Considerations for a Family Health Coverage Plan

When businesses consider health plans for their employees, it is important to remember to choose a plan that works not only for individual employees, but their dependents as well. At a time when health insurance options are numerous and costs are on the rise, family health coverage has become one of the most difficult areas for many benefits buyers and human resource directors.

Family Health Coverage:

According to a recent report by USA Today, the average family health coverage policy costs more than $10,000 per year. As a result, many Americans are choosing to go without health coverage for their family, deciding instead to pay out of pocket when medical emergencies arise. This is a risky decision, as an eight-year study showed that uninsured Americans receive less care and experience worse health outcomes than those with health insurance.

Out-of-pocket payers not only fail to receive adequate acute care, but also do not participate in preventive care programs (health risk assessments, health coaching, health education, etc.) or receive the necessary tests to determine if their lifestyle or genetic background may put them at high-risk for developing chronic health conditions such as heart disease, obesity or diabetes. Those who already have chronic conditions often will not participate in crucial disease management programs that help get them to the point of care for their condition.

A lack of proper healthcare options not only puts the health of employees and their families at risk, it also hurts the bottom line for their employers. Rates of absenteeism and presenteeism (an employee who comes to work, but has low productivity due to health issues) increase and high-cost claims from hospital visits and specialists increase when health conditions are no longer reversible, and the employee decides to start coverage.

Many employers, faced with out-of-control insurance costs and the risk of an unhealthy workforce, are increasingly deciding to implement onsite or near-site health centers as an option for providing healthcare to employees and their families. These health centers, such as the ones provided by Marathon Health, can be utilized by eligible employees and family members (often at no cost) for acute care, occupational health, disease management/chronic condition care, preventive care and health coaching, and onsite dispensing of medications where allowed by state law. As a result of the total population health risk management model used by Marathon Health, companies experience substantial savings over time through preventive care and risk stratification/proactive outreach to high-risk members, greatly reducing expensive hospital or specialist visit claims.

Employees list family health coverage as a top reason for taking or staying at a job, aiding in recruitment and retention efforts. Surveyed employees often cite onsite health centers as the top benefit provided by their employer. In addition to greatly reduced rates of absenteeism and presenteeism, having an onsite or near-site clinic decreases the distance an employee has to travel for health care, thereby reducing time away from the office. Most importantly, onsite health clinics ensure the continued health of employees and their families, a benefit to everyone.