Employers who offer health benefits to their employees will need to make decisions about which benefits they should offer and who will be covered according to applicable state and federal laws.
The decision to offer healthcare benefits to the employees requires careful consideration.
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Employers must consider these things when making the decision about which type of plan they will offer:
- What services will your plan cover? There are some federal and sometimes state mandates that you need to be aware of, as well as special rules for small business owners.
- What employees will your plan cover? You can choose to exclude part-timers.
- What are the eligibility requirements and waiting periods for new employees?
- What does the portability requirement for health plans mean to you?
Health services that are covered
It is likely that there are differences in the level of reimbursement offered by different employers and in the type of care they cover. If you take a look at ten different plans from different regions of the country, you will see that they all cover inpatient surgery.
However, some plans may only reimburse 80 percent above a $500 deductible. Others may reimburse at 90 per cent if a network provider was used, 70 percent if not. Still others may reimburse at 100% if the surgery was performed outpatient.
The Patient Protection and Affordable Care Act and the related legislation, which was enacted in 2010, heavily regulates the insurance sector. It also imposes coverage and benefit mandates. It requires that all qualified health plans must offer at least an essential health benefits package, except for grandfathered plans.
