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Tag Archive for: employee engagement

Common Health Insurance Terms to Help You Understand Your Plan

March 12, 2023/in News

If you’re considering purchasing health insurance, you may feel overwhelmed by the variety of terminology associated with it. From coinsurance to deductibles, there are numerous health insurance terms you should know before you enroll. But don’t worry; we’ve got you covered. We have translated some of the confusing terminologies around health insurance into plain English to help you better understand your health insurance coverage.

Let’s dive in.

Coinsurance

Coinsurance is a health insurance term that refers to the percentage of the cost of a healthcare service that you are responsible for paying after you have met your health insurance plan’s deductible. 

For example, if your healthcare bill is $1,000 and you have already met your deductible, and your coinsurance is 20%, you will be responsible for paying $200 (20% of $1,000), while your insurance company will pay the remaining $800. Coinsurance is one of the ways in which health insurance companies share the cost of healthcare services with their policyholders.

Copay

Copay refers to a fixed amount of money that you may need to pay out-of-pocket for a covered healthcare service or supply. For example, your health plan may require a $20 copay for an office visit or a $10 copay for a generic prescription. After you pay the copay, your health insurance plan will cover the remaining cost of the healthcare service or supply. 

Copays are a way for health insurance companies to share the cost of healthcare services with their policyholders. Copay amounts may vary depending on the type of healthcare service or supply, and the specifics of your health insurance plan.

Deductible

A deductible is the amount of money that you need to pay out-of-pocket for healthcare services before your insurance plan starts covering those services. For example, if your plan has a $1,000 deductible, you will need to pay the first $1,000 of healthcare services you receive during the year before your plan starts contributing to the cost of covered services. Once you’ve met your deductible, your insurance plan will begin to share the cost of healthcare services with you. The amount of the deductible can vary depending on the specifics of your insurance plan and is an important factor to consider when choosing a plan, as it can significantly impact your out-of-pocket costs for healthcare.

Essential Health Benefits

Let’s talk about Essential Health Benefits – a set of healthcare services that must be covered by plans in the Health Insurance Marketplace, as required by the Affordable Care Act. These benefits include emergency services, hospitalization, maternity and newborn care, mental health, prescription drugs, preventive and wellness services, pediatric services, and more. 

In-Network Providers

Understanding the difference between in-network and out-of-network providers is critical. In-network providers are a group of doctors, hospitals, and other healthcare providers that your health insurance plan has partnered with to provide care to its members. 

Out-of-Network Providers

When you receive healthcare services from a provider that has not partnered with your insurance plan to provide care to its members, this is known as an out-of-network provider. It’s important to note that using an out-of-network provider may result in additional costs for you, so it’s crucial to know which providers are in-network before receiving care.

Another important term to be familiar with is out-of-pocket cost, which refers to the amount you pay for health care services. This may include your deductible, coinsurance, and co-pays.

The out-of-pocket maximum is the most you’ll pay in a policy period, usually one year, before your plan starts to pay 100% of the covered Essential Health Benefits you receive. This limit must include deductibles, coinsurance, and co-payments, but typically does not count premiums toward your out-of-pocket maximum.

Monthly Premiums

Monthly premiums refer to the regular payments that an individual pays to their health insurance company in exchange for coverage. This payment can be made on a monthly, quarterly, or yearly basis depending on the insurance plan. 

The amount of the premium varies based on a number of factors, such as the type of coverage, the individual’s age, location, and the level of benefits they choose. It’s important to understand the cost of the monthly premium when selecting a health insurance plan, as it can impact your budget and overall financial health.

Preventative Care

Preventive care is health care services focused on keeping you healthy before you may become sick. These include routine check-ups, patient counseling, screening tests, and immunizations. Plans must offer these services at no cost to you when the services are provided by in-network doctors. This means they can’t charge a copayment or coinsurance, even if you haven’t met your deductible for the year.

Provider

Lastly, it’s important to understand what a provider is. This refers to a person or place you go to receive health care services. Examples include doctors, hospitals, pharmacies, and more. Check with your health insurance plan to find out if a provider is in-network or out-of-network.

By familiarizing yourself with these health insurance terms, you can better understand your coverage and make an informed decision when choosing a health insurance plan.

Still Have Questions?

We serve employers who want to offer their employees affordable benefits. We simplify the complexity of providing those benefits and ensure compliance with the Affordable Care Act. We provide affordable benefits for the everyday person. We are different because of our personal service, speed of implementation, and innovative approach to providing benefits coverage.

Learn more about us and our services, here.

https://www.sbmabenefits.com/wp-content/uploads/2023/03/iStock-639494602.jpg 1414 2121 Nathan Ines https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png Nathan Ines2023-03-12 16:00:272023-03-10 16:13:36Common Health Insurance Terms to Help You Understand Your Plan

How Voluntary and Worksite Benefits Can Help Employee Retention

February 7, 2021/in Employee Retention, Voluntary Benefits, Worksite Benefits

Attracting and retaining the best employees is likely of the utmost importance to you and your business. There are many ways to show your employees you care. One of the most effective ways is through offering voluntary benefits as part of your health insurance plans.

Read more
https://www.sbmabenefits.com/wp-content/uploads/2021/01/Copy-of-Copy-of-Template-2_-colored-image-1.png 1080 1080 Amanda Rogers https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png Amanda Rogers2021-02-07 08:53:002021-11-30 15:53:11How Voluntary and Worksite Benefits Can Help Employee Retention

How to attract the best employees: Voluntary benefits

August 17, 2020/in News

Looking for ways to attract the best employees in a market where thousands of employees have been laid off? Offering voluntary benefits adds a level of insurance coverage that many workers have not previously had access to. Benefits beyond the traditional 401(k) and health insurance are vital to attracting the right talent for your business.

Read more
https://www.sbmabenefits.com/wp-content/uploads/2020/07/Screen-Shot-2020-07-27-at-5.44.15-PM-1.png 709 1074 Amanda Rogers https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png Amanda Rogers2020-08-17 07:00:002021-11-30 09:28:22How to attract the best employees: Voluntary benefits

The Best Ways to Keep Employees Engaged and Excited About Work

July 23, 2020/in Employee Engagement, Employee Retention, Voluntary Benefits

Keeping employees engaged and excited about work can be a difficult task for some employers. There are a few things you can do as a leader within your organization to foster employee happiness. One of the main ways is to offer voluntary benefits. Employees are looking for insurance when they are looking for a company that will serve them, but they also require additional benefits, and other creative approaches to benefits. In the article below, you will see the best ways to keep employees engaged and excited about work, and how important it is to offer more than just health insurance. At SBMA, we have insurance options that include vision, dental, and other voluntary benefits. Check out our plan options here!

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https://www.sbmabenefits.com/wp-content/uploads/2020/07/Screen-Shot-2020-07-21-at-3.36.27-PM.png 708 471 Amanda Rogers https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png Amanda Rogers2020-07-23 19:00:002021-11-30 08:26:18The Best Ways to Keep Employees Engaged and Excited About Work

How Can Vision and Dental Add Value for Your Employees?

July 22, 2020/in Employee Engagement, Employee Retention, Voluntary Benefits

Voluntary benefit plans are an important part of employee insurance opportunities. Among these voluntary benefits, vision and dental insurance are an important part of employees voluntary benefit plans. How can vision and dental plans add value to your employees’ wellbeing? Here are a few ways:

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https://www.sbmabenefits.com/wp-content/uploads/2020/07/Screen-Shot-2020-07-21-at-3.30.00-PM.png 604 898 Amanda Rogers https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png Amanda Rogers2020-07-22 07:00:002021-11-30 08:19:25How Can Vision and Dental Add Value for Your Employees?

How Worksite Benefits Benefit Everyone

July 21, 2020/in Worksite Benefits

Employees can choose from a number of insurance products to complement their coverage and to help achieve a greater degree of stability. Worksite Benefits (voluntary coverage) plans may be 100% paid for by employees or cost-shared with the employer. Here’s why worksite benefits benefit everyone.

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https://www.sbmabenefits.com/wp-content/uploads/2020/07/brooke-cagle-uHVRvDr7pg-unsplash-1-scaled.jpg 1707 2560 Amanda Rogers https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png Amanda Rogers2020-07-21 15:16:122021-11-30 08:01:38How Worksite Benefits Benefit Everyone

How Employee Benefits Improve Retention

July 21, 2020/in Employee Engagement, Employee Retention, Voluntary Benefits

The Affordable Care Act, enacted in 2010, ensured that everyone was able to receive health insurance regardless of if they have pre-existing health conditions or for any other discriminatory reasons. This Act gave employees the ability to leave their employers if the only reason they were staying was insurance reasons. Employees who were stuck in their jobs to receive benefits now had the opportunity to look for opportunities elsewhere.

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https://www.sbmabenefits.com/wp-content/uploads/2020/07/kylie-haulk-ISUdOA3kdAk-unsplash-1-scaled.jpg 1709 2560 Amanda Rogers https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png Amanda Rogers2020-07-21 14:29:442021-11-29 15:50:28How Employee Benefits Improve Retention

The Difference Between Group and Voluntary Benefits

July 21, 2020/in Voluntary Benefits, Worksite Benefits

There are many options to consider when choosing what coverage you would like to include in your group benefits plan. When considering the purchase of voluntary benefits versus buying group benefits options, you need to understand the advantages and disadvantages of both. Here are a few significant differences that will allow you to make a more informed decision.

Read more
https://www.sbmabenefits.com/wp-content/uploads/2020/07/emma-dau-n_4iTY1KmDE-unsplash-1-1-scaled.jpg 1707 2560 Amanda Rogers https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png Amanda Rogers2020-07-21 14:24:152021-11-29 15:46:55The Difference Between Group and Voluntary Benefits

Voluntary Benefits Aid in Attracting the Best Employees

July 21, 2020/in Employee Engagement, Employee Retention, Voluntary Benefits

Including options for voluntary benefits and supplemental benefits is quickly becoming the norm for most employers who offer health insurance to their employees. As an employer, attracting the best talent and keeping them is of the utmost importance to maintaining a successful business. Over the last few years, there has been an increase in demand for voluntary benefits. While major medical coverage is the foundation of a good employee benefits program, it’s important to ask the question: how can I use these voluntary benefits to make my company more attractive to new prospects?

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https://www.sbmabenefits.com/wp-content/uploads/2020/07/Screen-Shot-2020-07-21-at-11.31.04-AM.png 717 1072 Amanda Rogers https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png Amanda Rogers2020-07-21 11:32:172021-11-29 15:37:36Voluntary Benefits Aid in Attracting the Best Employees

What Benefits Improve Employee Retention?

July 21, 2020/in Employee Retention

Offering employees the benefits they want and need is one of the best ways to retain talent and improve your employees’ satisfaction. There is a large portion of employees who view benefits as an essential factor in their satisfaction with their job and company. So, what employee benefits can you implement that will differentiate you from your competitors? Here are a few options:

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https://www.sbmabenefits.com/wp-content/uploads/2020/07/Screen-Shot-2020-07-21-at-11.10.21-AM.png 715 1077 Amanda Rogers https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png Amanda Rogers2020-07-21 11:11:562021-11-29 15:36:45What Benefits Improve Employee Retention?
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