To this effect, a healthcare-sharing plan is emerging to catch the attention of many small businesses considering alternatives to conventional healthcare insurance to help employees achieve affordable healthcare benefits. Among those alternatives are healthcare-sharing plans that allow the business owners to gain low healthcare cost management with the sentiment of the community through members. Yet finding the right one can be very challenging. This article will highlight the major considerations when selecting a Health Share plan for your small business.
What Are Health Sharing Plans?
Health sharing plans, also known as health care sharing ministries (HCSMs), are organizations where members share healthcare costs. Unlike traditional health insurance, these plans are not governed by state insurance regulations, which allows them to offer more flexibility and often lower costs. Members typically pay a monthly subscription, which gets collected and split to cover each other’s medical costs. Now that you have this, understand the general architecture of such plans before really delving into details about the choice of the right health-sharing option for your small business.
Review Your Business Needs and Objectives
Before browsing health sharing, you need to consider the specifics of your needs and what you want for your business. To achieve that, ask yourself these questions:
- What is the budget limit for employees’ health care?
- How many employees will be under this health-sharing plan?
- Which type of health care service do your employees require more often?
- Do your employees need a plan that provides preventive care and wellness services coverage?
Considering these factors, you can now choose your final option that is best suited to your business needs and your employees’ requirements in terms of the health-sharing plan.
Examine the Network of Providers
The most important thing to consider when choosing a health-sharing plan is the network of healthcare providers. While traditional insurance generally has a defined network, health-sharing plans are generally more flexible.
- Make sure that the plan you choose has a wide network of hospitals, doctors, and specialists.
- Look for plans that partner with reputable providers to guarantee quality care for your employees.
- Check if the plan allows members to receive care outside of the network and under what conditions.
The potential to access a big network of providers significantly improves the satisfaction level of the employee and makes sure the employee can receive the kind of care needed without burning through out-of-pocket dollars on out-of-network services.
Review Eligibility Requirements
Health-sharing plans have distinct eligibility requirements that differ dramatically. The requirements mostly consist of:
- Lifestyle requirements such as not smoking, and other weight limitations.
- Religious affiliations or beliefs, since most HCSMs are based on shared faith
- Age restrictions
Consider the above eligibility criteria very keenly and determine if it will work effectively with different age groups being in the company as they apply. If your workplace has a mixture of ages then ensure that your policy should provide for such varying lifestyles as well as believes
Consider Cost Structures and Member Contributions
One of the most important factors in choosing a health-sharing plan for your small business is cost. Traditional insurance does not always have easy-to-see cost structures, but in a health-sharing plan, most of them clearly state how much is contributed each month from the member. Understand also what percentage is contributed from the medical cost on each plan, since there can be a tremendous range in this area, also.
Ask if there are any add-on fees or charges such as administrative fees or individual services that the sharing plan does not pay for.
With this understanding of your total cost of coverage, you can now evaluate whether any given health-sharing plan has the potential to fit into your budget yet still maintain the coverage needs of your employees.
Coverage options and what is and isn’t included
Not all health-sharing plans are the same. In this regard, there are things that one should observe: types of medical costs covered. These include the following: routine check-ups and preventive care, emergency services, hospitalization, prescription drugs, maternity care, and mental health services.
Discuss any exclusion or limitation in coverage. Some plans will not cover pre-existing conditions, and others will deny specified treatments, which will affect your employees’ health needs. Be sure that the plan meets high standards in comprehensive coverage according to your employees’ requirements.
Be informed about the handling process
Here perhaps more than in any other health-sharing feature lies all the difference. In all likelihood, it’s because of the difference between the health-sharing program and the insurance that the claim process is going to be pretty different from anything that the employees may have dealt with before.
- Find out through which channel you file the claims and for how much time.
- Know which papers are asked for at the time of the refund by the members for medical spending.
- Know the duration time for the approval of claims and the payment over that claim.
A clear and easy process in making claims can greatly determine the difference an employee would have when having a relationship with the health sharing plan, hence finally satisfying him about your company’s benefit package.
Review Member Support and Resources
The more support given to a health-sharing plan by their members, the better their experience becomes. Look at some of the plans with resources that may include;
- Websites of member portal; manage accounts and view expenditure
- Customer service support to ask questions and resolve issues
- Educational resources about options in healthcare and preventive care
- Having strong support enables your employees to better take care of their health concerns and reduce confusion regarding the plan.
Conclusion
Therefore, choosing the right health-sharing plan for your small business is an important decision. The right health-sharing plan may go a long way to ensure good employees’ health and the financial health of your business. Key factors guiding that choice would include measuring your business needs, assessing provider networks, understanding costs, examining options for coverage, and seeking member support. Adopting health-sharing plans is a step towards a healthier workforce in the face of the challenges presented by modern healthcare.
Contact HSA for America to learn more about how Health Share Plans and HSAs can benefit your business and help you create a healthier, happier workforce.
