Help Employees Make Better Health Care Decisions

Posted on Monday, July 15, 2019

On average, consumers spend 10 hours researching new car purchases. They spend four hours shopping for new computers. They devote five hours to finding the best vacation deals. And they spend two hours, on average, choosing a new TV. 

In contrast, the surveyors found that 40 percent of workers spend fifteen minutes or less researching workplace health insurance benefits as a new open enrollment period approaches. Another 25 percent don't even spend five minutes on the issue. 

That's unfortunate because health insurance represents several thousands of dollars out of each employee's pocket, including family coverage. The plan selection also affects the deductibles, copays and other amounts they pay out of pocket, year in and year out, for health care for themselves and for their families. When you account for the fact that this is a recurring annual expense, it's frequently an even bigger expense than the automobile they spend 10 hours researching. 

That's why choosing a health care plan – even from a menu of sponsored plans provided by your employer – deserves substantial time, effort and due care. 

As it stands, however, we have a fundamental mismatch between the health insurance plans that customers are buying and what they think they are getting: 

Three in four workers do not understand or have only a rudimentary grasp of what their plan covers or doesn't cover. 

Two in three workers believe they are not substantially better prepared for open enrollment decisions this year than they were last year. 

Two in three workers don't understand changes that carriers and plan sponsors have been making to their health insurance coverage from year to year. 

Meanwhile, nine workers in ten simply sign up for automatic re-enrollment without taking the time to adequately review the plan options offered during annual open enrollment periods.

 What To Do 

Encourage employees to ask managers, their HR representatives or employee benefits specialists about the choices. Stage an informational meeting at the beginning of the open enrollment period, or if possible, arrange for your health insurance agent to come in and make a presentation outlining the available options and answering questions about coverage. 

Employees can:

Attend seminars when they are offered.

Plan for the worst case: Will you be able to afford a significant hospitalization on your plan? If not, consider upgrading to more comprehensive coverage, if available.

Do your research. Look over plan materials carefully.

If you are married, involve your spouse in the decision.

Spell out any deductibles, up front expenses, exclusions, co-pays and co-insurances. Compare them between plans.

Take a look at voluntary benefits, if any, and see what supplemental benefits are available.

Does your family history indicate an elevated risk of cancer, diabetes or other hereditary illnesses? Consider a critical illness policy, which provides additional benefits in the event you are diagnosed with a covered illness. You may need the benefits to compensate you for time off work, for help with co-pays and co-insurance, travel expenses for treatment, family accommodations, and the like.

Review your individual disability coverage, if any, as well. Many times workers need more disability insurance than employee coverage offers, alone. 

If employees have questions, be sure they know that the HR department is there to get those answers for them, so everyone can make informed decisions about this important area of life.  

Posted in Tax Topics For Individuals

Disclaimer: The information contained in Dulin, Ward & DeWald’s blog is provided for general educational purposes only and should not be construed as financial or legal advice on any subject matter. Before taking any action based on this information, we strongly encourage you to consult competent legal, accounting or other professional advice about your specific situation. Questions on blog posts may be submitted to your DWD representative.