10 questions to help clear up health plan confusion for employees

Published May 19, 2014 4:51 AM

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Updated May 19, 2014 9:47 AM

1 Min Read

1. Is there a waiting period before Im fully covered?

The lines are starting to blur now, says Bryce Williams, a managing director at Towers Watson. What was originally defined benefit and what is now defined contribution. The reason is because as employees select plans with higher deductibles and with a health savings account attached to it, they actually now are in the game of spending those first dollars

[Images: Shutterstock].

2. Does the plan include spouse and/or dependent coverage? If so, how long can dependent children stay on my plan?

Coverage of spouse or dependents is a valued benefit among employees. However, employers have started to rethink this benefit offering, forcing many spousal participants, if they are eligible for health plans elsewhere, to find their own coverage. In 2014, about 12% of employers plan to exclude spouses from health care coverage, up from 4% in 2013, Towers Watson said.

3. How much sick time, vacation time, and holidays are provided?

Employers that offer more sick time or flexible work arrangements are in tune to their 21st century workplace. Failing to offer these benefits can translate into a less connected workforce that is less likely to be loyal to their employers.

4. What type of retirement plan is there? How much does the company contribute? Is life insurance provided?

Encouraging employees to contribute enough to the 401(k) plan in order to bank on the benefits of the employer match is essential. Life insurance, as an added benefit, can help relieve employee concern about spouses or dependents.

5. Does the company offer short-term and long-term disability coverage?

If employees suffer from an unexpected medical condition or become disabled, having short-term and long-term disability coverage is essential to securing their financial needs.

6. Does your employer give you an electronic wallet of funds to spend on the plan features that are important to you?

The context, so to speak, between employee and employer for health care is definitely changing, says Williams. Employers are looking at strategies where they get much more defined contribution-like approaches, where really they are just putting the dollars in and empowering the employee.

7. Do you get a decision support engine to help pick the best plan for you or the free help of a licensed adviser who knows health insurance plans inside and out?

The only way that defined contribution strategies work are that we give people two things: 1) a massive choice of plans, and 2) if you give them not only the tools online, but the people and experts to talk to. This helps them customize, shape and make a great plan decision, Williams explains.

8. Are you tempted to go for the lowest sticker price?

Today, transparency comes in the form of not only what your employer is paying but also what is your piece to pay, Williams explains.
Being clear and transparent to your workforce helps employees truly understand what employers are investing in when it comes to health coverage and other benefits.

9. Do you have tools that let you shop for the lowest price health service in your neighborhood, such as MRIs and labs?

High-deductible health plans or HDHPs have led to increased cost for health screenings such as MRIs or lab tests. Its key for employees to know price options for nearly every health service option, which can foster better and less costly picks for both parties.

10. Do you get tips/education on generic drugs?

Prescription drug prices are a concern for most people. Having less costly options, as well as promoting these options to your workforce can help them deal with rising medical costs.