Offering benefits is a great strategy for companies to show recognition and also improve relationships with their employees. When it comes to Healthcare and Insurance plans are always on the agenda.
These types of services are good and bring a number of Medical Benefits to your company. However, it is necessary to understand each of them to hire the one that most fits the profile of your business and the needs of your employees.
1. Social benefits
After salary, health insurance is the most appreciated benefit by the employees in terms of the Remuneration policy, allowing them to access a set of coverage at lower prices than those in the individual insurance market.
There are companies that participate in the inanity of their employee’s insurance. Others even offer it and there are still those that extend any of these benefits to the developer household.
The measure generally integrates the company’s social benefits policy and may include other incentives, such as childcare checks, pension funds, or school book collection. For companies, there are tax incentives. The amount spent annually on employee health insurance premiums may be deducted in full, in the event of IRC.
Most insurance sits mixed, i.e. they combine the reimbursement and agreed network modalities, although simplified versions can be negotiated.
By the reimbursement component, the insured person may use any healthcare provider of his choice and be reimbursed by the insurer for part of the expenditure in the percentage provided for in the policy.
By opting for the agreed network, the insured only pays part of the expense at the time the medical act is carried out (e.g. EUR 15 for a special consultation). The insurer subsequently pays the service directly to the provider.
3. Capital limits It
It is the annual list that each employee will have for the coverage provided for in the policy. For example, 25,000 euros of capital limit for hospitalization and 1500 euros of capital for outpatient clinic.
As a rule, insurers offer predefined packages, which combine different coverage, such as hospitalization, outpatient clinic or stomatology.
But if you have a negotiating margin, you can customize the set of coverage you want to make available to employees.
In this sense, it should take into mind the profile of workers. If you are surrounded by young people, it is natural that they value childbirth coverage, for example. For companies with employees of higher age groups, the concern with possible costly surgeries, provided for in the hospitalization coverage, will be relevant.
Hospitalization is the basic coverage of health insurance, always present in policies. With capitals between 5 and 500 thousand euros, allows access to a private hospital or clinic in case of hospitalization for more than 24 hours.
The insurance covers medical fees with surgical interventions, treatments, utensils and medicines, the room and the hospital rate. When the plan includes birth coverage, a portion of the capital is reserved for these expenses.
Highly valued by employees is usually outpatient coverage, which gives access to general practice or specialty consultations, treatments and auxiliary diagnostic tests. It also covers small surgeries that do not need hospitalization.
Not always included in group policies, but much desired by employees, is the coverage of stomatology, for hygiene, consultations and dental treatments. However, it does not pay for aesthetic interventions, such as bleaching or the application of gold teeth, for example, and some still exclude dental correction devices.
There are also optional coverages, which enrich the policy, but also make it more expensive. This is the case of prostheses and orthosis prescribed by doctors, whether glasses and contact lenses, whether wheelchairs, crutches or hearing aids. This is also the case for drug coverage, which accounts for pharmacy expenses, provided they are associated with a prescription.
5. Network of Providers
Networks of clinics and hospitals agreed with the insurer when it operates in this modality.
It is desirable that the network has good coverage in the region where its employees live and work.
If your company has employees in various areas of the country, be careful to choose a conventional insurer with a network of providers with wide national coverage.
Also, If the company has its workers concentrated in one region, confirm the presence of a relevant number of clinics and hospitals agreed in this area of the country.
That’s where big companies like FedEx, USPS, DHL and United Parcel Service made mandatory for their employees to have an Insurance before joining. Further, UPS logistics is giving many Benefits to their Drivers as Premiums that include Insurance, 401 (k) plans, and Healthcare.
with UPSers, workers do receive many discounts. Multiple Benefits can be redeemed using the Enterprise:
- Cost reduction with absenteeism.
- Reduction of employee turnover.
- Reducing the costs of accidents at work.
- Reduction in the number of medical absences.
- Minimizing the risk of suffering labour actions.
- Improvement of the reputation before residents, administrators and employees.
- Increased productivity and Time Management.
When opting for the agreed network, it is up to the insurance beneficiary to pay a small part of the expenditure at the time it is made.
This co-payment can correspond to a fixed amount or a percentage of the cost of the service. For a specialty consultation, for example, you can pay 15 euros. For an exam, it may be stipulated that the insured always pays 10% of its cost.
To these amounts, it is possible to add an annual deductible, charged on the first use of the insurance in each inanity.
Some insurers charge, for example, 25 euros in deductible for each coverage triggered.
Different is the reimbursement of the insurer in the form of reimbursement.
When accessing a non-agreed provider, the insured pays the full expense and can then send the invoice to the insurer through their portal, which reimburses it in the previously agreed percentage. The reimbursement table varies according to the type of medical act and is made known to the insured at the time of insurance.
It may provide, for example, for reimbursement of 70% of the costs of specialty consultations or 80% of clinical analyses.
7. Periods of grace
When insurance is contracted by companies for their employees, it is possible to negotiate the reduction or even elimination of grace periods in some of the coverage. Login to the portal to check the details. Otherwise, it is common to impose grace periods of 60 to 90 days for some coverages, which will only come into force after that period. Usually, these periods are even longer for delivery coverage. However, grace periods only apply to situations of illness or pregnancy, as accident cases are covered from the first day of the policy.
8. Age limits of permanence
The generality of group policies, negotiated for companies, does not close the door to the accession of any of the employees, regardless of their age.
However, it is common to set age limits of residence, which are around 65 or 70 years, coinciding with the retirement age. For the household, there are companies that limit the participation of child premiums until they reach 18 or 25 years.
Is the amount that your company’s employee will pay annually to join the insurance (unless the company fully take the premium and offers the insurance).
And this is where negotiation with the insurer can bear good fruit, achieving competitive prices.
Then, depending on the employee benefits policy you implement in the company. You can additionally establish differentiated premiums for the employee’s household if it is possible to include them in the policy. This is usually an option that gives more negotiating power to the insurer. Not only because it expands the range of policyholders, but also because it dilutes the risk associated with diseases since households end up including people of all ages.
That’s why you need to be very careful before picking a health insurance plan.
It is no wonder that their negotiating power to obtain discounts varies depending on the relationship it already maintains with the insurer, taking into account the size of the insurance portfolio which keeps them awarded.
Then you’re likely to get additional discounts as the number of insurance workers grows.
Hiring insurance for 15 employees is not the same as signing up for a policy for 150.
And if they still bring their families together, the greater the negotiating power.