Employee Health Insurance

Health insurance is a virtual must today. With the rising cost of healthcare, consumers simply need health insurance coverage in order to receive proper medical attention when needed. There are many different employee health insurance plans available today and choosing the best one for you and your family depends on your understanding of each plan and its benefits.

A traditional plan or fee for service plan is the most commonly offered employee health insurance plan today. This is where each employee is permitted to choose their own medical care provider. The insurance company will pay the provider or will reimburse the employee for any services that are rendered.

Managed care includes Preferred Provider Organizations or PPOs and Health Maintenance Organizations or HMOs. These are very popular employee insurance plans. In an HMO, health care is typically prepaid and employees are required to use specific doctors who contract with the organization to provide healthcare services. Under PPOs insurance companies will negotiate a discount with certain physicians and hospitals in order to provide services to employees. Employees will be given a list of physicians and medical facilities from which they much choose and they are required to pay a specified amount for each doctor’s office visit. This amount is normally between $10 and $25 for each visit.

Self-insurance is another option for employees. This is typically when an employee has taken on all or at least most of the risks associated with healthcare costs. Outside insurance companies typically take care of filing claims and other paperwork and the employee must pay those claims. Employers do often provide some assistance with paying claims for those who are self-insured although this will vary from employer to employer. This insurance provides employees with more control over their choice of physicians and other factors but require employees to be completely liable for all claims. However, there is an option to set a cap on healthcare spending. Once that cap is met the insurance company will begin paying the claims.

Many small businesses have begun to decrease the amount of benefits that they offer to employees due to the rising cost of health insurance and healthcare. Many companies that write health insurance policies for smaller businesses simply charge too much for smaller companies to afford. They often demand extensive medical histories for all employees and a single pre-existing condition from one employee could possible drive the premium up for all employees or the carrier may simply refuse to sign on any employees at all. The policy may also be canceled when it comes time for renewal if one employee becomes seriously ill during a policy period.

Some states are not requiring certain benefits. If an employer does offer benefits then he or she may be required to provide specific coverage types. An employer who cannot afford these mandated coverage amounts may simply drop employee health insurance completely. It is important that you understand the policy that is provided to you through your employer. If no insurance is offered through your employment then there are other ways to purchase your healthcare coverage.

Be careful to compare prices from various different companies in order to receive the best benefit package as well as the lowest rates. Of course, this if for those who do not have access to employee health insurance. If your employer offers insurance that you can afford it is often best to take that plan. Many employers pay a significant amount of the employee’s premium each month, making the insurance much more affordable for employees and their families. Some plans include vision and dental coverage for employees and their families. Again, you will need to speak with your employer to learn about what specific coverage is offered to you through your employer.

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