How reading those boring benefits materials from your employer can actually pay off
Start actually benefiting from your work benefits.
Open enrollment season is underway, an annoying and confusing time for nearly 50% of U.S. employees who don’t understand their benefits materials, according to the International Foundation of Employee Benefit Plans.
Many workers don’t even take enough time to look over their company benefits — 57% of employees spent less than 30 minutes making their open enrollment choices, according to a 2016 Aflac WorkForces Report. And a whopping 90% don’t make any changes to their benefits package each year.
“It’s important to know your plan, and if you have a few options, really understand what you’d have to pay out of pocket,” Jennifer Fitzgerald, CEO and co-founder at Policygenius, an online insurance marketplace, tells Moneyish.
Here’s everything you need to know before electing new benefits this year:
Know how health insurance works
Health insurance doesn’t always cover 100% of your costs, and there’s usually an out-of-pocket limit. After you hit that limit, your insurance will pay 100% of health care costs. This is where the difference between premiums and deductibles comes in.
A premium is the amount of money you pay for having health insurance, just like a monthly fee to access Netflix or the gym. Your deductible is the amount of money you need to pay out of pocket before your insurance company starts paying for your services. Then there’s a copay, which is what you’re responsible for paying each time you get a medical treatment, see a specialist or fill a prescription once your deductible is met.
Typically, insurance plans with low premiums are paired with higher deductibles. So while you may think it makes sense to sign up for a cheaper plan, you could end up spending more out of pocket if you use your insurance a lot during the year.
“If you’re looking at different plans, the big driver is the deductible; how much the health care costs you’ll have to shoulder before your insurance kicks in. Typically if you’re younger, without chronic health conditions and rarely go to the doctor, it’s best to opt for the higher deductible plan because that keeps your monthly premiums lower.”
Choose the right health plan for your needs
There are are few different types of health plans you can typically choose from. Here are the most common:
Health Maintenance Organization (aka HMOs).
This is one of the cheapest options, but it’s a bit inconvenient because you can only choose a provider that’s directly associated with your plan and you need referrals from a primary care physician to see a specialist.
Preferred Provider Organization plan (aka PPOs)
This plan allows access to any healthcare provider you want, though in-network providers are typically much cheaper, and you don’t need referrals. Since they’re more flexible, this option is typically more expensive.
Point of Service (aka POS)
This plan is a bit of a hybrid between HMOs and PPOs; you have in-network HMO providers, or you can see PPO or out-of-network providers.
High-deductible health plans ( aka HDHPs)
The HDHP is defined as a health plan with an individual deductible of at least $1,350 or a family deductible of at least $2,700. “Younger, healthier people who don’t expect to go to the doctor often might be better off with this plan because it can lower their monthly premiums,” Fitzgerald suggests.
How can you decide between the different options? Think about what’s more important: affordability or the convenience of going to any doctor you choose. “HMOs are [one of] the most affordable, but they’re stricter. You can’t go out of network and you need referrals to see specialists. Is that worth saving money? Or would you rather pay more for the convenience of a PPO or POS plan that gives you more options?” Fitzgerald advises. “That’s a decision each individual or family will have to make when they’re considering their options.”
Don’t forget about dental and vision plans
Not every plan will include dental and vision insurance for adults. When you’re shopping for health insurance, you can choose to look at plans that include health and vision, which are sold as standalone products that are optional. “You won’t be hit with the individual mandate penalty if you don’t have them,” says Fitzgerald. This resource can help you figure out if you need a dental and vision.
Consider contributing to a Health Spending Account (HSA) or a Flexible Spending Account (FSA)
The HSA is a medical savings account available to employees who are enrolled in a high-deductible health plan. This account can help you pay for any health costs you may incur, though you can only put up to $3,450 for yourself or $6,900 for a family in there. “It’s like a 401k for health care costs. It’s pretax money and you can use it for any health care expenditure. That money rolls over every year. It’s kind of a no brainer,” says Fitzgerald.
If you have an HMO, PPO or POS plan, you may want to use an FSA to save for medical expenses or child care — that is if you expect to spend money on medical expenses or child care in the coming year. Like with an HSA, the money you put into your FSA goes in on a pretax basis allowing you to use tax-free dollars to pay for what you need, so it’s like getting a discount on medical services. There are two different kinds of FSAs: health care and dependent care. The limit is $2,650 per FSA. However, the money doesn’t roll over from year to year, so it’s use it or lose it.
Get disability Insurance
Disability insurance will replace all or part of your income for a specified period of time if you’re unable to work thanks to an illness or other disability. Typically, employees must volunteer for this and depending on the company and your salary, contribute around $100 to $200 a month for coverage.
“Disability is the most overlooked and misunderstood benefit out there and typically the most important [other than health insurance] particularly for young people,” says Fitzgerald. “Most companies will have a limited amount of sick leave and once you exhaust that you don’t have an income.”
Short-term and long-term disability options are separate insurance products since they cover separate periods. Short-term is for the first few weeks or months when you can’t work, and then it ends. Long-term starts paying a percentage of your salary, usually 50 to 60 percent, at some point after short term ends and lasts a lot longer because it’s designed to protect your income if you’re disabled for more than a few months. It’s smart to get both, so if any employer doesn’t offer either, you can seek it out at a provider like Aflac.
Think about purchasing life Insurance
It’s gloomy to think about, but life insurance will pay your your beneficiaries (typically a spouse; parent, child, or sibling of your choosing) money if you die. You’re responsible for premium payments to the insurance company and the beneficiary is the person due to get the life insurance claim. In particular, you’ll want life insurance if someone else — like a spouse or child — depends on your income to live. This guide can help you figure out what kind of life insurance you might want to get.
Don’t miss out on opportunities for free money
Take time to consider — and sign up for — any other benefits outside of health insurance like a 401K or student loan repayment assistance. Some companies also offer wellness perks like a discounted gym membership too.
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