The Express Blog introduces a new series called the Basics of Benefits for U.S. leaders and job seekers.
In today’s complex employment landscape, understanding the intricacies of workplace health benefits is more important than ever. While it may seem overwhelming at first, taking the time to familiarize yourself with common terms and concepts can significantly impact your financial, physical, and mental well-being, and overall job satisfaction.
A recent MetLife report found 55% of employees don’t fully understand their benefits options, with Gen Z at 60% and millennials at 64%. Additionally, 60% of all employees want better information from their companies about enrollment options.
These findings highlight the critical need for clear and comprehensive communication about health benefit offerings to ensure employees can make informed decisions.
“Your HR team is your partner in navigating and maximizing your workplace benefits,” said John Humphries, Director of Benefits at Express Employment International. “Don’t hesitate to reach out with questions or for guidance; understanding your options fully can help you make the most of what your employer has to offer, and support your overall well-being and job satisfaction.”
By staying informed and being proactive, you can ensure that you are taking full advantage of the health benefits available to you and making decisions that best support your needs and goals. Now, let’s delve into the core health benefits and insurance terms to help you better understand and utilize the essential components of your benefits package!
Common Workplace Health Benefits and Terminology
These terms are often used in the context of health insurance plans:
- Deductible: The amount you pay out-of-pocket before your insurance coverage begins.
- Copay: A fixed amount you pay for a specific medical service, such as a doctor’s visit or prescription.
- Coinsurance: The percentage of the medical cost you pay after you’ve met your deductible.
- Embedded Deductible: A deductible that applies to specific services, such as prescription drugs.
- Explanation of Benefits (EOB): A statement from your health insurer detailing the services provided, the costs, and the amounts paid by your insurance.
- In-Network vs. Out-of-Network: In-network providers are doctors or other healthcare providers that are part of your health plan’s network, and you typically pay lower costs for their services. Out-of-network providers are not part of your network, and you may pay higher costs.
- Out-of-Pocket Maximum: The maximum amount you’ll pay for covered medical expenses in a given year.
- Preventive Care: Routine check-ups and screenings that are often covered by health insurance plans at no cost to the insured employee.
- Reasonable and Customary: A standard used by health insurers to determine whether medical services are appropriate and fairly priced.
- Flexible Spending Account (FSA): A tax-advantaged account that allows you to set aside pre-tax dollars to pay for eligible medical and dependent care expenses. Generally, you must use the funds within the plan year, though some plans offer a grace period or allow a small amount to roll over.
- Health Savings Account (HSA): A tax-advantaged account that allows you to save money for future medical expenses. Contributions to an HSA are often tax-deductible, and withdrawals for qualified medical expenses are tax-free. Funds roll over year to year, and you can keep the account even if you change jobs.
Health benefits vary across companies and some can be secured elsewhere if you want coverage that isn’t offered by an employer.
Remember, your employer may have valuable resources available, such as benefits guides or dedicated personnel, to assist you in navigating the process. Don’t hesitate to reach out to them for further clarification or support. By being proactive and educated about your benefits, you can maximize their potential and ensure that you are utilizing them to their fullest advantage.
