Custom Choice, Exceptional Value
A traditional health plan for small groups should be economical, top-quality, and custom-designed to meet your specific needs. No two companies are the same, why should their insurance plans? A good traditional health plan should offer a dependable base of inpatient and outpatient benefits, including wellness services, and a choice of life, dental and short term disability insurance to round out your benefits package.
Flexibility is the key. The plan should offer the flexibility to structure your medical insurance program to meet the exact needs of your group. You should have the opportunity to save money by selecting a higher deductible, lower benefit percentage and higher out-of-pocket limit, or just the opposite … the ability to provide richer benefits so you can compete with larger businesses for key employees.
Three Aspects of Customization
A good traditional health plan should allow you to select the plan type, the desired benefit payment structure, and only the options you want.
Look for the following plan types when doing your research:
PPO Copay Plans feature physician and hospital networks. A covered person pays only the selected copay amount for each covered visit to a physician’s office, urgent care center, or non-surgical outpatient facility.
PPO Plans feature physician and hospital networks but do not include an office visit copay. They are generally more economical than PPO Copay Plans.
Hospital-Only PPO Plans offer hospital networks but not physician networks. They are a good choice where there is no local physician network or if the local physician network does not meet your employees’ needs.
Traditional Indemnity Plans are best suited for those who live and work outside a PPO network area. Plans are subject to usual and customary charges.
HSA and HRA Plans are high deductible health plans specially designed to work with recent, federally approved financing programs, known as Health Savings Accounts and Health Reimbursement Arrangements.
The next aspect of plan customization is payment structure. You can control the cost of your insurance premium by selecting the amount of the lifetime maximum benefit, annual deductible, office visit copay, rate of payment, and out-of-pocket limits.
Finally, a comprehensive traditional health plan should offer optional benefits that you can include or not, based on your group’s needs and your need to control your costs. Some of the options to look for are:
· Outpatient prescription drug coverage — including preferred pricing, brand name purchase options, a mail order service, and non-network purchase options
· Accident Medical Expense (AME) benefit — 100% first-dollar coverage for treatment of an accidental injury that is received within 90 days of the accident
· Maternity benefits
· Waiting period — you choose the amount of time all new employees have to wait before being covered
Additional coverage — such as life, dental, and short term disability
It Pays for Employees to Take Good Care of Themselves
Encouraging your group to take advantage of Wellness services is a great way to reduce your overall insurance costs. A pound of prevention is worth an ounce of cure, right? All worthwhile traditional health plans should include a broad range of wellness benefits for children and adults — all designed to encourage good preventive health maintenance. Some of these services to consider are routine physical exams; EKG, treadmill, and proctosigmoidoscopy; colonoscopy; and a preventive screening program including lab, x-ray, and immunizations.
Premium Only Plans: A Great Way to Make Your Savings “POP”
Another great option you should consider when developing your traditional health plan is a program called Premium Only Plans (POP).
Internal Revenue code provisions allow for employee contributions for premium payments to be made on a pre-tax basis. In most cases, taxable income is reduced and take home pay is increased so your company's Social Security and Medicare tax expense is lower. As a result, the value of your benefits program increases while the tax expense for your business is reduced.
While there are certain circumstances in which it is more advantageous for employees not pay for premium costs with pre-tax dollars (such as when a reduction in Social Security wages would be disadvantageous or when a family’s medical expenses are more than 7.5% of their income so they can itemize) but POP should be beneficial to nearly 100% of employees. Please consult with a professional tax advisor to make sure you fully understand the POP program.
Traditional Health Plans Should Offer Flexibility, Dependability, and Savings
The benefits of an Assurant Health Traditional Health Plan are clear, simple to realize, and easy to implement. You can customize your plan to suit your budget, and your employees get great benefits. Contact Assurant Health to discuss how you can benefit from a plan today.