Why Do Employees Pass Over Healthcare Offerings?

Talor Bianchini
Talor Bianchini23 Aug 2022

Health insurance is one of the most important benefits that employees consider when applying for and accepting a job. As an employer, it's essential to understand what specifics they are looking for in a healthcare plan. If your employees are choosing to opt-out on your group plan, it may be for various reasons, including cost, benefit preferences, and the provider network offered. 

If you are looking for a health insurance alternative to offer your employees, Mira has you covered. Depending on the size and budget of your company, Mira offers a wide variety of group plans that you can offer your employees, starting as low as $45 a month for each person. This grants access to low-cost virtual and urgent care visits, up to 80 percent over 1000 different medications, and same-day lab testing. Save yourself and your employees money; sign up for Mira today.

Why Do Employees Pass Over Healthcare Offerings?

Employer-sponsored health insurance is the most common type of health insurance coverage in the United States. As a result, recruitment and retention for jobs are very reliant on the health insurance benefits offered by the company. Around 46 percent of Americans stated that it was a deciding factor when accepting the offer to their current position. Therefore, choosing a plan to offer your employees is a huge decision. It takes a lot of work to find something that meets everyone's needs. 

Although employer-sponsored health insurance may seem ideal for most, many often opt out of the group insurance plan offered by their employer. This may be surprising, but there are several reasons why some choose a different health insurance route. As an employer, you may be curious about what drives employees away from the plan you selected for them. 

1. Cost 

Cost is one of the major factors that help employees decide whether or not they want to enroll in your insurance plan. Employers and their workers split the yearly health insurance premium cost, with employers covering about 83 percent. Depending on the type of plan offered, this percentage can change dramatically. If the plan you are offering is too expensive, your employee may decide to get their health insurance through a family member instead.

Although this is usually over half the yearly premium cost, it's not always doable for most people. They may have a lot of bills to pay, mouths to feed, etc. A larger yearly premium may mean a lower deductible, but this may feel unnecessary for those with little to no medical problems. It doesn't make sense for some to pay extra for better benefits if they know they won't have to use them. 

Especially in smaller companies, the cost for family plans is extremely high. This may be their only source of income for some families, so an expensive plan may not be in their best interest. Around 28 percent of workers from small companies must pay over half of the monthly premium for their monthly plan, compared to only 4 percent of large companies. Smaller companies usually cannot afford to be as generous as larger companies and can only help out so much. 

If you are looking for a better, more affordable health insurance plan for your employees, Mira is here for you. Starting at $45 a month per person, your workers could have access to low-cost virtual and urgent care visits, same-day lab testing, and up to 80 percent off over 1000 different prescription medications. With Mira, there are no deductibles and affordable co-pays. Mira will keep you and your employees happy and healthy. Do them a favor and sign up today. 

2. Benefit Preferences 

Another barrier you may be facing when trying to offer your employees health insurance is their benefit preferences. Chances are, you have a wide variety of people working at your company, and it may be difficult to find a plan that meets everyone's needs. These preferences can be influenced by their financial situation, age, family size, and health status. If the plan isn't something that they believe they will utilize, it may not be very valuable to them, and they won't want to enroll. 

One survey found that the top three benefits people are most concerned with are coverage for emergency care, preventive care, and prescription drugs. When browsing through potential plans, consider looking for ones that offer these benefits, as your employees will most likely be satisfied. If you are looking to switch up your plan, consider sending out an anonymous questionnaire to all of your workers to see what they need when it comes to health insurance. 

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3. Provider Network

When choosing a health insurance plan for your company, you also must consider the provider network the plan offers. If a provider is 'in-network,' they have negotiated discounts with the insurance company and provide lower rates to people utilizing this kind of health insurance. If you use an in-network provider, they cannot charge patients for the remaining balance of their care. They can only accept the previously negotiated cost with the company and any co-pays or coinsurance.

As a result, this can save lots of money for employees, especially if they are visiting the doctor often. If the provider network of the plan you choose to offer doesn't encompass where they would like to go for their healthcare needs, your employees may also decide to opt-out of your plan. A lot of this boils down to cost and personal preference, and experience with certain providers. Consider adding this to a questionnaire to send out to your workers as well to determine what facilities they want in their network. 

Other Ways to Provide Coverage 

If your employees aren't satisfied with the current healthcare coverage you are currently offering, you may want to find an alternative way to get them what they need. There are several other ways to enhance the benefits they are already receiving and provide other coverage.  

1. Implement an FSA

A flexible spending account (FSA) is a tax-exempt savings account that both employees and employers can contribute to. These accounts can be used to pay for co-payments, deductibles, and a wide variety of other healthcare expenses. This money can help pay for any out-of-pocket expenses that your spouse or dependents incur as well. If your chosen plan doesn't have extensive benefits, the FSA can help provide this added coverage. 

An FSA is available for any health insurance plan and may allow your employees to utilize their benefits better. Unfortunately, the money in the account does not carry over from year to year. Your employees will be required to use all of the money before the plan year ends. You can decide to allow a two-and-a-half-month buffer period or allow your employees to carry $570 of any unspent money in the account to the next plan year. 

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2. Health Reimbursement Arrangements

A health reimbursement arrangement (HRA) may be an alternative to a group insurance plan. Companies that utilize HRAs set money aside for their employees to reimburse them once they purchase an individual health insurance plan. The money helps to cover the cost of the monthly premium. This is cost-effective for both employees and employers. Especially for smaller companies, group plans can become very expensive, so this is often a more affordable option. Employees can choose a plan that is right for them and their needs and don't need to pay more than is necessary. 

There are two different types of HRAs, depending on the size of your company. Qualified small employer HRAs (QSEHRA) are meant for companies with less than 50 full-time employees that don't want to offer group health insurance. A maximum contribution limit is calculated for both individuals and families each year. The second kind of HRA is an individual coverage HRA (ICHRA), which companies of any size can utilize. It can be used on its own or with a company's group health insurance. 

3. Self-Funded Plans 

Another alternative you may offer your employees is a self-funded or self-insured plan. Instead of choosing a group plan that all employees use, self-funded plans are more customizable to each person. Employers pay for out-of-pocket costs as they are presented. This option is more beneficial for large companies, as they have the money and resources to support this style of insurance. The costs a company may incur will be very unpredictable from year to year. However, this is a great way to provide quality health coverage to each employee and ensure they get the benefits and care they need. Typically, a third-party administrator (TPA) is hired to deal with the medical claims from employees.

Bottom Line

When applying for jobs, health insurance benefits are a major factor in people's searches. Research has found that it is a key factor in recruitment and retention in companies and should therefore be a top priority for employers. Often, employees may decide to opt-out of the health insurance plan provided by their employer. This is usually due to high costs, benefit preferences, and the providers available in the network. If your employees aren't satisfied with their current plan, consider looking for an alternative to meet their needs. 

An affordable way to better meet your employees' needs is by signing up for Mira. For as low as $45 a month per person, Mira can offer low-cost virtual and urgent care visits, up to 80 percent over 1000 different medications, and same-day lab testing for those at your company. The level of care is customizable depending on the size and budget of your business, so you can easily find a plan that is right for you. Don't hesitate to provide better coverage; sign up for Mira today.

Talor Bianchini

Talor graduated from Penn State University with a B.S. in Biobehavioral Health, and minors in Spanish and Diversity & Inclusion in May of 2022. She has a passion for health equity and diversity in health. In the future, Talor hopes to work in public health policy reform to help eliminate health disparities. She enjoys reading, cooking, and listening to podcasts in her free time.