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