Avoid These Common Mistakes in Group Health Benefit Plans

Posted on: April 27, 2020 by iSure

All too often, business owners or their administrators are forced to deal with employee and administrative issues that could have been avoided. It is important to work with an insurer who has experience in handling business benefits so you can focus on business operations. Take note of these common mistakes that are made while administering health insurance benefit plans to try to avoid them.

Not Understanding Eligibility Requirements

Having group health benefit plans for your business does not automatically mean every employee is eligible. There are so many factors that can come into play, such as the number of hours an employee works and how long they have been with your company. Generally, employees are expected to work thirty hours each week, and then satisfy the waiting period before they are eligible for the group plan. Before promising an employee group health benefits, first ensure the employee meets all eligibility requirements, which an insurer can help you determine.

 Waiting Period Miscommunications

Sometimes, the plan administrator unfortunately does not keep track of the waiting period (number of consecutive days an employee must work in order to meet eligibility to be added to the plan), which inevitably leads to issues.

Avoid waiting period problems by ensuring that newly hired employees know exactly how long they have to work before they can be enrolled in the plan. Also, make sure that your waiting period coincides with how long it typically takes to know if an employee will work out in your company.

Incomplete or Untimely Paperwork

Prompt and complete submission of paperwork is one of the most crucial elements of health care plan submission when employees are added, terminated, or making changes to coverage.

Communicate to employees  that they must include all of their information on the application in order for the application data to be entered properly and to prevent any complications with the applications being processed. Group administrators must also make sure they are completely up to date on the insurance carrier paperwork and employee paperwork must be submitted in a timely manner. It is a safe bet that all paperwork should be in no later than the effective date of the change.

 Poor Reconciliation

Reconciling your carrier bill is the quickest and easiest way to make sure an employee has been properly removed or added to your bill. Review your bill each and every month to ensure all covered individuals are listed on the bill and all terminations have been removed from the bill.

Not Asking for Help

Most individuals truly care about their access to healthcare which can make emotions run high when certain situations are not going smoothly. If there are any issues, concerns, or questions, it is important to take action immediately. Oftentimes an error is easily correctable.

Leaving Employees Out of the Process

A key success factor of benefit plans is that employees feel it is valuable and truly useful. Be sure to involve employees when selecting benefits  and ultimately implement a plan that will actually be used by staff and meet their needs. Speak with employees about what coverage they want and what they need, so you can set expectations and look for plans that meet the majority of their needs.

About iSure Insurance Brokers

After serving leaders in the Greater Miami market for more than three decades, iSure Insurance Brokers has become the provider of choice for discerning commercial clients and individuals alike. Because no two insurance programs are or should be alike, you can be sure that iSure will craft a comprehensive approach to protection that is as unique as you are. We welcome the opportunity to protect what you have worked so hard to build. Please contact us at (855) 221-3406 to learn more about what we can offer you.

Posted in: Employee Benefits