Every employer can relate to hearing the top 3 complaints about group health insurance. Trying to offer a competitive benefits package to employees, you can be certain that there will be complaints about the benefits that are being offered. The benefit that brings the biggest noise is typically health insurance or medical coverage. The reason is this is the benefit that is used most often and let’s be honest, the most expensive. According to Investopedia, “Group health insurance plans are purchased by companies and organizations and then offered to its members or employees. Plans can only be purchased by groups.”
We are sharing the top 3 complaints that we hear from clients and options that can be done to help mitigate the noise on the health insurance coverage.
#1 Complaint: Cost, Cost, Cost
Cost is by far the most common complaint when it comes to group health insurance. Health insurance is the biggest line item on a company’s budget for the year and the biggest expense that is being deducted from employee’s paychecks. With this being the biggest expense for employees this will be the number one complaint that a company will hear. What Diversified Insurance has found is if a company is transparent about the overall cost increase and shows what the employer is paying this will help lessen the noise.
Other strategies to help with the cost is offering voluntary benefits, such as accident or hospital plans in which if an employee or dependent were to be admitted into the hospital, they would receive a payment to help pay towards the medical plan. The other option an employer can do is contribute towards any funding accounts, ie Health Reimbursement Accounts (HRA) or Health Savings Account (HSA), which would work alongside the medical plan that is being offered.
Complaint #2: Plan Design
How often have you heard some say that their health insurance plan “sucks” or “doesn’t pay anything”? With the number one complaint being cost, the option most employers take is to increase the deductible and out-of-pocket maximums to lessen the cost that is paid per month. But when increasing these items this is typically when the complaint of “my health insurance plan sucks” will be heard amongst the workplace. Ensuring that the employees understand what a deductible is and what services it will apply to is a key factor. For example, if the employer is offering a traditional medical plan the deductible would only come into play if a member were admitted into the hospital, having outpatient surgery, or any major lab work (MRI or CAT scan) done. If offering a high deductible health plan (HDHP) the deductible is what needs to be met before the plan pays for anything. Most employers that offer an HDHP also contribute to a Health Savings Account (HSA) to help ease the burden of the high deductible.
It is vitally important that everyone enrolled in the plan knows which doctor, clinics, and hospitals are classified as In-Network. When seeing a non-contracted or Out-of-Network provider, there is a higher cost to be paid and then there is the chance of being balanced billed from the doctor that was seen. The key to helping limit this complaint is to educate employees about the medical plans being offered to help eliminate the confusion of what all the insurance plan terms mean. Next, most insurance carriers have a cost estimator tool that can assist when looking at getting medical services done. This is another key point in educating the employee about the cost of the services they need.
Complaint #3: Too Many Choices
Employers that offer multiple plans, network, or carrier options are just asking for complaints. Many times, employers want to give employees multiple options to make them happy. But, what ends up happening is employees are more confused about what is being offered. The general population is not exposed to or knows about all the different plan design options, insurance carriers, and network options that are available like insurance professionals or HR/Benefit Managers need to know. When doing any Q&A’s with employees during their open enrollment period or new hire orientation, the employee will end up asking “which plan should I choose?” since they are worried that they will be making the wrong decision.
If offering multiple options, employees need to be educated throughout the year on all the variables that are offered. Explain the different networks that are being offered, carrier tools, and specifics on the plan design. When education is not communicated frequently and multiple options are offered, then the best option for the employer is to keep it simple – one carrier, one plan, one network.
Granted, you will still probably hear the top 3 complaints about group health insurance if this is done, but hopefully, the solutions listed above can help mitigate the noise from employees for your organization. If you want help with your employee group health benefits, please contact Diversified Insurance Group here.