Are you asking your prospective employer the right health insurance questions? President and Founder of Innovo Benefits, Group, Eric Gulko, explains what you should be asking before accepting the job in order to understand and make the most of company health insurance benefits.
You might be a slick negotiator when it comes to salary and time off, but health insurance is increasingly becoming a more and more important factor when choosing a new employer and deciding whether or not to accept a job offer.
For one thing, your health benefits should be comprehensive; you don’t want to be stuck with inadequate coverage should an emergency arise, otherwise your wallet could take a massive hit.
“Health care costs are rapidly becoming a substantial portion of employee’s living expenses,” says Kim Buckey, vice president of client services at DirectPath, a benefits education and services firm. She points out that potential out-of-pocket costs, whether it’s employee contributions or high deductibles, can cost people a significant portion of their median annual income these days.
In fact, according to research by the Kaiser Family Foundation, employees contributed about $1,213 to their own premiums in 2017, and $5,714 for family coverage. “As such, you’ll want to ensure you have the best health benefits possible and understand fully how that coverage works,” says Buckey.
To help you make the smartest choice, ask prospective employers these questions about their company’s health benefits.
Waiting periods for coverage today typically range from zero to 90 days, says Eric Gulko, president of Innovo Benefits Group, a benefits-management firm. If there is a waiting period before your new coverage kicks in, you’ll want to make sure you have coverage in place until the period is up—either by extending coverage from your prior employer through COBRA, coverage under your parent’s plan (if you’re under age 26), or through an individual plan, says Buckey. As part of your offer negotiation, you can ask if the company would be willing to partially fund your COBRA benefits for that period of time.
It’s rare to find an employer that will fully cover the premiums for their hires, much less their hires’ partners and children, too. But how much you’ll have to pay for family coverage varies widely.
Do some number crunching before to see if adding someone to your plan is the smartest choice for you financially. “Sometimes companies will penalize employees if their spouses have coverage available at their own workplace, but instead choose coverage under your employer’s plan,” Gulko says. That’s something you’ll want to verify.
Perhaps you already have great health benefits via your spouse. If that’s the case, you could ask if there are opt-out bonuses available should you choose to obtain your coverage elsewhere, says Gulko. But remember: There may be a surcharge on your spouse’s end to cover you, so be sure to check the math to see if it makes sense to skip coverage through your new employer.
If you are considering coverage under the Affordable Care Act, keep in mind that if you opt for health benefits purchased through the Exchange, you will not be eligible for a subsidy if your employer offers affordable coverage, says Buckey. “In general, group coverage through an employer is the less-expensive option,” she adds.
You don’t necessarily want to disclose your medical history before you’re even hired, but if you have a health condition, you want to be especially sure that health coverage will meet your needs. Your best bet is to just ask for a copy of the summary plan descriptions (SPDs) and/or summaries of benefits and coverage (SBC) of the options the company provides, says Gulko.
“The SBC outlines the out of pocket costs—copays, deductibles, coinsurance—very specifically by each common category,” says Gulko, “and it is written in the same format across all benefit plans across all companies.”
Another thing you can do, Buckey adds, is to inquire if the company offers any voluntary benefits, such as hospital indemnity plans, critical illness, or cancer insurance.
Many employers are moving toward high deductible health insurance plans that feature Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs), and/or Flexible Spending Accounts (FSAs). These accounts are designed to provide a financial safety net if you incur unexpected medical expenses.
“HSAs and FSAs can provide a mechanism to reduce your current income taxes and enable you to set aside funds to cover future expenses,” says Buckey. Along those lines, Gulko recommends finding out if the employer offers contributions to these accounts, which can be a nice added perk.
There’s no doubt that health care coverage is confusing, which is why many employers are now taking a proactive approach at helping employees manage their benefits. “An employer who provides employees with help in choosing a plan, with answers to their questions during the year as they use the plan, and support in resolving billing questions is an employer who is committed to you manage your health costs and minimizing your financial stress,” says Buckey.
“Ask for any documentation regarding wellness programs and related discounts and incentives,” says Gulko. These rewards programs encourage employees to “shop” for a lower cost for needed treatment, while also ensuring high-quality care.
Employees typically receive a percentage of the savings achieved by using a lower-cost provider, or a flat dollar reward, says Buckey—a win-win for the company and you. There may also be wellness programs that offer incentives for healthy habits, like going to the gym or getting a flu shot.
Many health insurance plans are offering narrower provider networks than in years past, so you’ll want to know the specific name of the network so you can go online and do some research to see if your current doctors participate.
While you may not fully understand the ins and outs of health coverage until you actually begin using it, the more information you have up front, the better equipped you’ll be to compare benefits packages.
“Like many things in life, we have to make the best decisions we can with the facts in front of us at the time,” says Gulko. “With health care being such a costly and important part of our lives, it only makes sense to ask a few questions about this as part of your offer-evaluation process.”
A great job offer is what you’re after, but remember: Salary isn’t the only thing that matters. Before signing on the dotted line, there are plenty of other considerations to weigh, from commuter reimbursements to sick days to promotion prospects. Could you use some help understanding the ins and outs of job offers? Join Monster for free today. As a member, you can sign up to receive career advice, job search tips, and negotiation strategies sent directly to your inbox to help you make smart, informed choices. Think of it as insurance for your career.
This article is not intended as a substitute for legal advice. Always seek the advice of a lawyer regarding any questions you may have.