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Proactively Confronting the Top Issues of Offering Employee Health Insurance

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The daily struggle for HR executives is in defending two all-important, but sometimes mutually exclusive, business interests. Human resource executives are torn between providing insurance coverage and benefits that are affordable and attractive in terms of good quality care for employees and the challenge of meeting the organization's budgetary goals and keeping the company viable in the eyes of the CFO and shareholders.

Giving these seemingly opposing objectives, it comes as no surprise that the government is stepping in with talks of mandated health coverage for all working Americans. Those discussions are only going to get more heated, placing HR executives in a unique position to confront and address these possible regulations by taking steps to positively and proactively manage the rising costs of healthcare for their businesses.

What's at Stake?

It becomes bold but true to say that the overall health, both physical and fiscal, of our country is at stake. With businesses worried about contributions inflating their budgets and employees seeing health coverage as a drain on their own paychecks, we are faced with a disconnect and a loss of what is in the best human interest for both parties.

Healthy employees are happier and more productive and miss less work. A business is more attractive if it offers exceptional benefits—not just for salaried employees but also for part-time and hourly staffers. But access to quality insurance that is affordable for employer and employee has been a challenge. Certainly, there are genuinely good intentions on each side of the argument, but the road to "somewhere" was paved by these very intentions. This is why it becomes so important to create a concrete solution that will meet the needs of both parties.

Ask your business-insurance provider if it provides coverage for all employees—salaried, hourly, and part-time. For these providers, offering limited benefit plans is a tremendous way to round out a comprehensive offering for clientele, particularly those in the restaurant, retail, and hospitality industries.

Who Are We Talking About?

Individuals with a household net pay of $75,000 or more are insured at 91.5% of this financial category, according to the Employee Benefits Research Institute. Therefore, you can make the assumption that when you are discussing options to educate and insure the uninsured, you are focusing on the lower end of the income scale—a vast majority of whom hold part-time (or sometimes several part-time) or hourly positions in the American workforce. This group should be rewarded for working, not penalized. We've all heard the story of individuals refusing to work because they would "lose their Medicare benefits." This truly serves no one and, sadly, actually encourages more folks to rely on government assistance programs—it's self-defeating and self-fulfilling.

Most of the uninsured individuals in this category are either electing to decline coverage because they feel it is too expensive, or their employers are not offering coverage because they feel that they cannot afford to contribute to a benefit plan that would service employees' needs. HR leaders must understand that there are solutions and alternatives to address both concerns, satisfy these seemingly competing and conflicting interests, and, again, proactively address what may be an inevitable, and possibly less attractive, government mandate.

A Solution for Both Employees and Employers

We are not discussing the kind of catastrophic coverage most likely already offered to salaried employees. The vast majority of individuals who fall between the cracks are young (between 25 and 40) and simply need basic coverage to go to the doctor or dentist and affordably fill prescriptions.

The issue with reaching this demographic depends upon offering these people affordable options paired with education from the employer to break their perception that they only need to visit a doctor when they are sick or that health coverage is not in their budgets. This attitude has become a vicious cycle in the United States healthcare system, and as a result, medical care is becoming more and more reactionary and significantly more expensive.

Limited benefit plans and so-called "mini meds" have risen up through the clutter in recent years to help the private sector combat the issue of affordable and comprehensive coverage for employees.

These plans are successful for employer and employee alike, especially when they are tied to a large PPO network. Networks help this segment of the population by not only providing discounts on provider fees but also by connecting people to providers like family doctors. Because many part-time workers have never had access to insurance coverage, their use of the healthcare system may have been limited to expensive emergency-room care or clinics with long waits for service. Through networks, employees can receive care from family doctors, giving employers healthier staffs and resulting in higher productivity and positive recruitment and retention figures.

In addition, there is no minimum contribution needed from the employer to set a limited benefit plan in place for its employees. However, it is important to consider that the higher the contribution from the employer, the more likely it is that employees will participate.

Providing limited benefits is a practical and tangible step employers can take to help workers gain access to quality and affordable care. In doing so, they are playing an integral part in the solution to our national healthcare crisis as well as serving their own business goals of recruiting and retaining employees. As an HR professional, it is important to ask yourself if you have explored every possible solution to meet the needs of your organization and its most valuable assets—its employees. If your organization has a significant number of part-time or hourly workers (500 or more), this consideration is critical. Proactively investigate and weigh your options, and address this issue on your terms before being forced to do so.

About the Author:

An award-winning writer and accomplished speaker, Susan Nicolai has worked as a marketing consultant for more than 20 years. Currently, she serves as the director of marketing administration for Planned Administrators, Inc. (PAI), a subsidiary of Blue Cross Blue Shield of South Carolina. For more information, visit
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