6 Things Employees Should Know to Understand Their Benefits

It’s no secret that employees value their health benefits. However, many workers find insurance plans confusing. At benefits enrollment time, workers tend to put off making benefits choices:

• 73% spend less than an hour on benefits planning.
• 41% take less than 30 minutes to review plan information.

Since employee benefits can change yearly, workers need to know their coverage options through good benefits communication. Review six things employees should know to understand their benefits.

1. Costs – Before reviewing new benefits packages, employees should know their current plans, including the monthly premium, copayment and deductible amounts. They should compare this information with new benefits offered for the following year.

Seeing these numbers side-by-side will help workers know if they need to budget more to cover out-of-pocket costs. Or, if there are several plan options, workers may need to select another plan to save money. It pays to understand all of the benefit costs.

2. Coverage levels and features – Help employees review current services and coverages offered by benefit plans. Talk through these questions:

• Which plan features do they use the most?
• Will they have new health needs in the next 12 months that they’ll need their benefits to help cover?

Also, check benefits plans for waiting periods on services and pharmacy benefits for critical medications. Reviewing these details can help employees determine if the benefits will meet their needs.

3. Network providers – Most employer-sponsored health plans have preferred providers and hospitals listed as in-network. Remind employees to verify if their health providers are in-network. If not, they may need to find new providers in the network or settle for out-of-network benefits.

Encourage employees to review these frequently used insurance terms to understand their benefits better.

4. Frequency limitations – Many employees and their family members need care from specialized health professionals. Educate employees on how to check if benefit plans limit the number of visits for specialty care, such as mental health, physical therapy or chiropractic care.

Knowing this information can help employees understand whether the benefits considered will provide the services and coverage they need.

5. Plan options – Educate employees on how to compare employer benefits alongside those available through their spouse’s work. This information can help them choose the benefits that best fit their family’s needs.

If employees anticipate family changes, such as marriage, divorce, or the addition of new dependents, they need to know the cost of adjusting coverage. When changing plans, it also helps to know when existing carriers need to be notified.

6. Insurance carrier reputation – If employee benefits packages feature plans from different carriers, educate employees on how to know each carrier’s history. A few areas to explore:

• Review coverage specifics of each plan
• Read evaluations on the carrier’s customer service and claims processing records.
• Check the carrier’s insurance ratings, financial stability, and how long they’ve been in business.
• Visit carriers’ websites and review news releases.

Gathering this information can help employees avoid selecting an insurance carrier with financial difficulties or problems paying claims.