Health care reform protects your employees from runaway health care costs with government-regulated limits, right? The answer is yes, but with a surprising caveat: Out-of-pocket limits are restricted to only those costs for essential health benefits covered under an individual’s health plan.1 That means patients can rack up bills for procedures, treatments or prescriptions not covered under their plan or outside their network. These costs won’t count toward their out-of-pocket limit but will directly affect their wallets.
A few simple tips can help you prepare your employees for and protect against unexpected medical bills.
1. Educate your employees about unexpected medical bills by explaining:
- “Covered” doesn’t mean “paid in full.” In insurance lingo, it actually means that deductibles, copayments or coinsurance for the procedure will count toward their out-of-pocket limit. ·
- Incremental health insurance costs may incur throughout the year, not just up front. Forty-six percent of workers say the amount of monthly premium or the coinsurance they have to pay for health care services is the most important factor when choosing their major medical insurance each year.2 That’s why having voluntary insurance can be essential to helping many employees pay for unexpected costs. And voluntary insurance pays even if a procedure isn’t covered under an individual’s major medical plan.
2. Voluntary insurance is a perfect complement. Many employees focus on the upfront cost of having health insurance instead of the incremental costs they may incur throughout the year. In fact, 46 percent say the amount of monthly premium or the coinsurance they have to pay for health care services is the most important factor when choosing their major medical insurance each year.2 So that’s why having voluntary insurance can be essential to helping many employees pay for unexpected costs.
Voluntary insurance works hand in hand with major medical plans to help make sure individuals who are sick or hurt have the funds they need to pay health-related costs their primary insurance might not cover, such as daily living expenses, like bills and groceries, as well as medical deductibles and insurance copayments, expenses major medical insurance isn’t designed to pay for. The important part is that voluntary insurance pays even if a procedure isn’t covered under an individual’s major medical plan.
3. Are employees interested in purchasing voluntary? Here are just a few statistics that point to a resounding yes:3
- Overall, 88 percent of employees at least somewhat agree they consider voluntary as part of a comprehensive benefits package.
- 64 percent of employees see a growing need for voluntary.
- Among employees who aren’t offered voluntary at work, 70 percent of them say if their employers offered the benefits options, they would be at least somewhat likely to purchase them; 28 percent of workers are very or extremely likely to purchase them.
As the saying goes, “An ounce of prevention is worth a pound of cure.” Taking steps now can help employees prevent high out-of-pocket costs not covered under their health plan and to be prepared when, and if, they do have unexpected medical costs.
To learn more, see the out-of-pocket
limits fact sheet.
1 Under nongrandfathered
2 2015 Open Enrollment Survey, conducted by Lightspeed GMI from June 23 – July 2, 2015, among 2,000 adults ages 18 and older who are employed full or part time at a company with three or more employees.
3 The 2015 Aflac WorkForces Report is the fifth annual Aflac employee benefits study examining benefit trends and attitudes. The study, conducted in January 2015 by Research Now, captured responses from 1,977 benefits decision-makers and 5,337 employees from across the United States, at companies with at least three employees. To learn more about the Aflac WorkForces Report, visit AflacWorkForcesReport.com.