How to provide health insurance your employees can actually use

Photos / Courtesy, Taro Health Jeff Yuan, left, and Frank Wu are founders of Taro Health.

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By Jeff Yuan and Frank Wu

Open enrollment is right around the corner, which means business leaders across the state are hammering out their health insurance offerings for employees for the year ahead. In this chronically-tight labor market, these are high-stakes decisions for all employers.

The good news is that saving money long-term and providing comprehensive health care coverage for employees don’t have to be mutually-exclusive propositions. Here’s how to make sure the health care plans you’re offering actually keep your employees well — and keep your bottom line healthy in the process.

Look for hospital and doctor networks that are comprehensive. No one wants to change doctors or try a new hospital, especially when they’re sick. It's important that your employees can access the doctors, hospitals and clinics that they know and trust, plus the best specialists.

Look for insurance plans with networks that include Maine’s two major integrated hospital systems, MaineHealth and Northern Light Health. (For the plans that Taro Health offers in Cumberland, Sagadahoc, Lincoln and York counties, Mass General Brigham is also part of in-network coverage.) Your employees will have peace of mind knowing that they can access the finest care around when they need it most.

Prioritize access to primary care. The vast majority of sick-day calls tend to be driven by everyday maladies like colds, the flu and cases of pinkeye. For many folks, getting in for a quick visit to a primary care doctor can make the difference between being able to keep up a regular work routine or having to disrupt the work week for sick days. To encourage people to seek out care when they need it, we’ve developed $0 copay plans for primary care. We’ve found that taking even nominal out-of-pocket costs out of the equation goes a long way toward encouraging people to seek out the help they need, so that they remain healthy and productive.

Offer low-deductible options. Plans with high deductibles and low premiums can seem enticing to those looking to save money in the short term. But they can create crippling financial burdens when folks need more intense medical care. Some plans on the ACA Health Insurance Marketplace have deductibles as high as $9,000. For most working people, that’s a lot of money to come up with on the fly, especially in the middle of a medical crisis. Make sure you’re offering plan options with low deductibles that are affordable both when your employees are healthy and when they get sick.

Make mental health care coverage non-negotiable. Although the stigma that once accompanied reaching out for mental health support has vastly diminished, the cost of mental health care often keeps people from seeking the help they need. That can result in a big drag on productivity and profitability, especially for small businesses.

A recent Gallup poll found that nearly one in five employees say they have poor mental health, and those employees have four times as many unplanned absences than their counterparts. To try to incentivize people to get the help they need, we’ve added free outpatient mental health care to our plan, with an unlimited number of visits. Providing this kind of access is relatively unheard-of. But we have heard from scores of consumers and doctors alike that this kind of access has radical impact for those who need help.

Tailor a plan to meet your business needs. If you offer health benefits and buy a small group plan, there are lots of different ways you can customize the plan to fit your budget: You can contribute a percentage of the premium; you can contribute a fixed amount; you can offer to cover just the employee or members of the family. Health insurance can be affordable and within your budget if you set it up properly. Work with your broker or representative to find the plan that best fits your needs.

About the authors

Jeff Yuan and Frank Wu are founders of Taro Health, which offers health insurance plans through the ACA Health Insurance Marketplace at CoverME.gov, as well as small group plans for employers throughout Cumberland, Sagadahoc, York and Lincoln counties.