The tools employers and employees need to stay well 

Are you asking the right questions of your onsite clinic vendor?

Are you asking the right questions of your onsite clinic vendor?

To ensure your clinic is a cost-saving investment in the health of your workforce and not an expense threatening the bottom line, ask these questions of your onsite clinic vendor.

Are you asking the right questions of your onsite clinic vendor?
Looking to improve the impact of your corporate wellness program? Prepare to get personal

Looking to improve the impact of your corporate wellness program? Prepare to get personal

Our experience and recent research on the subject finds that wellness program success relies on two important factors: health coaching and personalization. With these findings in mind, we’ve crafted ...

Looking to improve the impact of your corporate wellness program? Prepare to get personal
Real stories of health coaching and when wellness works

Real stories of health coaching and when wellness works

Research points to two major trends for healthy corporate wellness programs: customization and the power of coaching. While apps and trackers can help employees plan for healthy habits, when it comes ...

Real stories of health coaching and when wellness works
Providing benefits for an evolving workforce: what attracts and retains top talent?

Providing benefits for an evolving workforce: what attracts and retains top talent?

In addition to changes in education level, technical skills and culture expectations, a younger generation of workers brings a new perspective to the advantages of employer sponsored health insurance....

Providing benefits for an evolving workforce: what attracts and retains top talent?
Top five burdens facing human resources departments in  2017

Top five burdens facing human resources departments in 2017

At the beginning of our partnership, we ask clients to tell us about their biggest hurdles—the ones that cost them money and keep them from focusing on growing their business. Here's what we found.

Top five burdens facing human resources departments in 2017
Best practices for a seamless open enrollment, from communication to implementation

Best practices for a seamless open enrollment, from communication to implementation

Did you know that your employees would rather have a conversation with an ex than get into the nitty-gritty about their health plan during Open Enrollment? It’s time that employees learn to love thei...

Best practices for a seamless open enrollment, from communication to implementation
Hearing these questions from employees? It may be a sign to evaluate your health plan administrator

Hearing these questions from employees? It may be a sign to evaluate your health plan administrator

When the wrong health plan administration solution is in place, human resources teams are usually the first to spot the signs. Whether your office is overflowing with eligibility questions or customer...

Hearing these questions from employees? It may be a sign to evaluate your health plan administrator
Spotlight on cost: Why do medical procedures vary by 500 percent or more?

Spotlight on cost: Why do medical procedures vary by 500 percent or more?

Price variance is significant when it comes to healthcare costs, but rarely is there transparency among providers. To find a price usually requires effort—you can’t go to a hospital’s website and c...

Spotlight on cost: Why do medical procedures vary by 500 percent or more?


Health Plan FAQs: Top employee questions and how HR can help

Health Plan FAQs: Top employee questions and how HR can help

 

It’s not uncommon for employees to have questions about their health plan. In fact, a 2015 Harris poll found that two in five insured Americans did not have a good understanding of the services actually covered under their healthcare plans.

To help, we worked with our member support team to assemble the top eight questions employees have about their health plans and answered them in language everyone can understand.

For more helpful employee communication tips, access our 2018 open enrollment guide.

                                                                                     

1. What’s covered under my health plan?

Your employer will provide you with a Summary of Benefits Coverage that summarizes the key features of the plan (or plans) offered. This document details the benefits covered under the plan, including what you can expect to pay for services, coverage limitations and exceptions. If you have questions regarding your Summary of Benefits, your Human Resource department is able to provide you with a copy and review with you.

Healthgram members may access their Summary of Benefits through their Member Portal and ask any questions through the online customer service tool or over the phone.

 


Related resource: 10 must-know health insurance terms


 

 

2. How do I know who is covered under my plan?

The best way to understand who is covered under your plan is to review which plan selection you are currently enrolled in. If you have specific questions about coverage of a spouse or dependents, you can review your plan information in your Member Portal, call your Healthgram Advisor or speak with your HR department.

 

 

3.  How long are dependent children allowed coverage under a health plan?

Dependent children are typically allowed under the plan until they turn 26 years old, but plans can vary so check with your HR for more accurate information.

 

 

4. Once I am enrolled in a health plan, can I make changes to it? 

If you would like to make any changes to your plan it needs to be completed during your company’s open enrollment period. These changes may including adding or removing dependents (spouse, children) or changing the plan you are currently enrolled in if your employer offers more than one plan option. Outside of Open Enrollment, however, changes are only allowed when there is a Qualifying Life Event.

 

 

5. What is considered a Qualifying Life Event?

According to Healthcare.gov, a Qualifying Life Event includes the loss of existing health coverage including job-based, individual, and student plans, losing eligibility for Medicare, Medicaid, or CHIP, and turning 26 and losing coverage through a parent’s plan. Household changes, such as getting married or divorced, having a baby or adopting a child or experiencing a death in the family, also count as qualifying events. To know exactly which qualifying events are included in your plan, review your plan document or contact HR.

 

 

6. What is the difference between an in-network and out of network provider?

Your insurance company has partnered with specific networks to provide you with doctors, facilities and providers that would be considered in-network. The specific network has negotiated discounts with this group of medical professionals, so charges in-network should always be lower than those out-of-network. Out-of-network providers can end up being significantly more expensive and you may be responsible for the full amount charged for that visit. Healthgram makes it easy to search for in-network providers using your member portal.

 


Related resource: How human resources teams can help lower out-of-network utilization with effective communication


 

 

7. Are there ways to save on health care expenses?

Understanding your plan is the key to managing your health care expenses. The following four tips can also help you become an informed healthcare consumer and in turn can help you save on healthcare related spend.

  • Use an in-network provider for any medical treatment you receive.
  • Compare costs of procedures before seeking care. The cost for the same health care service can vary by 200 to 500 percent depending on where care is sough. If you’re a Healthgram member, contact your Advisor for guidance. Other sites such as Healthcare Bluebook are a great place to start.
  • Know your prescriptions. If your prescription has been on the market for a while, often times there is a generic version that has the same active ingredients but on average can cost 80 to 85 percent lower than the brand-name product. Always ask your doctor if a generic is available for the drugs you are prescribed.
  • Know where to go when you need care. You can curb your health care spending by avoiding the most expensive kinds of care, such as emergency care, when possible. Unless you are facing a life-threatening problem such as chest pain or major trauma, you may be able to seek care at an urgent care facility or by making an appointment with your Primary Care Doctor.

For more money-saving tips, start with this blog post.

 

 

8. How do I know if I am supposed to go the ER, Urgent Care or make an appointment with my PCP?

Always go to the ER for emergency situations, like a suspected heart attack or a broken bone. For non-life threatening health conditions, a trip to urgent care is usually more cost-effective, as there is a significant cost difference between the emergency room and urgent care. If the problem occurs during your primary care doctor’s regular office hours, call first and make sure you’re headed to the right place. Sometimes your regular doctor can squeeze you in on the same day.

 


Related resource: ER, Urgent Care, or PCP? How to Know Where to Go


 

 

Healthgram helps thousands of employees navigate the ins and outs of their health plans with the goal of creating more empowered and engaged consumers. Contact our team to learn how we can help you save on healthcare costs and create an experience employees love.

 

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Healthgram partners with self-funded employers, benefits advisors, hospital systems and other organizations to deliver a better healthcare experience.

To learn how we can help you accomplish your business goals, contact a member of our team.

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