Businesses Seek Guidance On Health Plan ‘Affordability’ And ‘Access’ ane ae TD Sea But across the U.S., employers and their workers are findingthat a balanced combination of the two is more exception than rule. This is why so many are turning to benefit experts for help, particularly smaller businesses with 100 or fewer employees. The Problem With so much high-profile and public discussion around health care reform, the concepts of affordability and access are getting bandied aboutas never before. Yet market forces frequently conspire to keep these ideas misaligned or even at direct odds. Common examples are new network configurations that offer a cost-access trade-off that’s not always simple to decode. For instance, a plan might offer lower premiumsfor price-sensitive cus- tomers in exchange for access limits to certain care providers—limits that are not alwaysclear to consumers. ‘This often leads to a very frustrating disconnect for businesses and employees seeking the best of both. A Solution Onewayto dial back frustration is to get connected to a good brokeror bene- fit adviser, says Ron Goldstein, president and CEO of CHOICE Administrators, the nation’s leader in developing and administering employee-choice health benefit programs and exchanges for employer groups. ‘The company’s exchanges include the country’s first and only multicarrier private exchange, California- Choice. =— LeNA wo, politicians and the media frequently combine the terms “affordability” and “access” asif they naturally go together. di i i ti ii national discourse on health insurance, — (NAPSA)—When it comes to the ae Many companies have found professional advisers can be the healthy choice whenit comesto finding the best health care plansfor their employees. down to price—for the plan premium, deductibles, co-pays, costs and so forth. out-of-pocket Access, on the other hand, is an ex- tremely complicated descriptor. At its baseline, “access” refers to whether physician, pharmacist, therapist, hospital and otherproviderservices are available and,if so, if there is an adequate supply. ‘This definition, however, only scratches the surface. Factors such as location, quality, use and moreare also important components in the overall equation. Also, coverage levels can lead to un- intentional distortions or misrepresenta- tions of “accessibility” A person covered by a Bronze plan living in a more pop- ulated region may have muchbetter access to care than someonewith Platinum coverage in a rural area. Assessing these potential disparities requires a keen eye andthe practiced handthat a health plan professional can effectively provide. Clearly, the notion ofhealth care accessibility is extremely complex. That said, most people tendto internalize and define “access” personally. They want to knowthattheir doctor, specialist or hos- “Today, there are a lot of new plan pital is available to them before making overwhelming to decipher,’ Goldstein not always easy to do. Benefit specialists play an integral role in helping small businesses shop and compareplans while working with employees to confirm that selected plans connect them to desired networksand care providers. Conversations aboutaffordability and access in the health care marketplace will likely continue to dominate headlines for months and years to come. Leaning heavily on the skills and insights of advisers will help businesses and their employeesfind theright equilibrium. options with manyvariables that can be said. “An agent can provide the necessary guidance and clarity to understand and navigate the trade-offs aroundcost, choice and availability” It's also where well-designed health care exchanges, private and public, can shine because they enable plan comparisons based on price along with many other choice factors. Take affordability. For many, the word connotes “inexpensive,” but the term is relative and depends on a myri- ad of factors such as household income, care needs, overall health and much more. At the core, affordability boils a plan selection. ‘This is simple to say but Learn More For additional information, visit www. mycalchoice.com or www.calchoice.com.
