| As an employer or a participant you might be | | | | of smoking, let’s just say that when an |
| leaving money on the table by not properly | | | | employee is ready to quit, it is easier to do |
| taking advantage of certain features and | | | | it with the help of professional programs. In |
| benefits of your company’s health | | | | the event that the Surgeon General is right |
| insurance. As a licensed Consultant and Group | | | | about the dangers of smoking, healthier |
| Benefits Brokerage company, with clients | | | | employees are happier and more reliable as an |
| across the country, we are successful in | | | | employee. This could also avoid future |
| reducing group benefit expenses because of | | | | hospital visits and catastrophic treatments |
| our experience and our intimate knowledge of | | | | as well as delay premature death.d. Weight |
| the factors used in determining pricing. This | | | | Management – Employees may take |
| top 10 list should be helpful in increasing | | | | advantage of weight management programs. In |
| your insurance knowledge, maximizing your | | | | some cases employees might already be using |
| plan benefits and possibly reducing your | | | | well known programs such as Weight |
| company’s expenses. | | | | Watchers™ or Jenny Craig™. Many |
| | | | scientific medical studies directly relate |
| Background and Overview: | | | | disease and health risk to an |
| | | | individual’s weight. Once again, a |
| For most companies, group benefit plans, | | | | healthy employee calls in sick less often, is |
| specifically medical benefits, are among the | | | | more productive, and on a selfish side, is |
| highest non-producing company expenses. | | | | likely to minimize the number of claims |
| Unlike other expenses, medical benefits hits | | | | against your Insurance Policy. Certain |
| home since it affects our employees and our | | | | company sizes in certain states may be rated |
| families personally. Therefore, it is of | | | | and premiums are charged based on the claims |
| paramount concern that the CFO and Director | | | | filed against the insurance carrier.e. Gym |
| of Human Resources take into consideration | | | | Membership – Discounts and |
| the needs of their employees, the needs of | | | | reimbursements may be available for health |
| their employees’ families, pricing, and | | | | club membership.f. Hearing - Certain hearing |
| specific benefits being offered. | | | | centers may have pre-negotiated discounts |
| | | | with your insurance carrier.g. Bicycle |
| The ability for an employee or an | | | | Helmets - Safety equipment such as bicycle |
| employee’s family member to use a | | | | helmets may be available at a discount with |
| favorite physician such as a Pediatrician or | | | | specific insurance companies and retailers. |
| an OB/GYN is often affected by this decision. | | | | Certain states mandate that children under a |
| The ability for employees and their families | | | | specified age are required to wear a helmet |
| to use specialized treatment centers in the | | | | while riding bicycles, skateboarding, or |
| event of a catastrophic medical situation | | | | roller skating. Even if helmets are not |
| also lies in the balance of the Health | | | | mandated, it is alarming how many serious |
| Benefits decision. Quality and access to | | | | injuries might have been prevented with the |
| medical care varies from insurance carrier to | | | | proper head protection. If you need or want a |
| insurance carrier. | | | | helmet anyway, you might as well get a |
| | | | discount on it.h. Store Discounts - Various |
| Staffing and Retention: | | | | retailers may have a pre-negotiated incentive |
| | | | worked out with your insurance company such |
| The primary purpose of Group Benefits as a | | | | as baby stores or household goods. This is |
| whole as it relates to employers is to | | | | good for the store from a marketing |
| attract and retain employees. It goes without | | | | prospective and it is good for the consumer |
| saying that the broader the benefits, the | | | | to get a discount.i. Security Improvements |
| easier it would be to attract and retain a | | | | – Security companies my provide |
| higher quality workforce. | | | | discount services for your home protection |
| | | | and safety additions.j. Stress and Alcohol |
| As a reciprocal, industries that utilize high | | | | Management - Different services may exist for |
| turn-over positions with minimum-wage | | | | stress management and alcohol rehabilitation |
| employees may not necessarily choose to | | | | and treatment programs.k. Mail Order |
| utilize the highest quality insurance | | | | Discounts – Certain carriers offer |
| policies to attract and retain employees. | | | | additional discounts for mail order |
| Employee pools may be abundant and the | | | | prescriptions. This is especially useful for |
| bottom-line total expenses may be more | | | | drugs prescribed for the long-term such as |
| important than the quality and level of care | | | | heart medicine or cholesterol drugs. You know |
| offered. | | | | you need it any way so you might as well |
| | | | stock up by mail. |
| With that said, let us share with you some | | | | |
| money-saving ideas and under-utilized | | | | 3. Not Getting a Second Opinion: |
| features of your medical benefits. Keep in | | | | |
| mind that some items may relate to your | | | | Different Insurance professionals have |
| current coverage while others suggest a | | | | different experiences and abilities. Some |
| change in coverage or a change in features of | | | | Brokers are only Brokers while others are |
| your plans. | | | | also Licensed Insurance Consultants. Some |
| | | | Brokers specialize in Property and Casualty |
| The following represents our list of the top | | | | or Life Insurance while others specialize in |
| 10 frequently made mistakes as it relates to | | | | Group Health. If you are concerned with your |
| Group Health Insurance. This list is in no | | | | Health Insurance rates and services, perhaps |
| particular order. Each item may or may not | | | | a specialist is what your company really |
| apply to your current situation. | | | | needs. |
| | | | |
| Top 10 Medical Benefits Mistakes: | | | | Speaking as an insurance professional, we of |
| | | | all people, respect and appreciate client |
| 1. Not Catching Medical Problems Early | | | | loyalty based on past service and existing |
| | | | relationships. On the other hand, how do you |
| To use a few cliché’s, “a | | | | really know that you have the most |
| stitch in time saves nine” or | | | | appropriate policy and features if you do not |
| “prevention is the best | | | | get a second opinion from a different Broker |
| medicine”, or “kill the monster | | | | or Consultant? If the relationship with your |
| while it is tiny.” I am not sure if the | | | | Broker is that solid, it would not be |
| last one is a main-stream cliché but | | | | difficult for your Broker to keep your |
| it does hammer home the point that prevention | | | | business. If your Broker’s skills are |
| is often the best medicine. Early detection | | | | not current and sharp as it relates to your |
| is the second best course of treatment. Many | | | | company, his/her complacency might be costing |
| doctors argue that colon cancer is extremely | | | | your company tens of thousands, if not |
| treatable if it is caught in the earliest | | | | hundreds of thousands, of dollars. |
| stages. If the cancer is not detected early | | | | |
| there is a risk of the cancer getting more | | | | Oftentimes, an insurance professional might |
| aggressive and spreading through the body. | | | | become complacent with existing clients. This |
| Every person should take the time to get | | | | may be due to increased workload, |
| regular exams. Every person should be aware | | | | understaffing, or the fact that they are too |
| of key medical indicators such as weight, | | | | busy finding new clients. They may not be |
| blood pressure, and cholesterol levels. As a | | | | focusing on your bottom line. |
| person gets to certain recommended ages, | | | | |
| mammograms and other early detection tests | | | | A second opinion introduces a fresh |
| should be done regularly. Just because you | | | | perspective regarding your company’s |
| never went for a cholesterol check does not | | | | health insurance needs and options. It keeps |
| mean your cholesterol levels are zero. That | | | | your broker honest and reminds them that they |
| is as foolish as driving around in an | | | | need to continue to service and provide |
| automobile without a gas gauge and assuming | | | | creative solutions if they wish to keep your |
| you don’t need to put gas in it since | | | | business. |
| there is no indication of the level. The life | | | | |
| you save with early detection could be your | | | | Make sure the carrier alternatives are of |
| own or someone who you love. | | | | “like kind and quality”. That |
| | | | simply means they are an apples-to-apples |
| Depending on the size of your group and which | | | | comparison. |
| state your business is located in, early | | | | |
| detection means fewer large insurance claims | | | | Mix it up a little. Find out what the |
| which translates into lower premiums for your | | | | increase (or decrease) in premiums might be |
| company. | | | | if you increase (or decrease) the co-pay, |
| | | | deductibles, in-network deductibles, and |
| 2. Not Using the “Value Added | | | | co-insurance. Look at different options with |
| Benefits” | | | | the drug plan as well. |
| | | | |
| Many times, when you think of medical | | | | Sometimes it pays to self-insure a portion in |
| benefits you only think about doctor visits | | | | order to reduce premiums. Look at the total |
| and drug plans. Often, employers and | | | | exposure, have your broker figure out worst |
| employees do not realize that their insurance | | | | cases scenarios, and contemplate the |
| carrier might also include services known as | | | | probability that the scenario could come |
| “Value Added Benefits”. | | | | true. This dovetails with mistakes #4, #5, |
| | | | and #6 coming up. |
| Health Insurance Carriers offer these Value | | | | |
| Added Services to encourage healthy | | | | 4. Not Looking at the Big Picture of Total |
| lifestyles. Healthy lifestyles would yield | | | | Costs |
| healthy employees which keeps insurance | | | | |
| claims down. | | | | Very often, companies only look at the |
| | | | monthly premiums associated with their |
| It is important to understand your value | | | | healthcare coverage. This is not the only |
| added benefits for several reasons. First | | | | variable when it comes to insurance rates. It |
| you, your family, and the employees you work | | | | is important to look at the total picture |
| with can benefit from these services. Second, | | | | which includes:a. Co-pay amountsb. In-Network |
| your management or human resources department | | | | and Out-of-Network Deductiblesc. In-Network |
| might come off as heroes just by telling | | | | and Out-of-Network Co-Insurance Levelsd. |
| employees about these value added benefits. | | | | In-Network and Out-of-Network out-of-pocket |
| The benefits are already included so you | | | | expensese. Out-Of-Network Reasonable and |
| might as well tell people about them. | | | | customary reimbursement levelsf. Gated or |
| | | | Non-Gatedg. Drug coverage co-pays, |
| Examples of Value Added Benefits Include:a. | | | | co-insurance and deductiblesh. Disease |
| Vision – some carriers have | | | | Management and Wellness Programsi. Employer |
| pre-negotiated discounts for vision care such | | | | Employee Contributionsj. Network |
| as eye exams and eyeglasses.b. Nutrition and | | | | Accessibilityk. Disruption Analysisl. Monthly |
| Supplementation – Certain carriers | | | | Premiumsm. Maximum Exposuren. Maximum |
| provide discounts or reimbursements for | | | | Benefitso. Tax Treatment (See #9)p. Quality |
| nutritional supplements. Supplementation | | | | of Coveragel. Introduced deductibles on |
| might keep employees healthier and prevent | | | | drugsm. Generic and non-formulary drug |
| certain diseases. Some employees are often | | | | discounts |
| already paying out-of-pocket for supplements | | | | |
| so any discounts become bottom-line savings | | | | Each of the above can be a topic unto itself. |
| for the employee.c. Quit Smoking - Employees | | | | We can offer a free consultation to look at |
| may be entitled to discounts on programs that | | | | your coverage and suggest ways to maximize |
| relate to quitting smoking. Without going | | | | cost savings and improvements. |
| into a lecture as it relates to the dangers | | | | |