Considerations for the health benefits of your business

Finding the right group health benefits for your organization can be daunting. Start by finding a trusted business partner who can help you navigate through the different options available so that everyone benefits. We’ve provided a checklist to get you started on this journey.

Develop a strategy –Determine who will oversee and manage plans internally and any goals you may have, including recruitment and retention goals.

To research – Familiarize yourself with basic healthcare terminology as well as the different types of plans and coverages available. Determine whether you want to stick with the basic health and wellness plans (medical, dental, and vision) or offer additional voluntary coverage for life, injury/sickness plans, pet coverage, insurance. long-term or short-term disability, etc.

Assess the needs of your business and your employees – Before looking for a broker, make sure (1) you know how much you are willing to pay in employee bonuses; and (2) estimate the number of employees who will accept your coverage. Interact with your employees to find out their preferences (i.e., prefer a higher monthly premium and lower cost of care or vice versa).

Find a broker – During your research, find a broker specializing in health insurance. Ask for recommendations and references. Also, make sure the broker has experience serving companies comparable to your size and understands your growth plans and strategy. You will want to make sure the broker knows your industry.

Defense of customers – Once you have selected a broker, share some of your business knowledge and industry standards with them to serve you better. Consider what options you want to offer your employees for health and wellness and voluntary plans.

Take advantage of the broker’s expertise – Be sure to ask them about health care trends and their recommendations. Your broker should provide ongoing support throughout the year, including managing and updating your coverage. Brokers need to understand your business goals and be invested in the future of your business.

Open communication – Your broker should periodically seek feedback from you and your employees. They should also provide you with “experience reports”. Mid-year is a great time to review your experience report to understand your employee behavior and plan for upcoming renewal. Asking for feedback ensures everyone’s needs are being met and if any changes to the health benefits are needed for improvement.

Other health-promoting factors to consider

When looking for a professional insurance broker:

  • Check with other local business owners for recommendations. Be sure to interview at least two, but no more than five, before making a selection. Consider who will lead your team and their expertise, especially with new plans, similar size, support team availability, reporting availability, and service guarantees.
  • Contact your chamber of commerce or local business groups or associations.

When you decide to use a certain broker, be sure to:

  • Ask about: (1) the amount of the fees or commissions; and (2) whether a separate fee will be added to the premium by the broker.
  • Restate the services you will receive.
  • Discuss how the broker will help you over the year.
  • Know which services are “in scope” or “out of scope”. In their presentations, they can talk about services that will be an additional cost and not provided as a standard part of the agreement.

Good things to ask a potential broker before signing up:

  • Ask if they have consolidated billing or explain their billing process.
  • Learn about compliance practices; how do they handle notices, disclosures, required audits and any other requirements of the Employees Retirement Income Security Act (“ERISA”) of 1974? Ask how often they perform a compliance audit and updates. Ask how they handle COBRA. Ask them if they use a “document wrap”.
    • A “packaging document” includes certificates and booklets of each health benefit. It satisfies the “ERISA” requirement that applies to these plans. It also allows employers to file only one Form 5500 rather than a separate form for each health benefit. It also helps if your plans are audited.
  • Do they have an online registration program, or is registration handled on paper?
  • Ask how they plan to communicate open enrollment each year? Who prints material for employees who do not have access to a computer (employees on leave, storekeepers, etc.)? Will they hold an annual open registration event for your employees? Will they also have a separate mid-year wellness event?
    • A wellness fair is usually held halfway through the annual open enrollment date, designed to educate employees about available services. This may include biometric screenings, eye exams, safety, first aid preparedness, stress reduction, smoking cessation, health club benefits, nutritional support, and more.
  • What type of access will employees have with them? Will they have a dedicated toll-free number? How often do they plan to meet with employees? Do they have an app?
  • Ask them about their onboarding process for new businesses. Find out how much time and resources you will need to dedicate to make this process a success. Find out what resources they provide to help you with the onboarding process.
  • Check reviews of online brokers. Before signing with them, be sure to ask for references. Give them the specific types of referrals you’re looking for, i.e. a new client (less than two years old), a client similar to your size, and a client who’s had a major plan overhaul over the past few years. last five years.
  • Make sure all plans meet the requirements of the Patient Protection and Affordable Care Act (PPACA), also known as the Affordable Care Act (ACA)

One last thing. I would highly recommend that an Employee Assistance Program (EAP) be added to every plan. It is a very low-cost plan, paid 100% by employers and available to all employees to support them in various life scenarios. The service is free and confidential for employees, available 24 hours a day, 7 days a week, and is a great resource for employees, leaders and families. It provides access to local healthcare professionals for mental health support, access to free legal consultation, and help with a challenge like elder care or even addiction issues. Ask your broker for more information on these types of plans and others.

Providing employees with a well-thought-out benefits package that’s tailored to your company’s needs and comprehensive enough to meet the needs of your team will go a long way in attracting and retaining the right talent.


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