Your employees can only change their health insurance once a year during the open enrollment period, unless they have a qualifying life event, according to The Balance. With this in mind, it’s important that they get it right when they make changes. What can you do to help your employees make the right decisions? Here are five tasks to consider:
1. Have an Insurance Broker Present Options
The person who convinced you this is the best policy for your company is often the right person to explain the new plans. The insurance broker has answers on the tip of their tongue that you’d normally have to research. This can be a great kick-off for open enrollment.
To keep reading, click here: 5 Ways to Approach Open Enrollment Correctly
Having all those opinions available is ideal as choosing a healthcare insurance is a confusing path as you have to predict your individual needs. Having that person there to answer questions is very helpful but they (the broker) should be neutral in what they present as choices which should be individualized per person.
Okay as the system stands, right now, several option coverage is mandated into every policy, so premium costs should also be discussed as why one insurance company is better than another. I am not talking about differences between Bronze and top tier plans. I am referring to why for example -Blue Cross costs more than Humana in same given area.
Also every person should be able to discuss and evaluate the costs of covered services versus what they really need. Some people need minimum care and would profit from welfare programs and some need continued care of ongoing ailments.
If the person is a female, coverage and cost of women health services should be explained in detailed information.e.g. birth control, pregnancy, OBGYN visits, etc as these are not included as a mandated coverage by healthcare programs.
Another issue to be address is age-out coverage by health insurance companies for those over 60 and for children living at home under the age of 26. All of this can be covered by an in-house broker.
Decisions on what to do, has to be thought thru, so follow up should be done especially for those who are newly enrolling or have had changes in status needing a new healthcare plan. But no pressure should be made to buy.
why for example -Blue Cross costs more than Humana in same given area.
Especially because BC has crummy coverage and charges you for a hospital visit ($500) instead of a co-pay ($45) if your doctor happens to have his office in a teaching hospital building.
Signed,
Bitter
No way.
This happened to you? That is ridiculous.
I am sure they acted like it was your choice… like you knew you’d be charged the $500 charge and decided to go there anyway, and are now trying to pull something and cheat them out of their fees.
Oy.
And the whole in network thing is a pain, too. I was referred to a dermatologist for a skin issue by my PCP. I made sure the doctor was “in network” by calling both that doctor’s office and my BC/BS group, so I went to the visit, paid the specialist copay, and had to go back in 3 months for a follow up, which happened to be on the first of the month. Paid the copay, etc.
Fast forward to me getting a bill in the mail for the balance of the office visit. They applied the copay but sent me a bill for $175. I called BC/BS to see if there was a problem with the coding. They said no, that the doctor wasn’t in network and I chose to see an out of network specialist. Turns out that the day before my visit was his last day “in network”. I had no way of knowing, nor did I think to check with the insurance company before my morning appointment. BC/BS ended up covering the visit “just that one time”.
Now I call every time I need to go to any other medical appointment other than my PCP’s office. What a pain.
HR picks the plans. We get stuck with the mess.