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The hidden cost of health plan illiteracy


It's that time of year again: back to school, start of fall, and the beginning of the annual health care enrollment process. If you are like most small business owners, you don't have a human resources director to take on the tedious, and, at times overwhelming burden of reviewing premium prices, comparing new plan options, and making the final decision with your insurance agent. It's all on your plate.

When you consider how rising health care costs will impact your business operations next year, make sure you consider one major cost that won't be listed on your contract: employee health plan illiteracy.

Ask anyone if they know their health plan inside and out, and not many people will tell you they do. However, if employees truly are ignorant about their coverage, they can easily make avoidable mistakes such as: seeing someone out of network, paying for doctor visits that would have been free as part of preventive care coverage, or becoming subject to penalties.

This illiteracy is critically important to an employer. Why? When an employee gets an unsettling bill in the mail and wants to dispute it, they have to call hospitals, insurance companies and physicians groups during business hours, which typically run from 8 a.m. to 5 p.m., Monday through Friday. If your company is open those same hours, then the employee is taking time away from their work to deal with claims. It is safe to estimate that an employee loses two to three hours of work productivity per claim.

And, if employees are frustrated with their coverage because of costs, disputes or other challenges, or if they misinterpret a high deductible as an inferior health plan, then you may experience increased and unnecessary turnover.

Here are three simple ways to help employees understand their benefits, utilize them to the fullest and keep everyone's costs down.

Request added value from your agent.
Chances are, you are or will be spending a lot of time in the next few months pouring over the details of different health plan options with your agent or health care consultant. Your employees deserve the same level of health plan training that you receive since there may be differences, loopholes and even consequences associated with a new plan. Ask your agent or one of their representatives to offer on-site workshops for your staff.

Hire a third party.
Insurance agents and health care providers are each tied to their separate pricing tools, for-profit influence or other incentives, and as a result, consumers can feel they are sent down many confusing paths on their quest for accurate information or resolution. Consumer advocacy services such as Patient Care are non-medical organizations that coordinate unbiased, independent information from all parties involved in health care. Advocates can be much more successful in answering general coverage questions, resolving claim issues and obtaining true cost comparisons ? and they can accomplish this while your employees focus on work.

Move over to SHOP.
The beauty of the Affordable Care Act is that it gives us standardization with the 10 essential health benefits covered in the Health Insurance Marketplace, and the ability to compare individual policies to group policies across participating insurance providers. Businesses with up to 50 employees can offer quality, affordable coverage to their employees at any time with the Small Business Health Options Program (SHOP) Marketplace. SHOP also offers templates for employee education and a comprehensive website for navigating every step, from health care coverage to care.

You want what is best for your employees and your business. If employees don't value their health in an appropriate way relative to costs, together you are all carrying an expensive burden.

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