Some employers offer health insurance plans as a means of attracting and retaining good employees. This employee benefit comes in many different forms, with several plan options to suit companies of any size. Before selecting a group health insurance plan, it's important to consider all the options available. Careful research and negotiation make it possible to cut costs and offer employees a plan with coverage that meets their needs.
Health Insurance Types
Health maintenance organizations (HMO) require plan participants to select a primary care provider from a network of health providers. This primary physician provides referrals to specialists when patients need specialized care. Preferred provider organizations (PPO) operate much like HMOs, but do not require participants to choose a primary care provider. Participants can choose providers within the network, or receive out-of-network care. Employers can also participate in a self-funded health insurance plan. With this type of plan, employers pay out of pocket for employee medical expenses, instead of paying a monthly premium to an insurance company.
Coverage
Fully-insured plans offered by insurance companies may be one size fits all, with little room for customization. HMO and PPO plans may cover preventive screenings, annual examinations, doctor visits, hospitalization and surgery. Comprehensive plans may also provide coverage for mental health services. High-deductible health plans, also known as catastrophic plans, have very high deductibles and out-of-pocket maximums. These plans have lower premiums than traditional health plans. Self-insured plans have more opportunities for customization. Employee benefit managers can choose the coverage options employees are most likely to use, and avoid paying for unnecessary coverage.
Cost
Benefit managers must determine the distribution of monthly premium costs. Some employers pay one hundred percent of the monthly premium, giving employees health coverage at no cost. Other employers share the cost of the premium with employees, splitting the cost 50/50 or 60/40. Some companies pay one hundred percent of the premium for managerial employees and share the cost of the premium with hourly employees. Work with an employee benefits broker to find a plan that fits your budget and provides adequate coverage for employees.
Plan Administration
Employee benefit managers, benefit administrators or human resources professionals often manage health insurance plans. One of the most important tasks for a plan administrator is paying the monthly plan premiums on time. This will prevent termination of benefits for non-payment of the premiums. Plan administrators also need to review monthly premium statements to identify errors. Quickly identifying overpayments or errors in the calculation of monthly premiums makes it possible for employers to save hundreds or even thousands of dollars. If employees pay a portion of the monthly premium, benefit administrators must work with the payroll department to set up bi-weekly payroll deductions for each employee. If an employee leaves the company, immediate termination of his health benefits usually occurs. If the company had 20 or more employees in the prior year, the terminated employee has the option to extend her health coverage temporarily under COBRA, according to the U.S. Department of Labor. The employee must pay his entire premium to maintain this coverage.
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