How do Other Practices Handle the Cost of Benefits?

Excerpted from MGMA Connexion, April 2007

Every employer is fighting the battle of continually increasing health insurance costs for employees. More and more employers, including those in the medical profession, are trying to determine a fair” way to share t”he burden. Even insurance agencies are wondering what to do with the cost of benefits that used to be covered 100% by the agency.

Here are some replies from a survey by MGMA:

"We offer three options: HMO, PPO and POS. Employees pay 20% of single coverage. If family members need to be covered, the employee pays the full difference."

"We are envious of practices that can offer benefits. We do not pay for our employees' group health coverage; and several employees are currently uninsured. The cost is too great of a burden for our practice."

"Our clinic pays 60% of the employee's cost and 50% of the family coverage. This is considered very generous, especially the family coverage, for our area. However this is a decrease from 100% payment for everything six years ago."

Here is the formula for our practice:

1. 100% for full-time employees (32+ hours per week), 75% family.

2. 75% for part-time employees (20-31 hours per week), 50% family.

3. If no insurance is taken, $3,000 full-timers or $1500 part-timers is placed in a medical flex plan. If they want cash, they can take half of the above amounts.

Our employees pay 15% of their health premiums (pre-tax). Everyone pays the same, but we offer a coverage waiver benefit for those with spousal coverage.

Our employees have 50% of their premiums, 100% for dependent coverage.

As you can see, policies vary widely. Decisions should be based on the fiscal soundness of the practice and the market conditions required to recruit and retain good employees in your area. Additionally, many companies are offering higher levels of deductibles and/or Health Savings Accounts to help mitigate costs.