As HealthShares become more popular, you may encounter employer-sponsored HealthShare memberships offered in their benefit packages. This can be a bit confusing, so this post offers a general idea of what to look for if you encounter medical cost sharing at work.

Minimum standards

In the United States, companies who have more than 50 employees must provide qualified healthcare assistance to their employees. A healthcare plan that meets the minimum value will pay at least 60% of the total cost of medical services for a standard population and includes substantial coverage of physician and inpatient hospital services. Most HealthShares agree to share at least 60% of the cost for eligible medical services, but many sharing plans don’t provide substantial help with some routine care, like visits to physicians.

Making it work

How, then, can a job offer a HealthShare membership as a medical benefit? They combine two types of memberships!

Employers who work with HealthShares will usually provide a HealthShare membership for services such as hospitalizations and surgeries, and then they will offer a traditional base insurance plan to help with preventive care such as doctor visits and prescriptions. Splitting healthcare costs into these two sections helps employers save money while still giving employees the care they need.

Employment benefit options

We have seen two HealthShares partner with other companies to offer a combined base health and HealthShare plan. A company called Planstin uses Zion Health for its HealthShare; the sharing ministry Sedera partners with Scoop Health and a few others.

How do I choose?

• Employers – Carefully review both the base health plans and the HealthShare guidelines. Any program that only provides discounts for care does not meet federal minimum standards. You’ll want to choose a plan that makes it easy for your employees to visit the doctor (both primary care and specialists), get prescriptions and immunizations, and helps them pay for critical needs. A better benefit package always costs more money but paying more for good care protects you from paying a government fine later and attracts higher-quality talent to your workforce.
• Employees – Know your own health needs. Employers who offer these combined HealthShare-and-insurance plans usually have a few options for employees to choose from, and your best chance to find one that will work for you is to know what you need. Read all information carefully. Take your time. Pay attention to how the plan will pay for pre-existing conditions, doctor visits, routine care, mammograms and colonoscopies, surgeries, and prescriptions. Write down any restrictions you see and take some time to decide whether they will impact you. Don’t skim the plan information; don’t rush. Healthcare can be life-changing, so this is one instance when it is best to go slow.

Summing up

Hopefully this gives you a better idea of how employer-sponsored HealthShare membership can work. It may be a feasible option for both businesses and employees, so don’t dismiss it! Just be sure the offered care meets minimum standards, and your own needs,  before you enroll.