How to Choose the Right Employee Medical Plan and Exercise Cost Containment

There are many options available to you when it comes to choosing an employee’s medical insurance plan. Namely;

  • The Annual Premium
  • The intermediary recommendation
  • The benefits of the plan
  • The insurance company

We want to get there.

  • Comprehensive Program to achieve the company’s objectives
  • A reasonable premium
  • Both the intermediary and the insurer should provide acceptable service.

These are some of the points we have highlighted for you to consider.

You can use either a Package Plan, or a Customize Plan to get the best deal.

For companies with 10 or fewer employees
These modules are often run as a family business. All employees are closely connected with senior management and, if necessary, the business owner. Every employee is equally important in the company’s success.

This is why most business owners will think about having a program that provides equal benefits for all employees.

We see here how a business owner plans to provide a medical package for employees.

  1. You can use 2% of the annual payroll as a guide to determine the annual budget for a program that offers medical insurance.
  2. What is the cost of medical treatment if a member of staff is hospitalized because of an accident or illness?
  3. What are the financial implications for the company if it doesn’t have an employee medical plan?
  4. What kind of medical benefits should the employee receive? And what extension is possible for dependents?
  5. Consider a package that offers an age bracket option. In some cases, the renewal premium will not be affected by high claims experience.
  6. Is the package plan able to cover pre-existing conditions?
  7. Is the amount of hospitalisation in line with current medical costs and treatment?

A customized plan may not be beneficial to a small or medium-sized company, as we don’t have enough staff to get a better discount on the premium.

For companies employing more than 10 people
These companies have a certain hierarchy of management, with each department and person having a specific role within the organization.

We generally view the organization chart as

  • Level 1 – The Directors
  • Level 2 – Senior Management
  • Level 3 – Executive
  • Non Executive Level 4

The population ratio of the area is also considered to be high.

  • Level 1 take-up to 10%
  • Level 2 take-up to 20%
  • Level 3 – Up to 30%
  • Level 4 – Up to 40%

With this demographic profile, HR can determine which benefits are eligible by the individual responsible within the organization.

This is how a HR decision maker plans for an Employee Medical Program

  1. The employees can be divided into different categories such as Senior Management, Executive, or Non Executive.
  2. Extension of benefits to dependents or to a specific category only
  3. Additional benefits, such as
  4. Budget for premiums each year
  5. What are the additional benefits and clauses of the plan?
  6. What is the stop loss factor? For example, lock in premium (b), Refund (c), Individual capping

Who should you appoint to be your intermediary

These are some things to consider when choosing the right man for the job.

  1. What level of knowledge does he have to manage your employee’s medical plan?
  2. You have engaged an intermediary to manage your program, but you still need to submit your claim directly to the insurer.
  3. If there is disagreement regarding the outcome of a claim, who can appeal to the insurance company?
  4. Who answers your query about claim issue, your insurer or your intermediary
  5. Are there benefits communication options for staff members once the plan has been implemented?
  6. Are your queries being sent around from one department into another? Or do you have one point contact who can answer all of your questions.
  7. How long does it take for a claim to be settled?

You will save more time and money by having someone to help you with your next review, since every company is different.

Insurance isn’t about product. It’s always about the service and the benefits. Each individual and company must make informed decisions about what they want from their insurance program.