How to Provide Medical Benefits to Employees

Medical coverage has practically become a universal benefit for employees in companies throughout the United States. Employers have a wide range of medical benefits plans available to them, including traditional medical insurance, health maintenance organizations and self-funded, cafeteria or Section 125 medical savings plans for uninsured medical costs. Companies can also decide how to split the costs of medical benefits between employer and employees.

Instructions

Difficulty: Moderate

Provide Medical Benefits To Employees

1. Establish review criteria for choosing the medical benefits package that you will provide to your employees. Emphasize available selection of "in-plan" health professionals and facilities, manageable costs, choice of plan structure such as traditional group insurance or health maintenance organization, availability of preventive programs, such as fitness club memberships, and coverage for other services such as mental health.
2. Solicit the volunteer involvement of your employees to consider and review medical benefits plan proposals to narrow down options for your decision.
3. Contact the public agency in your state that is charged with the mission of extending health care coverage to all employers or providing universal health care coverage. With related legislation passing recently in several states, these state agencies are often the first place for small businesses to find cost-controlled medical benefits plans in their state.
4. Solicit preliminary proposals from the major health insurance providers and HMOs in your area. You will need to provide bidders with information on your employee pool.
5. Select your medical benefits plan and start coverage by beginning an enrollment period for your employees.
6. Include a clear statement of all related policies in your personnel policy handbook and review these with your benefits provider and staff. These policies should include consistent, legally compliant statements concerning the number of hours that employees must work to be eligible for coverage, the portion of premiums to be paid by employer and employees and the specifics mandated by COBRA and FMLA for your benefits coverage.
7. Continue medical benefits coverage for any employee on Family and Medical Leave Act (FMLA) leave or military leave on the same basis as if the employee had continued to work.
8. Provide terminated employees with the option of continuing COBRA-mandated medical benefits coverage, at their expense, if you have 20 or more employees and the terminated employees have been covered under your medical benefits plan. Familiarize yourself with COBRA requirements concerning the duration for providing such coverage.

Tips & Warnings

• Avoid paying first-dollar costs for medical benefits. You can control costs and often obtain cheaper overall premiums by opting for a medical benefits plan that includes employee co-pays and even deductible amounts for some procedures.