Article by Sharma
Offering a well-conceived, reliable and patient-friendly health plan is essential both for attracting clients and retaining good healthcare professionals. Employers should also know that good healthcare benefits provided to employees will keep them healthy, increases productivity and less staff turnover.
Many small businesses however do not understand the need to offer good group insurance policy to their staff. According to the nonprofit Kaiser Family Foundation, only 59 percent of small businesses with less than 200 employees provided group health insurance. As health care costs escalate, small business owners are finding it increasingly difficult to afford the premium amounts. Moreover, insurance companies apply higher rates to small businesses when compared to larger companies.
While serious efforts are being made for universal health care or at least some kind of major healthcare reforms, it is necessary for both health insurance companies and insurance seekers to do their bit to realize this laudable goal.
Health insurance policies provide all types of schemes and plans. But the two broad categories of insurance are individual and group.
Individual health plans are meant for individuals and their family members. These policies generally require a detailed medical history to know of any preexisting conditions. The plan’s cost depends on the applicant’s health status and lifestyle. Applicants with serious or chronic medical problems may be denied coverage.
Group health insurance covers a number of individuals under one master policy, which is availed by an employer, a professional organization, a union, or other associations for providing cover to their employees/members. Today, a peculiar phenomenon is being noticed. Because the rates of health insurance for small businesses are rising steeply, individual workers may be able to get cheaper coverage by availing individual health policy than the group policy can provide.
The category of group health insurance offers a number of different plans, including defined networks, fee-for-service plans, and health savings accounts. Defined network plans (also called as managed care plans) allow the employees to pick doctors from within a prescribed group or network.
Under Health Maintenance Organization (HMO), members receive care from medical providers who are enlisted by the HMO, usually from within a specific geographic area. Under HMO, specialist services can only be procured if the primary care physician makes a referral. Under Point of Service (POS) plans members visit health care providers within a defined network and require a referral from a primary care physician in order to see a specialist. But unlike HMOs, POS allow enrollees to visit doctors outside the network, on condition that the enrollee pays a higher percentage of the bill. Under Preferred Provider Plans (PPP), enrollees pay a certain amount to visit the network doctors and a higher amount if they wish to go outside the network. In general, PPP offers less choice than POS, although members need not get a referral to visit a specialist.
Over the past few years, Health Savings Accounts (HAS) or tax-exempt accounts that employees use for certain kinds of medical expenses, are becoming popular. In some states, employees also can use their HSA to save for retirement.
Employers can make tax-deductible contributions to his employees’ HSA, which will make the plan more attractive for the workers. HSA is regulated by the federal government, which each year sets a minimum deductible and maximum out-of-pocket cost for these plans.
In recent years, both small and large businesses have started keeping the costs of their health plans down in various ways. One of the most popular ways is to institute wellness programs at the job. The wellness programs include posting information on the benefits of exercise, nutrition, and other health topics.
A wellness program might actually entail encouraging employees to adopt healthier lifestyles. In the long run, wellness programs can suppress the cost of group health plan because employees will be less likely to become sufferers of heart disease, diabetes, high blood pressure, and obesity.
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