Knowledge is power: Help employees understand their insurance coverage
Health insurance continues to be a difficult topic to understand, even for those who have it.
Health insurance is an invaluable — and, for companies with 50 employees or more, mandated — workplace benefit. But how impactful is your company’s group health insurance plan if employees don’t understand their coverage?
Policygenius surveyed 1,500 American adults from October 1 to October 3, 2019 and found that health insurance continues to be a difficult topic to understand, even for those who are employed and ostensibly receive workplace coverage.
Related: Employees want more help understanding their health care coverage
Moreover, more than one in four people (27.2 percent) have avoided care or treatment because they were unsure of what was covered by their plan. The percentage was still significant (19.8 percent) among higher-income earners.
What can you do to make sure your employees know what’s covered? The best way to combat uncertainty is through health insurance education and awareness.
Understand the pain points
According to the survey, many Americans are confused about basic health care facts and fundamental health care costs. For instance, only two-thirds of people with health insurance knew what a premium was. A little more than half (58 percent) were able to properly define deductible, and only 48 percent were able to correctly define copay.
People were also unaware of the ten essential health benefits covered by the Affordable Care Act—an overwhelming 87 percent didn’t know what benefits, like hospitalization, ambulatory services and mental health care, were required by law.
How to help employees make sense of their options
Given the lack of knowledge about basic health insurance terminology, providing a cheat sheet that explains how health care costs are covered might be useful for employees. A basic glossary of terms and examples can go a long way in helping people understand what they’re expected to pay for.
These terms are the foundation for understanding health insurance, and once employees know what the terms mean, they’ll be better equipped to understand plans and choices. You could even start with an informative training session where you explain the essential benefits (like preventive services) covered by each plan, and how these services are typically free.
Make the summary of benefits accessible
Although most people with employer coverage know they have health insurance, they may still be unclear about how their specific plan works. While insurers offer plan details online, reading through them is time-consuming and tedious. If possible, posting an informational brochure and the shorter “summary of benefits sheet” on your company’s intranet could promote health care literacy.
Additionally, at the explainer meeting mentioned earlier, demonstrate how employees can find out more information on their own. Knowing how to check the insurer’s formulary to see what prescription drugs are covered or how to search for a preferred doctor’s in-network status are tools employees can use independently to better understand their coverage and individual needs.
Give extra pointers and tips
Speaking of provider networks, consider giving employees additional background or secondary primers. For instance, there are doctors that are often out of network, like mental health practitioners and anesthesiologists who are often contractors. Many people also confuse in- versus out-patient care and may need some to hear clarifying examples.
Once you’ve covered the basics, you can delve into the details. The Policygenius survey shows that about 33 percent of people aren’t aware of a few other important aspects of the health care law, including the fact that children can stay on their parents plans until they are 26 or the investment opportunities provided by an HSA.
Explain relative costs
Employees might not be aware of all the costs they can expect to encounter. Cheaper health insurance premiums might seem attractive to employees, but when plans are provided by their workplace, the price difference (and savings) between the different tiers of plans might not actually be as high as imagined. It might be helpful to point out the relative costs of individual non-group plans because many people with workplace coverage may not understand how much they’re saving with employer-subsidized health insurance. While not everything will be applicable to everyone, it’s important to increase their knowledge.
Use multiple forms of communication
Employees might continue on their health care education journey with a blitz of company-wide information sessions with both human resources and the insurance provider. Hosting multiple communications over multiple platforms both during and leading up to open enrollment can increase the outreach potential. Requiring managers to discuss these benefits packages with their team members at one-on-ones or weekly meetings could also give employees the opportunity to voice any concerns in-person.
Many companies use an instant messaging platform, which could be especially useful in answering questions directly and providing a casual yet communicative forum for questions and answers. At the end of the day, it’s not likely that an employee will be upset that their workplace was extra insistent on helping them understand their health care.
Elissa Suh is a personal finance and insurance expert at Policygenius in New York City. She previously worked in television research and written about film for IndieWire, MUBI, and Paste Magazine.
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