There are some benefits on plans that should be eliminated or enhanced to give more value to employees and stakeholders. By having them on your plan, they are subject to abuse. It is not necessarily your employees’ fault, and the practitioners are all too willing to take your benefit dollar as far as it can go. Since benefit renewals are all based upon the previous year’s claims, a plan could be subject to huge increases, benefit reduction or in extreme cases, plan cancellation. So here are the benefits we should get rid of from our plan.
Here are only a sampling of some of the benefits that you should be aware of and discourage having them on your employee benefit plan.
Most companies have Accidental Death & Dismemberment (AD&D) on their group benefit plans but should they? This benefit provides benefits for injury resulting in loss, or permanent and total loss of use of body parts. It also pays out a benefit in the event of death caused by accident on or off the job. It’s a benefit over the years that don’t cost very much (relative to Life and LTD), and rates have increased nominally for years. There’s a reason why premiums have stayed flat…..because it seldom pays a benefit.
What if you could get the same AD&D benefit + incorporate a critical disease component or a cancer rider for around the same price as your typical AD&D coverage. Why not get something that brings some additional value to your AD&D policy. You may actually have employees perk up as opposed to having their eyes glaze over when talking about this in a benefits meeting.
Many plans already have enhanced versions of this benefit with very little difference in cost. So are you getting this upgraded benefit?
Off-The-Shelf Orthopaedic Shoes
Another benefit that needs to be eliminated from plans is off-the-shelf orthopaedic shoes. These are standard shoes sold in speciality stores for usually a lot more money. It’s like going and getting your favourite pair of running shoes and putting them through your benefit plan. If everyone was to discover this loophole in their plan, how quickly do you think it would take for claims to run out of control?
Oral Hygiene Instruction for Adults
Although this is not as common as it used to be, I still see it pop up in about 30% of the cases that we work on. This is when the dentist or hygienist explains to you how to brush and floss your teeth properly. I’m alright with a one-time explanation to a child, but oral hygiene instruction for adults is a little excessive. Next time, you may want to YouTube it instead. Consider that this explanation if on your plan can cost over $50 per visit.
More Than 8 Scaling Units
When at the dentist, it’s important to understand not only what you’re being charged for but also for how many units of time. A unit of scaling represents 15 minutes. When was the last time you were at the dentist for a cleaning and were in the chair more than 30-45 minutes total? Check the total number of scaling and polishing units charged. An extra scaling unit charged can cost more than $50. It is critical to scrutinize your bill and watch how long you’ve been in the dentist’s chair.
There are many areas on your plan that can be subject to abuse. One of the most important preventative measures is education and communication to employees on how to become better consumers of health and dental products and services. When everyone realizes that they can positively impact the bottom line, employees tend to be the protectors of the plan instead of the abusers of the plan.