It is that time of year again where companies offer the choice to change your Employee Benefit Plans. An open enrollment period can be once or twice a year with the time frame being about one month to make the changes to your existing plan. If you have not turned in your signed applications within the allotted time frame you will have to stay with the previous plan you chose when first hired.
A Company will send out literature explaining the dates and perhaps a time to learn about all the offerings to choose from. It is well worth an Employee’s time to become informed on each benefit and research Hospitals in their area. Each Insurance Company prints an Explanation of Benefits that will outline each option available. Depending on the Broker the Human Resources Department works with a comparison of the plans will be given to help in decision making.
If your Employer allows flex time for doctor appointments you might want to consider a Hospital closer to your work than residence. During lunch hours you can observe the facilities for their hours of operation. For a single person this could be a better option with less time away from work.
For those who are in the child bearing years it is a good idea to contact various Hospitals in the Plan to see what options they offer before you choose. If it is a teaching Hospital the Doctor listed in the Directory will most likely not be the attending Physician. I chose a Primary Care Facility for my first pregnancy with the only option for each prenatal visit being either a mid wife or registered nurse. I inquired about the delivery and insisted on a Doctor, which was my right.
In some States it is now mandatory to have a two-day stay after delivering a baby while others you leave within a twenty-four hour period. You can pre-arrange a birthing plan with the options for medication early on. Another consideration prior to signing an application is the policy for visitors and where the baby sleeps. One other point is to call the local number for your emergency and ask what is the nearest Hospital you would be transported to.
The following is a brief description of the choices having to face when picking Health Insurance:
PPO – Preferred Provider Organization – These plans have the option of 80/20 coverage where you get to choose from a number of Physicians. The decision also on which deductible makes the price fluctuate. For the employees who maintain overall good health with the only visit being a yearly physical this is the best choice. You pay the out of pocket expenses on the few visits you make while choosing a high deductible. Check the rating for the Insurance Company to see if rated A+ by Best or Moody’s.
HMO – Health Maintenance Organization – This is where the plan you pick is the place you see the same group of doctors and the Hospital is affiliated within. There is a co-payment for each visit that can be from two dollars to ten and up. These are typically cheaper in monthly cost but can get expensive if you have monthly visits with children also. They will most likely want you on a regular basis to maintain your health. I get letters informing me I have to schedule an appointment.
EPO – Exclusive Provider Organization – If you are employed within the Medical Field this would be the option to pick the Hospital you are affiliated with. The Hospital might be one of a few within a system so there will be some options to choose which facility to become a member.
Prescription Plans – There are many options available depending on your local Pharmacy and whether they are located nation wide. The comparison will be in the Generic and Brand prices. Many plans offer the discounted generic prescriptions only while others have a mail order option. You might end up paying a few dollars for each prescription and worth comparing all companies. Many Medical offices now have pharmacies in their buildings, this would be part of a HMO plan.
AD&D – Accidental Death & Dismemberment – This costs a few dollars each deduction period and well worth signing up for. It will usually include air travel, car travel and inside the home. For example, a Los Angeles Newswoman had an accident while reporting a story suffering severe burns and loss of limbs.
LTD – Long Term Disability – This is another option that has a smaller cost that has options to decide. This is also a benefit on many credit cards and might be already one the employer pays but for an added cost you can ask for more coverage.
Cancer Services – Prevention and Early Treatment
Home Care – Hospice, Medical Equipment, Health Aides
Behavioral Medicine – Psychiatric, Alcohol and Drug Abuse – Mental Health
Alternative Therapies – many are now offering acupuncture and chiropractic services
Urgent Care – is there a separate facility and entrance – available 24 hours
Transportation – this is an option we have, they pick up senior citizens free of charge
Pre-existing Condition – Mention what all members of your family may suffer from, being an asthmatic I have never been turned down or charged more. Another example would be if you use a hearing aid.
Vision Care – There is a limit to how many visits, choose from directory
Smoking Cessation – this might be covered and worth considering in a plan
At this time you can make changes to your Charitable donations through United Way, change your plans for Profit sharing, join a credit union and switch to direct deposit. It is advised to read over the literature, make phone calls, discuss with family members and choose the best Benefit Plan for your future health needs.