What’s New In Company Healthcare Plans

Posted by on Jun 21, 2016 in company benefits | 0 comments

What’s New In Company Healthcare Plans
If you are fortunate enough to work for a company that provides health coverage, you may find that you’re taking that coverage for granted. And that can be a mistake. While an employer may assume the onus of healthcare costs, as an employee, you should be an informed partner in this plan, as well. You should understand whether your company’s can accommodate different medical conditions, or offers “one size fits all” coverage, for example. Will your company’s policy in fact be adequate for your particular health needs? You should also be familiar with all of the plan options under this work policy, and fully understand how various plan deductibles work. Some workers are lucky enough to have employers who bring in specialists on an annual basis to have all this explained to them. And many other workers need a health care advocate to make sure that they have the very best affordable healthcare possible, regardless of what their employer is offering.

In addition to company offered health plans that may either not offer adequate coverage for some employees, or may cost more than a policy offered by a private insurer, workplace coverage is subject to frequent changes. There could be many reasons for such changes.

  • The employer may have changed insurance providers
  • The employer may have changed the payment ratio to the insurance provider
  • The insurance provider may have merged with another provider or made other internal changes that affect policies

Sometimes company healthcare plan changes are so small that you may never be aware of them. Or they could be mildly annoying, like having to get used to carrying a new type of identification card, or a different co-pay amount. Or they could be big, potentially catastrophic ones, like suddenly not having coverage that you were counting on. You may have heard about the big changes coming to the Affordable Healthcare Act (ObamaCare) in 2016. And these changes will have some impact on healthcare plans offered by employers. But there are other recent changes as well that employees should be keeping an eye on in order to insure that they are protected.

Changes To Benefits

Many people are focused on the changes to premiums that they must pay as we enter Year Two of “ObamaCare”, but insurance providers have made changes to what they’ll pay for services as well, and these tend to be overlooked by employees. For example, in 2016, some providers may charge plan holders no fees for generic drugs. But they may charge significantly higher rates for speciality ones. Likewise, the amount of “non-drug” coverage may be changing as well, for services such as physical therapy. Consumers can protect themselves here by reviewing benefit coverage for various services before deciding whether to leave a plan, switch to an expanded plan with the same carrier, or to purchase supplemental insurance with a private provider.

Changes To Deductibles

If you are an insurance policy holder, whether it’s health, auto, or homeowners, you’re used to paying this “out of pocket” fee before policy coverage kicks in. But a 2016 change for many insurance carriers concerning deductibles means not only an increase in deductible fees themselves, but what these deductibles apply to. For example, a few years ago the average insurance holding emergency room patient could expect to pay a few hundred dollars in deductible fees. Beginning in 2016, those deductibles could average a few thousands dollars.

And keep an eye on these trends that may become part of future policies:

More Willingness To Pay For “Quality”

Despite increases in prices, consumers have indicated in recent polls that they’re willing to pay for this, provided that they “get the best care”. This means not only paying more directly for services, but for transportion costs in getting there.

Younger Employees Want Insurers To Act As Advisers

More than 50% of insured employees between the ages of 18-34 would like insurance companies to advise them on potential future medical expenses.

“Remote” Medical Care

Some future appointments (like mental health counseling or follow-up visits) may be done via teleconferencing, meaning that employees may not have to leave the office to see the doctor.

As confusing and dry as insurance policy information can be, those covered by it should always take the time to review it thoroughly, understand what coverage it provides, and understand what their rights and options are in case of claim disputes. This is especially important given changes being made to “classic” policy options.

And employees should be aware that they can also purchase supplemental insurance in addition to that offered by their employer, or choose to use a private policy altogether. By educating themselves and being aware of all of their options, those seeking comprehensive healthcare coverage can find it in this very transitional insurance year.