Healthcare Options For Organizations

Healthcare Options For Organizations

Healthcare Options For Organizations

Rising healthcare costs are a concern for both individuals and employers. Survey data from Kaiser Family Foundation shows that 87% of employers feel it is unsustainable to offer healthcare benefits in the long run. 

Understandably, some employers are ditching health benefits altogether. However, if it’s too expensive to offer traditional healthcare, there are several affordable healthcare options for organizations you can settle on. Here’s what’s in store for each option. 

1. Small group health insurance 

The organization can take out a group health plan, and validating the plan requires at least a 70% employee participation rate. Employer and employee will split the cost of the premium rates payment. 

The three most common small group health insurance plans include:

a) Health maintenance organization (HMO) 

It’s a form of network health insurance plan for subscribers on a prepaid contract. The plan grants employees access to quality healthcare at an affordable price. 

That said, employees can only choose a primary care physician (PCP) from the HMO network and need a referral from a PCP whenever they go off-network. 

b) Preferred provider organization (PPO)

The PPO is the healthcare option of choice for most organizations because of its flexibility. Employees don’t need to choose a PCP, so they don’t need referrals before seeking care. 

Additionally, employees can choose an out-of-network provider at an additional cost and use the plan wherever they go. However, employees must co-pay for every doctor visit, even an in-network visit.

c) Point of service plans (POS) healthcare options for organizations

Point of service plans combine the best of both worlds—employees enjoy the benefits of in-network and out-network care, so they can choose which physician to consult. In addition, the plan offers low co-pays and no deductibles—best for employees who need frequent counseling and physical therapy.

Employees may require a referral from their primary care physician for certain services. The worker will submit a reimbursement claim to the insurance, which may decide only partially to cover the claim or refuse to cover it altogether.

2. Qualified Small Employer Health Reimbursement Account (QSEHRA)

QSEHRA is for employers who don’t offer group health coverage but allow their employees a tax-free reimbursement for qualifying health expenses. It is one of the most cost-effective healthcare options for organizations and gives employees the freedom to choose their preferred insurance plan. 

In 2022, the maximum amount an employer reimburses through QSEHRA for a single employee’s coverage is $5,450

3. Individual Coverage Health Reimbursement Accounts (ICHRA) 

The plan offers insurance reimbursements instead of buying them for employees. You have the freedom to determine reimbursements based on family size, employee class, and employee age. ICHRA allows employees to enjoy the following benefits:

  • Choose plans, including doctors
  • Have dental and vision insurance in their plans
  • Healthcare expenses reimbursement
  • Take the plan with them even when changing jobs

4. Small business health options program (SHOP)

SHOP is a marketplace established through the Affordable Care Act (ACA) meant to make it easy for small business owners to buy employee health insurance. 

The marketplace allows comparison of the different healthcare options for organizations available to your employees. It’s open to small businesses with less than 100 full-time employees. 

Employers may enjoy tax credits by purchasing healthcare plans through the marketplace. To meet the tax credits requirements, you must:

  • Pay 50% of the cost to employees
  • Have less than 25 full-time staff
  • Pay salaries less than an average of $56,000 a year

The marketplace has an unlimited enrollment period, so you can buy any time of the year. 

Bottom line

The best way to take care of employee health is to settle for one of the healthcare options for organizations, as your employees’ well-being directly impacts your business. 

Some of them allow employees to go off-network at affordable rates. There are even healthcare marketplaces where you can shop for the best deals.

Contact Health Consultants Group

To learn more about healthcare options for organizations, visit our contact page or give us a call at (800) 367-2482.