Healthcare for Small Business: Understanding the Jargon

Bobby Sain
January 4, 2023
5
min read

As a small business owner, one of the most important things you can do to protect your team is to offer the right benefits at the right price. Unfortunately, this can be tricky with so many confusing insurance terms out there like ERISA, COBRA, and HIPAA that are easily misinterpreted. 

Here are some tips on how to understand what these terms mean, whether you’re an employer or an employee.

Health Insurance and You

As a small business owner, you may be wondering if you need to provide health insurance for your team members. The answer is maybe. If you have 50 or more full-time equivalent employees, you are required to provide health insurance under the Affordable Care Act. If you have less than 50 full-time employees there are options that don’t cost you a dime but still allow you to provide your team access to the healthcare benefits that matter most. 

Health Insurance Terms

If you're a small business owner, there's a lot of terminology to know when it comes to health insurance. For example, you may have heard of HIPAA and ERISA

Here's a quick rundown of what these terms mean for your business: 

HIPAA (Health Insurance Portability and Accountability Act) is the law that gives people the right to keep their medical coverage from job to job, including when they retire or if they are out of work due to injury or illness. 

ERISA (Employee Retirement Income Security Act) is designed to provide retirement security for workers who can no longer work because of age or disability.

What is Dental Insurance?

Dental insurance is a type of health insurance that helps cover the cost of dental care. It's important to have dental insurance because it can help you pay for preventive care, like cleanings and checkups, and also for more costly procedures  like fillings, crowns, and root canals. Dental insurance is offered by employers, but you can also purchase it on your own. Each insurance plan has certain providers (dentists) in its network. In order to see one of these dentists, you will need to go through the plan before making an appointment. 

What is Vision Insurance? 

Vision insurance is a type of health insurance that covers eye health, allowing you to receive care for routine eye exams, contact lens fittings, and eyeglasses. Some coverage may include discounts for LASIK and other corrective surgeries. Similar to dental insurance, many employers offer vision insurance, although you can also purchase it on your own. Be sure to explore each vision insurance plan to see what providers are in the network and what coverage is offered. You’ll want to choose a plan that fits your vision needs. 

What is Life Insurance?

Life insurance is an insurance term that refers to the coverage that pays out a death benefit to your beneficiaries in the event of your passing. It's an important part of financial planning, especially for small business owners, as it can help ensure that your loved ones are taken care of financially if something happens to you. There are many different types of life insurance policies, so it's important to understand what they cover and which one best suits your needs.

What is Hospital Indemnity coverage? 

Hospital Indemnity insurance is a type of medical coverage that pays benefits if you are hospitalized. Regardless of your existing medical coverage, these benefits are paid to help cover costs that your primary insurance may not pay. Some examples of coverage may include fixed benefits for admission to the hospital, fixed benefits for each overnight stay, or a fixed benefit for a stay in intensive care. While you can purchase Hospital Indemnity on your own, many employers offer it as an addition to their health insurance plans. Each Hospital Indemnity plan is different, so it’s important to review your options.

How Does Short-Term Disability Work?

Short-term Disability insurance is a type of insurance that provides income replacement for a limited period of time if you are unable to work due to a covered accident or illness. The benefit period is typically 26 weeks, but can vary depending on the policy. To be eligible for benefits, you must be disabled and unable to perform the essential duties of your job. In most cases, you will need to provide medical documentation from a licensed physician to prove your disability. Short-term Disability insurance is usually offered by employers, but again can be purchased separately. 

What is Accident coverage?

Accidental insurance is a type of coverage that pays cash benefits if you sustain an unexpected accident or unexpected death. Accident insurance is usually offered to employees as an add-on to health insurance, although employees can purchase it on their own. Qualifying accidents allow you to receive cash to cover out-of-pocket expenses that your health insurance may not cover. While each Accident plan is different, many will have options to choose from that meet your personal needs. 

Understanding How to Talk to Employees.

When you're a small business owner, you wear a lot of hats. One of those hats is Benefits Administrator, and while that role comes with a lot of responsibility, it doesn't have to be complicated. 

Here are 3 tips for talking to your employees about insurance: 

1) Know the lingo. It's easy to get lost in all the words and jargon related to healthcare and life insurance; fortunately, there are definitions available online that can help guide you through what they mean when referencing terms such as deductibles, co-payments, coinsurance and more. 

2) Use charts and graphs. You don't need to make employees feel like they're sitting in an algebra class. Take the time to break down different aspects of healthcare or life insurance so people can see them visually--you'll have their attention much longer than if you just read off a list of things they should do or know. 

3) Be patient. No one likes to talk about insurance, that includes your employees. It will take time for people to understand these terms. Start by giving them basic explanations and over time, as they become comfortable with the idea of taking control of their own healthcare decisions, gradually add additional detail. Employees may still ask questions as this process unfolds but that means you're doing something right!

Offering Meridio Benefits gives you access to expert Benefits Guides at your fingertips that can help your employees learn more about your insurance offerings without any work from you. Learn more by visiting GetMeridio.com. 

 

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