Health Insurance 101 for Life Science Professionals
How much do you know about health insurance? Are insurance benefits even important to you? A recent BioSpace survey found that health insurance is one of the top considerations of life science professionals willing to relocate for a job. To learn more, we interviewed Carrie Richards Leary, a health insurance benefits professional. She explained some of the basics regarding insurance and gave advice for determining the best benefits plan for you and your family. Find out more about deductibles, types of plans, and wellness initiatives to preserve your health.
1. Can you tell us a little bit about your background before entering the insurance field?
Directly out of high school while attending college, I immediately started working for State Farm insurance selling home, auto, and life insurance. I have been in the industry ever since, I started strictly focusing on health insurance benefits for the past 6 years.
2. Why do you think employees are so concerned about their health insurance options?
I believe that employees are so concerned because they want to be able to use the health insurance policy they pick. They don't want to have to pay a lot out of money out of pocket to see a doctor or get a prescription. They want to be able to pick a plan that is affordable on a monthly basis.
3. What are some standard components of basic health insurance offered through companies?
Most companies usually offer two types of plans, a PPO (preferred provider organization) or an HMO (health maintenance organization). The PPO is more of an open network plan, where doctors participate in and out of network. It gives the insured person pretty much free range to use whatever doctor they want, as long as they participate in or out of the network. The only downside is they may pay a higher cost if they use an out of network provider. The HMO is more of a limited closed network plan, where they only pay benefits to doctors who participate in the network. In this type of plan, referrals are usually required, although they have been becoming more lenient with this.
Most plans will have a deductible to meet first (if there is a hospitalization or such). This is a maximum out of pocket fee, meaning the most they would pay out of pocket in a calendar year. In addition, they usually have copays for most other services such as doctor office visits, urgent care visits, and prescription drugs, just to name a few. The plans will normally offer preventative services covered at 100%, meaning physicals and routine services can be completed at no charge.
A lot of health plans now offer wellness and reward programs for employees. For instance, Humana offers a program called Go365. It focuses on rewarding their employees for yearly physicals, vision and dental exams, as well as workouts. They say that the employer is then rewarded as well, because the employee has less sick days, lower medical claims, and increased productivity. It is a win-win for everyone.
4. What are some components of higher-tier health insurance? Why are these considered premium options?
Higher-tier options are what I consider the "Cadillac" type plans. They are usually referred to as a Gold plan. They have lower deductibles, out of pocket expenses, and copays. Most commonly, individuals that have health conditions, who may use the insurance a lot can opt for this type of plan. Also, many women who are pregnant may choose this option. These are considered a premium option because it has all the bells and whistles, but it also comes with the cost. It is not cheap.
5. How could a job candidate or employee bring up the topic of wanting more health insurance options with their employer?
Depending on the size of the company, usually more than one health plan can be made available to employees. I believe when it comes to the employer offering alternate coverage options, they are looking at what it will cost the business. Most employers are required to pay 50% of the employee only premium. They think by offering any type of health benefits, it is good because a lot of businesses are now shying away from offering these benefits (because it is not required). I personally think it is advantageous because it helps with retention. As a job candidate or employee, I would certainly bring this up. They would be more likely to take the job or stay longer because of the additional options.
6. What general advice would you give to life science professionals when it comes to health insurance?
When selecting your health insurance benefits, consult with the HR department to make sure you understand what you are getting. If there is not an HR person and it is a smaller company, call the benefits company and speak with the agent who set the plan up. They will be able to fully disclose all the details about the plan or plans available. They should be able to guide you based on your health needs or wants. Many people don't know the difference between an out of pocket max and a deductible. These things are very important when it comes to making a decision on what plan may be best for the individual.
Porschia Parker is a Certified Coach, Professional Resume Writer, and Founder of Fly High Coaching. (https://www.fly-highcoaching.com) She empowers ambitious professionals and motivated executives to add $10K on average to their salaries.
Carrie Richards Leary is a licensed health insurance professional who has been in the insurance industry for the past 15 years. She takes pride in spending time with her clients to make sure they are fully educated in the health care choices that they choose.