5 Steps to Ensure Medical Cost-Sharing Is Right For Your Business
Key Takeaways:
- The Evolution of Challenges of Traditional Health Insurance
- Innovated Solutions for Businesses Healthcare Offerings
- 5 Key Steps To Take
Most business owners are frustrated with their employee medical benefit plans because the Affordable Care Act (ACA) mandates their compliance with traditional health insurance, which is costly and flawed. Over recent years, it has become a catastrophic coverage product by transferring a significant portion of medical costs to the employee.
Savvy business owners are finding alternatives to traditional group health plans, both conventional and unconventional. Conventional alternatives have been facilitated by Health Reimbursement Arrangement plans released by the IRS subsequent to the ACA. HRA’s provide a compliant way for employees to obtain individual insurance plans for their families that can be subsidized by the employer with pre-tax dollars in a way that meets the ACA mandates for affordability and coverage. To learn more about HRA plans, see our blogpost on Health Reimbursement Arrangements.
An unconventional alternative to insurance is the merging of virtual primary healthcare services with medical cost sharing. We refer to this solution as “Next Generation Healthcare” because it is comprised of systems that have been proven to be effective for more than three decades and bypasses the traditional health insurance industry which currently acts to limit the efficient and affordable access to healthcare. Optimal teleHealth markets this solution as our Optimal Care Membership. Learn more about our Optimal Care Membership offering in our blog, Optimal Care – Better Than Health Insurance.
These next generation healthcare services are not, by themselves, compliant with the Affordable Care Act, but when offered to employees as a part of an overall medical benefits plan that includes either group health insurance or a health reimbursement arrangement, the business will be compliant with the ACA even if no employees enroll in the available insurance plans.
The 5 Steps:
Before engaging in medical cost sharing, it’s essential to take several preparatory steps:
- Research and Understand: Gain a comprehensive understanding of medical cost-sharing principles, including how it works, its benefits, limitations, and potential risks. You can learn more about the difference between medical cost-sharing vs. healthcare insurance in our blog, Healthcare Insurance vs. Medical Cost-Sharing
- Assess Your Healthcare Needs: Evaluate your healthcare needs, considering factors such as pre-existing conditions, anticipated medical expenses, and frequency of healthcare utilization.
- Compare Options: Research different medical cost-sharing organizations, comparing factors such as membership requirements, sharing guidelines, coverage limitations, and monthly costs.
- Review Membership Guidelines: Carefully review the membership guidelines and eligibility criteria of your chosen medical cost-sharing organization to ensure you meet all requirements.
- Budget and Financial Planning: Assess your budget and financial capabilities to determine if medical cost sharing aligns with your financial goals and ability to meet monthly sharing obligations.
In conclusion, medical cost sharing offers a viable alternative to traditional health insurance, providing efficient, affordable, and compliant healthcare coverage for businesses of all sizes. By understanding the challenges, exploring innovative solutions, and embracing next-generation healthcare models, businesses can ensure that medical cost sharing is the right choice for their employees and their bottom line.
If you are interested in learning more about medical cost-sharing offerings check out our blog, Optimal Care– Better Than Health Insurance.
