Common Questions about Worksite Benefits

2.5 minute read

One low-cost way that employers are enhancing their benefit packages is by offering worksite benefits. Worksite benefits can help supplement your employees' core health benefits by providing them with additional financial protection in the event of a covered accident, injury, or hospitalization. Benefit payments can help cover out-of-pocket expenses not fully covered by regular health insurance. Worksite benefits include accident insurance, critical illness insurance, and hospital confinement indemnity insurance.

Thinking about implementing worksite benefits? Here are some important questions you may want to ask first.

Eligibility

Some insurance carriers only offer worksite benefits to those organizations with 100 or 200+ employees. If you’re a smaller group, ask the carrier if you’re eligible for their plan.

Participation Requirement

A participation requirement is the number of employees who must enroll in the coverage for it to be offered. The lower the percentage, the more favorable it is to you.

Billing Method and Administration

• Do I receive a list invoice?
• What am I responsible for administratively?

Rate Guarantees

How long will the rates be secure? Note that rates are usually guaranteed for 2-3 years and are typically stable after that.

Claims Process

• How does the process work?
• Can employees submit claims online?
• What’s the typical turnaround time for payment?

Implementation/Enrollment Process

• How does the enrollment/implementation process work?
• Is the plan rolled out to everyone at once (like your group plan) or do employees meet one-on-one with a sales representative?
• Does the carrier believe in using high pressure sales to meet their quotas?
• Are representatives educating your employees? Are they willing to educate employees on other benefits that they may not directly represent?
• Does the carrier offer annual enrollment services?
• Are the representatives commissioned or salary based?
• Does the carrier employ their own implementation staff, or do they outsource to a third party?

Service

• What type of ongoing service will you and your employees receive?
• Does a representative meet with you on an annual basis to see how things are going? Are they available for questions from both you and the employee?
• What is the carrier’s standard response times?
• Are representatives available for employee meetings or benefit fairs?

Wellness Incentive/Benefit

Does the plan include a wellness incentive? Most worksite plans offer a wellness benefit, which could reimburse an employee, spouse, and/or dependent children each year for having certain tests and routine exams done.

Other Services

What other services does the worksite provider provide? (E.g. Flexible Spending Accounts, FMLA Services, Benefit Administration System Administration, or HSA/HRA Services)

For more information about worksite benefits, contact your NIS Representative.