America's Benefit Specialist November 2023

CUSTOMIZABLE BENEFIT SOLUTIONS

Companies with a high turnover rate and predominantly low-skilled workers, such as restaurants, retail establishments, hotels and other hospitality businesses, can benefit from com bining direct primary care with MEC or similar plans. HOSPITAL INDEMNITY COVERAGE Even minor hospital visits can result in significant financial strain. While HDHPs provide coverage, the high deductibles can be challenging for average families in today’s economic climate. Bearing a substantial portion of hospitalization costs out of pocket can exacerbate an already stressful situation. Hospital indemnity plans offer coverage for hospital ad missions, intensive care and emergency-room treatments without requiring deductibles. Employees can also extend this coverage to their spouses and children. When coupled with a hospital indemnity plan, a DPC membership allows employees to access day-to-day health care for themselves and their dependents with minimal or no out-of-pocket costs. Utilizing unlimited primary-care services enables individuals to detect and address diseases and acute conditions before they escalate to the point of hospitaliza tion, providing peace of mind, especially for families living paycheck to paycheck. HIGH-DEDUCTIBLE HEALTH PLANS AND SELF-FUNDING Businesses of all sizes have embraced HDHPs as a cost-cutting strategy for healthcare provision. To mitigate the impact of HDHPs, integrating DPC is a prudent choice. Others are ex ploring self-funding and level-funding options in tandem with DPC to divert claims and curtail overall premium expenses. With DPC, employees gain access to routine care benefits. By utilizing their DPC membership for primary and preven tive care before tapping into their HDHP or self-funded plan, employees can reduce their out-of-pocket expenses and circumvent costly primary-care deductibles. This approach also benefits employers since fewer employees relying on health plans for routine care translates to reduced insurance claims expenses. Minimizing primary-care costs for staff while lowering employers’ claims expenses makes DPC an ideal companion. CHANGING TIMES IN EMPLOYEE BENEFITS Ensuring equitable and accessible healthcare for employees is no longer discretionary – it’s a necessity. Businesses face unprecedented challenges in recruiting and retaining top talent. Besides competitive salaries, superior benefits are a pivotal factor distinguishing one employer from another. Consequently, organizations are prioritizing strategies that set them apart without depleting their resources.

doctors are not burdened with filing claims or constrained by time limitations imposed by insurance requirements. DPC plays a crucial role in reducing the costs associated with health plans by diverting claims from major medical plans. When combined with other benefits, direct primary care can have a substantial impact on lowering an employer’s healthcare plan expenses through the efforts of brokers. In this article, we will explore some of these impactful partnerships. LIMITED-BENEFIT INDEMNITY PLANS Indemnity health insurance plans present a dual advantage, making them particularly appealing to employees. These limited-benefit plans provide coverage by offering a fixed daily benefit amount to offset the expenses associated with standard medical services. Employees find these plans highly advantageous because they provide peace of mind by covering critical services such as hospitalization, surgical procedures, anesthesia, acci dent-related costs and other high-ticket medical expenses. Some plans even grant access to a national PPO discount network, helping individuals reduce their out-of-pocket healthcare expenditures. Moreover, individuals benefit from the knowledge that, in addition to their DPC membership, which allows for unlimit ed visits to primary-care providers, virtual-care consultations and prescription discounts, there’s supplementary coverage available from the indemnity plan should the need ever arise. Employers also find this partnership advantageous be cause it enables them to offer their employees high-quality primary healthcare at a minimal cost and with minimal administrative burden. Additionally, it enhances their ability to attract and retain top talent at a reduced cost. These prod ucts are readily available and straightforward to implement, as bundles are already available in the market. To explore DPC/indemnity offerings, it’s best to consult with your direct primary care source. DPC AND MEC HEALTHCARE PLANS Minimum essential coverage is a plan that meets the Afford able Care Act requirements for health coverage. Although it does not provide preventative care, it does provide employ ers with a solution to avoid the ACA penalties. Employees, however, are left with an inadequate plan that does little to benefit their long-term health journey. Ideally, combining a MEC with DPC increases the value associated with that plan. Because DPC provides access to primary medical care, well ness and chronic disease management, it plays a vital role in ensuring individuals can get the care they need when they need it. The value DPC provides makes it a more attractive offering to employees who may be more inclined to choose this over a standalone MEC.

32 ABS | benefitspecialistmagazine.com