Health Care Plans have led to many questions for organizations who desire to provide and remain in compliance with regulations, while leaving the “affordable” in Affordable Care Act. The cost of healthcare and health insurance is high and seems to increase annually. Today we will take a look at some creative ways to help employees and employers mitigate the complex and expensive health care system.
- Ensure that your particular group is fairly treated within the health insurance marketplace. You are likely aware that the nonprofit industry is rated, on average, 15% to 20% higher by health insurers. Typically churches are rated even higher. For this reason, it is imperative to consider how you are going out to market as a group.
- Timing is everything. You don’t want to get stuck making decisions under the pressure of a deadline. To avoid this – consider when your plan will renew and be sure to allow plenty of time to review the dynamics of your group. Provide information to your insurance company, leaving plenty of time for them to look at all aspects of your group and acknowledge the positives so they can offer you the best possible policy.
- Approximately 40% of groups that have over 50 employees renew their health insurance January 1. Second to January, December and July are the next most popular renewal months. For this reason, we suggest avoiding those dates and presenting your request for a proposal in the off-season. This way you allow the insurer to thoroughly and objectively look at your group without the added pressures that exist in those busy months.
- Check the accuracy of your claims data before you submit it to your potential insurer. Errors or incomplete documentation can potentially weigh negatively on your request and risk ratings.
- Look at all of the options for your group’s health plans. Self-funded plans are a notable option that are growing in popularity. Although self-funded plans have their own risks associated with them, there are also potential benefits to be considered. For instance, with self-funded plans employers:
- Are given more information on group claims as well as on larger individual claims.
- Are given more control of the plans features and drug card program.
- Can benefit from controlled health risks and lower claims. Because of this incentive, employers tend to be motivated to take advantage of wellness programs, data analytics, and additional opportunities to reduce health risks for their group.
- Can diversify their providers based on different components of their plan. Vendors such as drug card providers, network, disease management, and more can be selected individually.
- Communicate with your employees regularly. Due to the complexities of the Affordable Care Act and increased costs, employees have more questions than ever. This new system offers many different and unfamiliar ways to obtain health care. such as walk-up clinics and free-standing surgery centers. These options are confusing and difficult to navigate. In addition to the annual, one hour health care options meeting be sure you maintain open and consistent lines of communications with your employees to help them understand and make the best choices regarding how to spend their health care dollars. Some ideas for communication are lunch and learns, WebEx meetings, mass-emails or even mass-texts.
- Inform your employees of their options before they make a claim. Even within network, health care provider’s costs can vary greatly. Costs for an MRI can vary upwards of 200% depending on where the service is provided. Take advantage of online tools that can aid individuals to better understand the procedures and costs before they have them performed. Your employees will be especially grateful for the opportunity to save on out-of-pocket expenses and co-pays.
As Beck and Company’s Certified Public Accountants and Business Advisors, we understand that you, as small business owners, want to do what you can for your employees and hope this information has helped you understand your options more thoroughly. To learn more about our accounting services to help you navigate through these tricky processes, visit here. Contact us here at Beck and Company CPAs so we can help you with your unique needs as small business owners navigating healthcare and the Affordable Care Act.