How Do I Choose the Right Employee Benefits for My Family?

Steps to Selecting the Best Family Health Benefits

Young Family With Newborn Baby
Hinterhaus Productions / Getty Images

With health care premiums on the rise and employer group benefit plans offering less in terms of actual coverage (after out of pocket deductibles are met), many consumers have found themselves struggling to choose the right benefits to meet family needs. Is it wise to merely accept the group benefits offered by an employer, or to select a plan that’s offered by state approved marketplaces – to take advantage of tax savings and government subsidies?

Then, there’s the question of whether the health insurance will actually cover provider services or if a family will have to seek approval before getting a health procedure done.

Barriers to Selecting the Right Benefits for Families

The Affordable Care Act (ACA) was supposed to help families to obtain low-cost health insurance and wellness coverage, while supporting long-term responsible use of health care. Unfortunately, many families have been faced with premiums that are far from affordable, and a wide range of costs when trying to find affordable health care services.

On top of that, surprise medical bills are commonplace because consumers are finding it difficult to understand the new plans. A Kaiser Family Foundation survey revealed that, “nearly 7 in 10 of individuals with unaffordable out-of-network medical bills did not know the health care provider was not in their plan’s network at the time they received care.”

Granted, these issues are being worked out as health care reform transforms the landscape of benefits. Talking with your HR administrator to sort out problems like these, and working closely with the benefits liaison can help.

Guidelines for Choosing the Best Family Benefits

When making the decision to purchase family benefits, there are some easy guidelines to follow.

It’s important to set aside some time with your spouse or domestic partner to accomplish this goal.

  1. Decide what pressing health needs or goals need attention this year. Before open enrollment, your family should have a fairly good idea of some of the health concerns that need attention this year. Even if this focus is just on preventative care, there should be some health goals discussed. Things like pregnancy, pre-existing illnesses, and more need additional attention.
  2. Review and compare all plan EOB documents carefully. You may have a ton of information to go over, but the best place to start is by gathering all the plan explanation of benefit documents that list out the benefit information for each plan. Get these from both spouses’ workplaces. Then go through them to determine the plan premiums, the deductibles, and the out of pocket costs for office visits, ER visits, and prescriptions.
  3. Go through the process of inquiring about state marketplace benefits. Now, head on over to the health care reform website and find your state health marketplace. Login and start inputting the demographics for your family, including your annual income, and all family members in your household you will be covering. You will end up getting several quotes, and you can review these EOBs alongside what you already have.
  1. Select the health care plans that offer required minimum coverage, at the best rates. Go with the health care plan that offers you the best possible percentage cover amounts for your networks, the least amount of out of pocket costs and deductible, and the best perks for your family. Some plans may offer similar coverage amounts, but the monthly premium will be different. If you are offered a government subsidy, you could get a plan that is equal or better than what your workplace offers with less cost to you.
  2. Get signed up for the company Health Savings Arrangement early. Once you have selected a suitable health care plan for your family, if it is a high deductible health care plan, then get signed up for the company sponsored Health Savings Arrangement now. You will save money by purchasing any prescriptions and paying for non-covered costs using pre-tax dollars.