AFFORDABLE HEALTH BENEFITS - A Thing of the Past?

In today’s radically changing healthcare industry, individuals and small employers have an almost impossible task of securing affordable healthcare.  Everyone including small employers is receiving increases of 6 to 20% in their monthly premiums and a corresponding reduction in the benefits.   In addition, individual and small group restrictions are increasing to the point where many small groups can no longer qualify for the traditional major medical programs.

To further complicate the problem over the past 5 years, the cost of health insurance benefits have been passed on to the individual thru increased deductibles, elimination of employer paid dependent coverage, and decreases in the benefits included in many employer paid plans. 

Individuals and employers are at a cross roads as to what to do given new government regulations and escalating health care costs.  Many employers, large and small, are considering dropping health insurance benefits and either paying the employee a certain amount of money per month to obtain individual insurance or not providing any type of benefit assistance. 

Fortunately there are alternatives to be considered when trying to solve this problem of obtaining affordable health benefits for both the small employer and the individual. 

CHOICES THAT CAN BE MADE

1. Employers continue to pay the increasing high premiums if the cost can be passed on to the organizations customer.
2. Cancel the insurance plans and pay the employees a benefit allotment each month.
3. Cancel the insurance plans and inform the employees to obtain individual coverage if they can obtain the coverage or if they can afford to obtain the coverage.
4. Pay the employees a monthly stipend to cover some or all the cost of individual insurance.
5. Chose an insurance plan that is not a major medical plan but a limited insurance plan that provides limited coverage for the major medical needs; hospital, doctor visits, labs, etc.

The individual is really restricted in the choices that can be made.  The problems that must be considered when obtaining individual health insurance:

1.  Review the offerings of the State Insurance Programs (future exchanges) offered in the individual’s home state.  These plans tend to be very expensive and many people cannot afford the monthly premium. 

2.  Review individual major medical plans offered by different carriers recognizing that such limitations as age and health status can be a big obstacle in obtaining affordable plans. 

3.  Obtain an individual limited insurance plan for the individual and family that cover most of the major expenses associated with health care; hospital, doctor visits, lab tests, etc.  There are few or no restrictions on these plans such as age or health problems.   These plans must be selected with the understanding that they do not provide the amount of coverage of most major medical plans but do offer protection from extreme financial losses.  But, as the name implies, the plans pay specific amounts

For specific procedures or visits.  For example, $70.00 for a doctor visits.  Organizations utilize these types of plans to provide coverage for many of their employees. 

4.  The small employer and the individual should research several reputable discount medical programs that are promoted in the marketplace offering discounts on such services as physician and hospital visits, dental procedures, prescriptions, and vision needs that should be incorporated into an affordable, individual health plan.   Discounts from 10 to 60% can be achieved when using these programs and some offer assistance in negotiating expenses with hospitals, doctors and dentist.  Recently Forbes Magazine published an article comparing dental discount programs with dental insurance and stated that the discount programs were often more cost affective.

NO EASY ANSWERS

The bottom line is there are no easy answers to the problem of securing affordable health benefits.  A person must do a personal healthcare assessment including such important things as income level, job security, age, and health status.  The starting point must be “how am I” and “how much can I afford to pay per month”, and “how much risk can I afford to take”.   Of course, if there is a spouse or family the assessment must include those family members.  
The next step, if a person can afford it, is to establish not only a health benefits plan and budget but to establish a certain amount per month to place in a health savings account or sometimes referred to as an HSA.  This can be a formal HSA or an individual savings account and that decision will depend on a person’s income and tax levels.

The final step for the individual is to do the research necessary to understand the various plans and the various components associated with different types of plans being offered in the marketplace and what will be offered in the next several years.  The days of the employer picking the plan and paying for the plan is quickly evaporating.  The individual will have to take charge of his or her health and health benefits and not rely on just the employer to provide the best alternative. 

The small employer must make the identical assessment as the individual but include such things as impact on the workforce, turnover of employees, and the impact on production and customer service.  

As we all know, the healthcare industry is changing rapidly and everyone must become personally responsible for researching, planning and implementing their own health plan to protect their health and well being.  The first questions everyone should ask any healthcare provider is, “how much does it cost” and “is it a necessary test or procedure”.  Then, “THE CHOICE IS REALLY YOURS!”

Company & Individual Bios:

Strategic Franchise Services (SFS) is marketing organization selling both health and life insurance products and services to individuals, small businesses, and associations.  SFS is part of a national health care consulting organization, Strategic HealthCare Initiatives (SHI) based in Dallas, TX. Additional information about these two organizations can be found at www.strathealthcare.com and www.healthcaresavers4u.com and a corporate blog at www.healthsavers4u.com

Richard Fuchs is the President and co-founder of Strategic Franchise Services.  He has over 20 years of management experience in a Fortune 100 company and has started an owned several small business including Strategic Franchise Services.  Mr. Fuchs is a published author who wrote and marketed three national training video based training programs utilized by many government organizations and major corporations.