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Helpful Tips as You Consider a Health Plan for 2019

As we approach the fourth Quarter and 2019, many of you are making decisions regarding your employee benefit plans. Concerns about what coverage to provide in this highly competitive employment marketplace and the cost of coverage have been hot topics we are hearing about. Did you know that there are many factors to be considered other than just the obvious premium rates of the plans?



Important plan Issues to consider when selecting a benefit plan/carrier for your employee benefits include:

  1. Benefit Levels provided including deductible, co-insurance and out of pocket maximum
  2. Benefits that are available to employees that are not subject to the plan deductible – these are normally the benefits that most employees use throughout the year. The Chamber plans have 11 service areas that are paid “first dollar” without having to satisfy a deductible.
  3. Cost of coverage – do you receive a discount in rates for paying a high percentage of the cost of the employee and dependent premiums?
  4. Does the plan provide significant Accident Benefits not subject to deductible? This has become more important as deductibles have increased in recent years. The Chamber has responded to those needs by providing a 1st dollar $ 1000 per occurrence Accident Benefit not subject to the deductible.
  5. Does the plan have an Accidental Death & Dismemberment Benefit? The Chamber plan provides a benefit on the employee for $25,000!
  6. Does the carrier provide coverage for Air Ambulance, a cost area that can easily result in a bill over $50,000 and reach near $100,000 in some instances? The Chamber Plans provide benefits that are 2 to 3 times that of many other plans.
  7. Does the Pharmacy benefits cover prescriptions that are being prescribed to your employees? This is an area which can be significantly different between plans/carriers which have differing Preferred Drug Lists, does not cover brand drugs or requires lengthy preauthorization processes before filling.
  8. What is the panel of providers who contract with the carrier? This is a critical issue and one that can result in significantly higher out pocket cost to the patient if a non-member provider is used. The Chamber plans include approximately 98 % of area providers and has a national network of out of area covered providers for those with dependents living out of State.
  9. Does the carrier provide COBRA administration for terminating employees or dependents who lost coverage for other reasons?
  10. Does  the carrier that administers the plan offer great customer service? The Chamber monitors the service of our carriers and believe we have “Best in Class “ service from Pacific Source Health Plans.

 

If you have any question or would like additional information on the Bend Chamber Health Plans, please contact Shelley Junker, Bend Chamber of Commerce @ 541-598-5275 (shelley@bendchamber.org) or Lisa Thompson, Johnson Benefit Planning @ 541-382-3571 (lisa@johnsonbenefitplanning.com).

 

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