international coverage), and access to providers (e.g., remote employees, employees with extensive commutes). To play it safe, finding a health insurance provider that offers an extensive network of providers and specialists will help your employees access affordable care.

4. Proactive healthcare solutions

Most people don’t think much about healthcare until they need it. But healthcare is more than just treating existing health issues; it encompasses preventive care and general wellness services. In the search for a health insurance provider, business owners should consider offering online resources, information, and other wellness programs that could benefit employees. 

From immunization information to health workshops, these wellness benefits could increase employee engagement and satisfaction, resulting in higher productivity and lower healthcare costs. For instance, more than 61 percent of employees will make healthier day-to-day choices if the organization offers a well-executed wellness program. Find a health insurance provider that not only invests in employees’ present but also their future healthcare needs.

Alternative healthcare perks to offer employees

These alternative, non-insurance healthcare options typically cost little to nothing for an employer and are strictly optional to employees. While these alternative healthcare options are not health insurance, they provide innovative, flexible, and affordable ways to navigate unexpected medical needs.

Telehealth services

In 2020, telehealth services catapulted and thrived during the ongoing pandemic, offering employees access to board-certified healthcare professionals through private and secure phone, mobile app, or video chat. Statistics show that patients who have had a virtual care visit, 80 percent, on average, plan to schedule this type of visit in the future over an in-person visit. As a result, many more employers are looking to incorporate this alternative healthcare option to maintain and improve employee well-being while preventing employee absenteeism.

Medical cost-sharing community

Medical cost-sharing helps participants manage medical costs that are paid out of pocket. Covered costs include everything from deductibles and copayments, but does not cover out-of-network providers or non-covered services. Members of these communities typically require monthly membership fees. To participate, a member must fulfill the initial shareable amount (IUA) for a qualified need before the community begins to share. A “need” is a medical expense that exceeds a member’s IUA. At the current time, medical cost sharing is not available for the COVID-19 vaccine

Cost reimbursement

Premium reimbursement for employee medical costs is another way that employers have opted to assist employees during the COVID-19 pandemic. With this benefit, employers reimburse a percentage of an employee’s paid premiums, tax-free. As part of a group plan, or a health reimbursement arrangement (HRA), the employer will design the type of plan that best meets the needs of their employees and decide the qualifications for employee reimbursement. 

Medical discount cards

Medical discount cards, like those advertising discounted or lower prescription costs for name-brand medications, provide patients and their families an inexpensive alternative to traditional insurance plans. When paired with an existing insurance plan, the discounts can be significantly deeper. Employees who prefer using cash to pay for their medical expenses will be most interested in locating participating providers and pharmacies. 

Employers are faced with a number of new challenges in 2021, employee healthcare benefits notwithstanding. WeWork’s Business Solutions, powered by VensureHR allows employers to reevaluate their healthcare benefit options and anticipate employee needs, without sacrificing quality or breaking the budget. Ensure the wellness of your employees while attracting and retaining the most qualified candidates for your business, as a WeWork member.   

Julie Dower is a marketing and communications manager working for Vensure Employer Services, living in Chandler, Arizona. A mother to infant twin girls, she holds a master of science in technical communications from Arizona State University and a master of arts in English from Northern Arizona Universit

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Lizz Morse is a marketing and communications supervisor at Vensure Employer Services. She holds a master of science in psychology from Grand Canyon University and has been published in Attorney at Law Magazine, Real Estate Agent Magazine, and The Good Men Project, among others. Morse has also ghostwritten a number of articles focused on small business administration and operations, appearing in publications such as Thrive Global and Small Biz Daily. 

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