Ways to make your Health Benefits work for You

Information from the US Dept of Labor and the Employee Benefit Security Administration

Health insurance has been and continues to be a huge concern for individuals, employers and employees alike. Even if you are receiving health benefits through your employer there are still certain things to keep in mind to really make them work for you and your family.

  1. Understand your options: Take the time to review the plan or plans your employer offers and apply that to what will work best for your health needs. Be aware of options you might have within these plans. For example if there is high deductible look into setting up a Health Savings account which allows you to save tax-free.
  2. Review the available benefits: Understand you and your family’s needs and what the out-of-pocket expenses they may entail. Remember that the cheapest option, may not always be the best quality.
  3. Read Your Plan’s Summary Description: This will detail your benefits and your rights. Keep this along with any other correspondence you receive concerning your health benefits.
  4. Assess your benefits as your family changes: Marriage, divorce, births and deaths may all require a change to your coverage.
  5. Changing jobs or other life events can affect your health benefits: Be aware that COBRA (Consolidated Budget Reconciliation Act) may make you eligible to purchase health benefits through an employer in the event of job loss, change of job, divorce, etc.
  6. Consider HIPPA if you’re changing jobs: This regulates exclusions on pre-existing conditions.
  7. Wellness Programs: Many employers are now offering wellness programs to their employees. They encourage employees to work out, quit smoking and living a more healthy life style. Often times these programs may offer rewards such as cost savings.
  8. Retirement Planning: Understand how your current health benefits (or your spouse’s) will carry over into retirement.
  9. Know how to appeal a denied claim: If a claim is denied it’s important to know how to handle it. Know who you need to contact and maintain any documents or correspondence on the claim for reference.  
  10.  Take the steps to improve the quality of your benefits program: Do your research. Understand all the parts of your benefits program and to receive the highest quality. Again, know that the cheapest plan is not always the best choice for you and your family.

        These laws are good to keep in mind regarding your health benefit program.

       The Employee Retirement Income Security Act (ERISA) – Offers protection for individuals enrolled in retirement, health, and other benefit plans sponsored by private-sector employers, and provides rights to information and a grievance and appeals process for participants to get benefits from their plans.

       The Consolidated Omnibus Budget Reconciliation Act (COBRA) – Contains provisions giving certain former employees, retirees, spouses, and dependent children the right to purchase temporary continuation of group health plan coverage at group rates in specific instances.

       The Health Insurance Portability and Accountability Act (HIPAA) – Includes protections for millions of working Americans and their families who have preexisting medical conditions, prohibits discrimination in health care coverage, and guarantees issuance of individual policies for certain eligible individuals.

       The Newborns’ and Mothers’ Health Protection Act (Newborn’s Act) – Provides rules on minimum coverage for hospital lengths of stay following childbirth.

       Mental Health Parity Act (MHPA) – Requires that annual or lifetime dollar limits on mental health benefits be no lower than those dollar limits for medical and surgical benefits offered by a group health plan.

       Women’s Health and Cancer Rights Act (WHCRA) – Offers protections for breast cancer patients who elect breast reconstruction in connection with a mastectomy.

If you would like to learn more about The Seltzer Group’s Group Health Program please call 1-888-366-1000 or visit us online.

The Seltzer Group, located in Eastern Pennsylvania, specializes in developing safety, workers compensation, human resources, claims, and risk financing programs. They are a proud member of the Keystone Insurers Group and are nationally recognized for their expertise in workers compensation solutions. The Seltzer Group serves businesses and individuals locally, regionally, and on the national level.

Ways to make your Health Benefits work for You was last modified: August 26th, 2014 by Sarah McGorry