What Employee Health Insurance Options Are Right for You?
If your employer offers insurance in its employee benefits package, you’ll need to decide which options you want, and which ones are not for you. New employees are generally offered benefits after they are initially hired and pass a probationary period. If you are not a new employee, you will have to wait until open enrollment season to sign up for benefits or make any changes to your existing benefits package. The open enrollment period is usually from November 1st to December 15th.
The premium for your insurance coverage is deducted from your pay each pay period. Depending on the specifics of your employer benefits package, the company may pay for part of the cost. Your company’s Employee Benefits Director can give you specific details about open enrollment and what portion (if any) of the benefits are paid for by your employer.
Here are some of the most common insurance options offered by employers.
Medical
Your medical insurance portion of your employee benefits package will vary depending on the specific plan you choose. It may be provided through different types of health insurance plans such as a Health Maintenance Organization (HMO), Fee-for-Service Plan, (FFS) or Preferred Provider Organization (PPO) plan. Check to see if you may use doctors outside of the preferred provider plan and if you can, find out if there is a penalty for doing so.
Some plans pay less for medical procedures or office visits if you use an out-of-network doctor.
Find out what basic procedures are covered in each plan. The deductible (the portion you pay before your health plan pays) will vary depending on the type of plan you choose. Many plans offer free wellness visits and preventative care so check to see if the plan you choose offers these options.
If you are on a budget, you may be able to start out with a “basic” health plan that provides essential basic health care and upgrade to a more comprehensive medical plan as your finances allow. The out-of-pocket expenses for a basic plan will be higher but the premium will also be lower.
Vision
If you choose to add vision insurance to your benefits plan, you need to find out what type of exams are covered, the out-of-pocket expenses and what type of eyeglasses or contact lenses are covered. Some plans will allow for only one pair of prescription glasses per year, so you may have to pay for a second pair of glasses out-of-pocket if you want to have a back-up pair of eyeglasses. Some employers offer vision discount plans rather than vision insurance. With a vision discount plan, you will pay fully for the services but at a discounted price agreed to by the plans participating providers.
Dental
Good oral health is a part of overall wellness and a growing number of employers provide dental insurance to employees. There are several dental plan options your employer may offer its employees. A fee-for-service plan is one where the employee pays for services and is reimbursed by the insurance company. Most fee-for-service dental plans allow you to see the dentist of your choice, although services may be discounted when choosing a dentist in a preferred provider network. Indemnity plans pay a specific pre-determined amount for specific services (fillings, extractions, crowns, etc.) regardless of the actual charge for the service.
Orthodontic care is not always covered, so if you have a child who needs braces, make sure you choose a plan that includes this option.
Preventive care and cleanings may be covered at no charge under some plans, so look for this option as well.
Life
Typical life insurance options through employer plans offer $25,000 to $50,000 of coverage. Some employers pay for life insurance for their employees so be sure to see if your employer offers this benefit. If you need more life insurance, you can always purchase a supplemental life insurance policy on top of the employee policy provided by your company. If you have a serious medical condition and can’t find life insurance on the open market, this may be a good option to consider since you may be able to obtain life insurance with guaranteed acceptance during open enrollment with your employer or upon your initial hiring.
Flexible Spending Account (FSA)
A flexible spending account allows you to save pre-tax dollars to apply toward medical expenses such as co-pays, deductibles, and other out-of-pocket medical costs. You can also use the FSA to pay for health expenses for your spouse and children. One thing to remember—most FSA plans have a “use it or lose it” rule. You must use the money put into the account by the end of the year.
You will need to find out from your Benefits Director specific information about spouse/dependent coverage before enrolling in insurance options or adding a spouse or dependent on your insurance plan. Many companies offer a benefits class during open enrollment to discuss all the available options to employees.