A whirlwind of changes to the way health insurance in the United States is purchased and delivered has more Americans focused on cost and coverage than ever before. Suddenly, major medical insurance isn’t just a nice-to-have: It’s a must, much like auto and homeowners insurance are musts for those of us who drive cars or own homes.
Health care reform has turned workers’ attention to their personal health care situations. They’re also looking closely at their insurance coverage to identify gaps that might leave them vulnerable to medical expenses they’re ill-equipped to pay. Enter voluntary insurance, a type of coverage that’s not required or mandated, with enrollment that’s completely optional – which is why it’s known as “voluntary.”
Voluntary insurance works hand in hand with major medical plans to help ensure individuals who are sick or hurt have the funds needed to pay health-related costs their primary insurance might not cover, as well as other out-of-pocket costs. After all, when a medical event occurs, there are deductibles, copayments and treatment costs that aren’t covered to consider – not to mention the bills that continue to roll in even if an individual is too ill or injured to work.
According to the 2014 Aflac WorkForces Report,1 49 percent of today’s workers have $1,000 or less on hand to pay out-of-pocket expenses associated with an unexpected serious illness or accident, and 66 percent at least somewhat agree they would not be able to adjust to the large financial costs associated with a serious injury or illness. Perhaps that’s why so many are open to voluntary insurance: 52 percent of workers who don’t currently have access to voluntary benefits through their companies say they’d be at least somewhat likely to purchase them if their employers made them available.
With that in mind, here are several reasons employers should seriously consider offering voluntary options:
Voluntary insurance can help provide employees with financial safety nets that keep their minds on their jobs and not on money concerns. That’s especially important given that employees who participated in the 2014 Aflac WorkForces Report said personal financial issues are the top non-work-related issue that distracts them while they’re on the job.1
Voluntary insurance pays cash benefits workers can use to help pay unexpected health care costs that might not be covered by major medical insurance or to help pay bills that threaten their financial security.
Voluntary insurance pays cash benefits regardless of any other insurance coverage employees have in place, including policies available through government health care exchanges.
Employees who are offered and enrolled in voluntary insurance plans report higher levels of job satisfaction and believe they’re more financially prepared to cope with possible events such as disability/injury, death or similar unexpected events.1
Out-of-pocket medical costs are a reality – regardless of changes related to health care reform – and can add up quickly. Some can be very much unexpected, so it’s important to consider where they arise for our workforce:
Deductible: The amount owed for covered health care services before your health insurance or plan begins to pay. For example, if a plan deductible is $1,000, the plan won’t pay anything until you pay $1,000 toward covered health care services subject to the deductible. The deductible may not apply to all services.2
Coinsurance: The percentage you pay toward each covered health care service. The coinsurance is paid on top of any deductible. For example, let’s say your company offers an 80/20 health insurance plan and the allowed amount for an office visit is $100. Once an employee meets their deductible, their coinsurance payment of 20 percent would be $20. The health insurance or plan pays the rest of the allowed amount.2
Copay: A fixed amount – for example, $15 – that the policyholder pays for a covered health care service, usually when they receive the service. The amount may vary by the type of covered health care service.2
Non-medical costs: When faced with a serious accident or illness, there are various non-medical costs associated with a hospital stay or recovery time, including child care, transportation and reduced take-home pay due to missing work. These expenses can add up quickly, contributing to the overall out-of-pocket cost of being sick or injured.
Limits or exclusions: Due to health care reform, plans will no longer have lifetime or annual limits on essential health benefits, but there may be limits related to other items, such as the number of refills for certain drugs, the number of visits to certain specialists or the number of days covered for certain benefits. These limits or exclusions could mean unexpected out-of-pocket costs.
Out-of-pocket limit: Out-of-pocket costs are different than out-of-pocket limits. Out-of-pocket limits are established by the IRS, and for 2015 they are $6,450 for individual coverage and $12,900 for family coverage. This means a policyholder will pay coinsurance – in a variety of ways as determined by their health plan – up to your out-of-pocket limit. These limits apply only to covered expenses, so if they or a family member incur non-covered expenses, those will not count toward their out-of-pocket limit. This adds to potential unexpected costs.
With so much uncertainty swirling around benefits and options in the wake of reform, developing a plan to manage health care-related costs can be overwhelming for both employers and workers. Voluntary insurance options are a double win: They can help soften the blow of rising out-of-pocket costs for workers, and because premiums are employee-paid, they can be made available at no direct cost to companies.
Consider asking your benefits adviser about these popular policies:
For a more in-depth look at voluntary insurance, check out The growing importance of voluntary insurance benefits.
This article is for informational purposes only and is not intended to be a solicitation.
1 The 2014 Aflac WorkForces Report is the fourth annual Aflac employee-benefits study examining benefits trends and attitudes. The study, conducted in Jan. 2014 by Research Now, captures responses from 1,856 benefits decision-makers and 5,209 employees from across the United States. To learn more about the Aflac WorkForces Report, visit AflacWorkForcesReport.com.
2 Definitions and examples were adapted from healthcare.gov/glossary.
3 In Idaho, Policies A35100ID, A35200ID, A35300ID, A35400ID, A35B24ID, and A35BOFID; In Oklahoma, Policies A35100OK, A35200OK, A35300OK, A35400OK, A35B24OK, and A35BOFOK.
4 In Idaho, Policies A76100ID, A761ESID, A78100ID, A78200ID, A78300ID, and A78400ID; in Oklahoma, Policies A76100OK, A761ESOK, A78100OK, A78200OK, A78300OK, and A78400OK.
5 In Idaho, Policies A49100ID, A49200ID, A49300ID, A49400ID, and A4910HID; in Oklahoma, Policies A49100OK, A49200OK, A49300OK, A49400OK, and A4910HOK.
6 In Idaho, Policy A57600IDR; in Oklahoma, Policies A57600OK and A57600LBOK.