Employer sponsored health insurance is a critical component to any employee benefits offering. But most employers don’t realize or just aren’t made aware of the many options available irregardless of the size of their employee base. As part of our fact finding process, Warren & Associates will provide you with many alternate funding options for your employee health plan offering.
Fully-Insured Group Health Insurance
These plans are offered by traditional health insurance carriers. Most plans include a base deductible for major medical claims. After the deductible is met, benefits are usually paid at a percentage (80%) until a maximum claims dollar amount is reached. After that point, the insurance company pays the remaining eligible charges at 100% for the remainder of the calendar year. These plans typically include a doctor copay and prescription card copay benefit that provides 100% coverage after a small copay.
Partially Self-Funded Health Plan Arrangements
This is a health care plan funded partially by the employer. Most employers purchase a special insurance policy called stop-loss to help protect the plan. Self-funded plans may be self-administrated, or the employer may contract with an outside administrator to oversee the plan. These types of financial arrangements offer much more control to the average employer looking for alternatives to the rising cost of provide health plan benefits. Finding the right administrator is critical to the success of this type of arrangement . Along with accurate claims processing, we look to an administrator to take an active role in plan design, disease management and provider discounting.
Consumer Directed Health Plans
There is much interest in this type of employee benefits planning. In it’s basic sense, these types of plans place more financial responsibility on the individual to make Cost effective decisions for their healthcare services. One of the reasons healthcare costs have escalated recently is that most individuals have no financial incentive to seek the most cost appropriate treatment. What we are seeing is a shift back to the original intent for health insurance, protection from a financially devastating medical service expense. With Consumer Directed Health Plans, employees are typically responsible for most of the medical expenses below the deductible including doctor office and prescription expense. One type of consumer directed Health plan is The Health Savings Account. The Health Savings Account (HSA) is a tax advantaged savings plans paired with a high deductible health insurance policy. Individuals can deposit money into a taxed favored savings account and use the funds to pay for eligible medical expenses. Amounts deposited into the account are tax deductible and withdraws for eligible medical expenses are tax-free.