Posted October 6, 2016
It’s that time again: open enrollment season for employee benefits. Throughout the country, employees will be asked to sign up for benefits, modify plan coverage options or review new choices. Employees often are overwhelmed by the enrollment process and are uncertain which insurance benefits will provide the best coverage for their needs. Here are five questions to ask when evaluating health benefits:
1. How much coverage do I need? – Review your health needs and those of your dependents. Determine what type of medical services may be needed in the coming year, including dental, vision and hearing benefits. Ask yourself:
- Are there health needs that require care throughout the year?
- On average, how much is spent each year on prescriptions, doctor visits and other common services?
- Does anyone need dental fillings or crowns? What about orthodontia benefits for braces?
- Is there a need for new prescription eyeglasses or contacts?
- Will anyone need hearing care, such as a hearing evaluation and/or hearing aids?
Review the information provided by your employer and insurance broker to determine the type of insurance benefits and amount of coverage needed during the year. If enrollment meetings are scheduled, plan to attend one.
2. Do I anticipate any family changes in the coming year? The birth of a baby, adoption, retirement, marriage, divorce and dependent age changes almost always impact the benefits needed. Select plans that meet these needs. If the change is considered a qualifying life event, such as a birth or marriage, an employer may allow employees to make benefits changes outside of open enrollment.
3. What kind of health plans is available? Review plan prerequisites, copayments and deductibles. Know whether the plan is an HMO or PPO:
- HMO – A Health Maintenance Organization features lower costs for services, but the network of health care providers may be limited. The primary care physician must refer patients to a specialist.
- PPO – A Preferred Provider Organization is designed around plan flexibility and a larger network of health care providers. Patients do not need a referral to see a specialist. Seeing a provider in the network saves patients money. Premiums for a PPO plan may be higher than an HMO.
4. Can I customize my benefits? Some employers offer multiple benefits options, allowing employees to tailor their benefits package. For example, employees in good health may choose a lower-cost high-deductible medical plan and invest in dental, vision and hearing benefits.
5. Do the insurance carriers have a good reputation? Insurance companies often look the same, but, in reality, can be very different. Talk with family, friends and your benefits administrator to learn how well the carrier generally handles plan changes, claims processing and customer service issues.
Employers who offer the right mix of benefits find their employees are more productive. Watch this video to learn how benefits can impact performance.