Answering health care questions posed by employees can be stressful, especially when they’re unexpected. That’s why it’s best to take the time to fully prepare to address any concerns that may arise when your company renews or changes employee health benefits. Effective communication is crucial to ensuring that your employees understand the health plan options and services that are available to them.
According to the International Foundation of Employee Benefits Plans, less than one-fifth of employers think their employees truly understand their benefits. But this is a problem that’s not impossible to reverse. The key to answering your employees’ health questions, whether in one-on-one sessions or at larger meetings, is to remain calm and confident. Since preparation is key to doing so, here are six of the most common health care questions your employees are likely to pose.
1. Who Chooses My Health Plan?
If your company is offering health insurance, it’s vital to understand who will be selecting the health plan. If employees are allowed to select, they need to know which policies are offered.
2. Is My Doctor or Hospital Part of the Provider Plan’s Network?
Employees may prefer to see one specific physician over others. If this is the case, educate employees on how to gain access to the list of in-network doctors. In most cases, there’s a provider finder on the insurer’s website or app, where employees can find out whether their preferred doctor accepts their insurance plan.
If your company changes health insurance providers to better manage costs, this can mean that employees’ preferred doctors and hospitals are no longer available to them in the provider network. That said, there are still options for your employees to receive their preferred doctors’ services through an out-of-network arrangement.
3. Which Related Coverage Is Already Offered in My Employer’s Benefits Package?
Determine whether you offer a separate vision or dental package — or even disability or life insurance coverage. In addition, decide whether your company will provide reimbursement for additional coverage.
4. Has My Company Added Coverage for Alternative Medical Services?
Defined as products and practices outside the realm of standard care, common “alternative medical services” include acupuncture, chiropractic adjustment, physiotherapy, massage and reflexology.
Many health plans offer minimal or no coverage for alternative medical services. Explain to your employees that they can get some or all costs reimbursed through other coverage types.
5. How Do Deductibles, Copays and Coinsurance Work Alongside Out-of-Pocket Expenses?
Explain that most health insurance plans include a deductible — an amount the insured must pay out of pocket before the insurance company begins to pay its portion of employees’ medical costs for covered health care services. Make sure that employees understand the consequences of choosing high or low deductibles.
Copays are a fixed amount employees pay to see their doctor or a specialist. Make it clear that the amount employees pay in copayments generally does not count towards meeting their deductible, but it does count toward their total out-of-pocket costs for the year.
Coinsurance, on the other hand, is the percentage of medical costs a patient pays after they meet their deductible but before they meet their out-of-pocket maximum.
6. Has My Company’s Prescription Drug Coverage Changed?
Inform your employees if your company has implemented a new approved drug list or excluded some drugs from coverage. Advise your employees to switch to a generic or lower-cost alternative where possible.
Answering Health Care Questions
Along with studying up on employees’ top health care concerns, consider bringing in a health insurance advisor to explain additional coverage options. Provide tools like a list of in-network doctors or help employees get access to an online database. Here are a few helpful resources you may want to point your employees to:
- The Employee Benefits Security Administration (EBSA)’s “Top 10 Ways to Make Your Health Benefits Work for You” offers employees advice on understanding and making use of health insurance.
- Another EBSA resource gives employees special advice on how health care is affected by major life changes.
- To help employees understand health insurance terms, the Bureau of Labor Statistics provides a guide on words employees should know.
Since health plan options are company-specific, it’s a good idea to gather relevant tools and resources from your health provider and display links to this information via your company’s internal networks.
And helping employees understand their health plans and how best they can use them can benefit your company’s reputation. After all, employees who are well-informed about their health care and appreciate its benefits are more likely to take care of their health, stay with your company for the long term and view you as an employer of choice.
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