Both employers and advisors should be careful in discussing Health-care Spending Accounts and benefit plan coverage as an either/or situation. Most health plans will eventually pay the cost of their claims plus expenses over a short period of time – both insured and self-insured plans, although in slightly different ways. The spending account has to be a very significant amount to cover claimants over the average claim costs. An example would be an orthodontic or cancer claim could wipe out a spending account leaving nothing for other family members and other expenses whereas this would not happen under a benefit plan structure. Consideration of a truly flexible program would incorporate both concepts in a balanced fashion allowing for top up of excess expenses or coverage of coinsurance or deductible amounts. Design of programs to meet needs is important and it usually isn’t all one or another format to make it work effectively.
Gord:
Both employers and advisors should be careful in discussing Health-care Spending Accounts and benefit plan coverage as an either/or situation. Most health plans will eventually pay the cost of their claims plus expenses over a short period of time – both insured and self-insured plans, although in slightly different ways. The spending account has to be a very significant amount to cover claimants over the average claim costs. An example would be an orthodontic or cancer claim could wipe out a spending account leaving nothing for other family members and other expenses whereas this would not happen under a benefit plan structure. Consideration of a truly flexible program would incorporate both concepts in a balanced fashion allowing for top up of excess expenses or coverage of coinsurance or deductible amounts. Design of programs to meet needs is important and it usually isn’t all one or another format to make it work effectively.
Thursday, June 27 at 12:16 pm |