As you know, health plans can be complicated, and choosing the right one for your employees can cause many a sleepless night for HR professionals. Health care options continue to evolve, so it’s important to stay updated on these ever-changing aspects that may impact the health plan benefits you offer your employees.
As you consider your options, here are some key considerations from Michigan-based health insurer Health Alliance Plan (HAP). HAP is here to help you narrow your options and select the right plan for your organization’s unique needs:
Understand your funding options
Health insurance is no longer a take-it-or-leave-it benefit for employers. If you want to offer coverage to your employees, or expand the coverage you already offer, there are various funding options to consider.
- Fully insured — This is the traditional model of health insurance, with the employer paying a monthly premium to the insurer and the insurer taking on the risk of paying for, and managing, any claims that arise from that group.
- Self-funding — More and more employers are moving toward self-insuring their health plan. They can customize their plan to meet the specific health care needs of their workforce. The employer is subject to less regulation and lower tax on these types of plans, and there is greater transparency, with detailed cost and utilization data available in which to manage the plan.
- Shared funding — This is a form of self-funding that functions similarly to an insured plan. Employee single, double and family rates are provided and the annual cost of the plan for the employer is known throughout the year. Shared funding provides a stable, budgetary cash flow similar to fully insured. The advantage to this funding mechanism is that the employer has the ability to receive a year-end refund if the actual paid claims come in under the level of projected claims established at the onset of the plan year. This financial mechanism is designed and ideally suited for the mid-size employer market (for example those with between 35 and 200 enrolled). This model allows employers to take advantage of the economic benefits realized with a self-funded arrangement but with reduced risk and potentially lower costs than insured alternatives.
Finding the right fit
There are many decisions to make when choosing the best health plan for you and your employees, such as:
- As an employer, do I have interest in taking on some level of risk to potentially reduce overall annual costs?
- Do I prefer an insured arrangement with known, fixed premium costs to then be renewed annually?
- Does an appetite exist for having the ability to customize and manage the plan?
- Does the provider network offered by the carrier really provide the access to doctors, specialists and hospitals that employees and family members demand?
- Does the insurer have a reputation for exceptional customer service, accountability and support?
Another important — but often overlooked — consideration is whether the insurer offers worksite wellness programs. Wellness in the workplace reduces absenteeism, increases productivity and lowers stress. It makes a proven, positive impact on health care costs for you and your employees, and it helps you attract and retain the very best talent. For example, HAP offers a variety of onsite and virtual programs ranging from health screenings and flu shots to behavior change programs — all focused on educating and motivating employees to make healthy choices. These worksite wellness programs are open to all employees, not just those who are HAP members.
If you need help, it’s only a phone call away. Reach out to an insurance carrier like HAP or a licensed agent or broker. You can find agents in your area by contacting the National Association of Health Underwriters at nahu.org.