It is no secret that a large number of American workers are unhappy with cost control provisions built into their health insurance plan. This is not a new problem but it may be aggravated by the ongoing implementation health care reforms of the Affordable Care Act (ACA). Here are six ways that small business employers might help by offering supplemental help without breaking the budget:
1) Accident insurance – a simple low cost coverage that addresses employee fears of high emergency room expenses
2) Deductible supplement or out-of-pocket cost insurance – the most versatile coverage to help with the typical $5,000 to $10,000 annual out-of-pocket expenses of today’s health insurance policies.
3) Critical illness insurance – provides a larger source of cash during period of prolonged serious illness that typically accompanied by a loss of income and increased out-of-pocket expenses.
4) Independent health benefits advice – Most employees have access only to the firms that sell the insurance and employee benefits. Few have independent financial advisers who assist with health insurance issues, As a result, they never realize the full range of options and planning tools available. An on-call independent health benefits adviser can go a long way toward calming employee concerns about the new post-ACA health care landscape. At a cost of perhaps less than $50 per employee per year, this is often the most effective and most cost effective strategy for addressing employee health insurance concerns.
5) Telemedicine service – Increasingly reported as a valued benefit by employees in a range of situations. The cost is typically less than $250 per employee per year.
6) Concierge medical service – private doctor services in addition to insurance. The cost is higher – typically $2,000 to $2,500 per employee per year – but ensures that members have access to the best that our medical system has to offer.
The non-insurance options (#4, 5 and 6 above) tend to deliver more value for the dollar than an insurance plan.
If you are not sure that your small business is providing post-ACA employee health benefits in the most effective manner, I invite you to give me a call to discuss the options. Freedom Benefits works with small business employers and their independent agents and brokers to deliver the best overall health plan solutions.
Small business health plans are subject to regulation by the Internal Revenue Service, the U.S. Department of Labor and state insurance departments. The Affordable Care Act enacted in 2010 and implemented in phases from 2010 until 2017 adds many additional health plan requirements. This post does not include references or discussion but simply lists the topics as either in a category of allowed and recommended as a best practice or potentially problematic as of the date of the most recent article update.
The post addresses small businesses with more than 1 but less than 50 common law employees. This post does not address unique circumstances pertaining to one person businesses, S-corporation shareholder employees, church plans, union employee plans, independent contractors, the requirements of federal law known as COBRA for employers with 20 or more employees and some of the requirements of HIPAA.
Also consider that small businesses are not required to offer employee health benefits. This list only pertains to employers who voluntarily opt to provide employee health benefits. The overriding advice to all employers in this subject matter is “do it right or don’t do it at all”.
– Have a plan document
– Review your plan annually
– Make sure your plan was updated recently to meet market reform requirements
– Have a Summary Plan Description available for employees
– Notify employees in writing of eligibility for employer-provided health benefits and the benefits available through the public insurance exchange
– Pay for ‘excepted benefits’ including dental, vision, accident, employee wellness and limited benefit hospitalization plans.
– Pay for employer-sponsored group health insurance
– Pay for out-of-pocket expenses that are integrated with your employer-sponsored group health insurance
– Pay for employer contributions to employees’ Health Savings Accounts
– Provide employees with a source of independent advice on health benefits
– Presume that your insurance policy is the health plan document
– Pay for individual major medical insurance
– Pay for insurance provided through an employee’s spouse
– Pay for out-of-pocket medical expenses that are not integrated with your group health insurance plan, governed by a qualified written plan and verified by an independent claims processor.
– Include employer-paid health benefits as taxable employee compensation
– Discriminate in either the eligibility requirements or the payment of health benefits
– Inadvertently disqualify low income or part-time workers from government-paid subsidies for health insurance
– Rely on the opinion of the product seller as to the product’s legal standing
– Rely on legal or tax guidance by firms who are primarily selling insurance products
– Assume that your insurance company takes care of your company’s heath plan compliance requirements
– Administer your own health plan claims