Opt-in vs Opt-out Health Insurance: What You Need to Know

Opting in vs Opting out 

Offering employee benefits produces numerous positive outcomes for your company and your company’s employees. With this in mind, how does opting in and opting out of health insurance influence you as an employer?   

Opting in is the positive action taken to subscribe or enroll in health insurance whereas opting out requires that the employee automatically is signed up for health insurance, but they need to be able to unenroll just as easily. Persons opting in must check boxes or fill out information to agree to enroll. Persons opting out must uncheck or fill out information to end enrollment. 

A powerful example of the power of opting in or out comes from organ donations. European countries follow opting out options for organ donations. In order to indicate you do not want to donate organs in case of an accident, you must opt-out. Nearly all European countries with opt-out organ donation policies have nearly 100% organ donation participation among their people.

On the other hand, America and other countries that facilitate an opt-in policy with organ donation reap vastly different results.  Countries with opt-in policies have on average about 15% participation. 

The Association for Psychological Science found that “studies show that relying on inaction yields better results.”  

The psychology behind opting in and opting out

Psychologically, removing obstacles that make the desired behavior as easy as possible and obstacles in the way of unwanted behavior results in a performance of that desired behavior. Depending on the desired outcome, people will choose to opt-in or opt-out based on whichever action or option is easier.

The father of Social Psychology, Kurt Lewin, said, “make the actions you want to encourage easier, akin to moving downhill; and make the actions you want to discourage more difficult, aking to moving uphill” 

How does this influence your company? 

Employers encouraging employee health benefits because of their numerous positive rewards should consider using an opt-out method for higher retention of group health insurance.  

Opting out policies to consider are: 

• “Opt-out arrangements should be offered under a Section 125 cafeteria plan to avoid unfavorable employee taxation.
• The Affordable Care Act will consider certain opt-out payments as part of the employee’s premium for determining affordability under the act.
• Unconditional opt-out
  • Conditional opt-out 
  • Eligible opt-out
• Opt-out incentives should be offered to all eligible employees.
• Federal and state law may consider opting out incentives to be wages for overtime pay.” 

At SBMA, we offer affordable benefits for everyday people that are compliant with the Affordable Care Act. It covers medical, ancillary, worksite, and virtual health. 

Read about why health insurance is important for your business here.