Employer health insurance options: promoting wellness among Alaska employees.

• Author: Barbour, Tracy
• Position: INSURANCE

Health insurance is an important component of a competitive employee benefits package. Employers in Alaska can choose from a variety of health insurance options based on their group size, plan design specifications, costs, and other considerations to meet their employees' needs.

Health insurance for employees can include medical, dental, vision, prescription drug, hearing, and certain disability coverage, depending on how much employers want and can afford to spend. Employers can also offer wellness programs and employee assistance programs that help workers deal with personal, family, and work-related issues.

Popular health insurance options in Alaska include preferred provider organization (PPO) plans that enable businesses to save money by using in-network contractors and high-deductible consumer-driven plans that result in lower costs overall for employers and employees. Larger employers may opt to self-insure to curtail their costs.

Starting in 2015, businesses with the equivalent of fifty or more full-time employees must provide "affordable" health insurance or pay a tax penalty under the Patient Protection and Affordable Care Act, commonly referred to as the Affordable Care Act (ACA). These employers must provide certain benefits with every health plan, such as dental and pediatric coverage.

However, businesses with fewer than fifty full-time-equivalent employees don't have to provide health insurance coverage to their employees. Those that do may receive certain federal tax credits.

Buying Insurance Benefits

Alaska employers typically obtain health insurance plans through producers (brokers or agents) that sell products from various insurance companies. Brokers also have the expertise to tailor medical, dental, and other health plans to employers' budgets and needs. For example, Alaska USA Insurance Brokers, or AUIB, can work with businesses to create a strategic employee benefits plan. The tailored plan, which incorporates health care benefits, is designed to match their immediate and long-term goals.

"We analyze their current benefits program and evaluate alternative strategies against their desired outcomes," Senior Account Executive Benefits Manager Craig Kestran says. "Then we employ what we have learned and combine it with our extensive knowledge and experience in the employee benefits marketplace to create a customized solution with recommendations that support their stated goals and objectives."

He adds that designing a benefits plan offering is just the first step in successfully implementing and managing the overall employee benefits program. "AUIB will proactively support clients throughout the year with employee communications and education, open enrollment support, regulatory and compliance support, vendor management and performance, client service, and health and wellness consultation," Kestran says.

Employers in Alaska can also purchase health insurance plans directly from companies such as Premera Blue Cross Blue Shield of Alaska, Moda Health, UnitedHealthcare, Aetna, or Cigna. The Federally Facilitated Exchange, commonly called the "Marketplace," is another alternative for small businesses and individuals. It is essentially a place for individuals to shop for health insurance if they don't already have insurance coverage from another source.

Plans from Premera

Premera Blue Cross Blue Shield of Alaska has a variety of plans that Alaska employers can choose for their employees. Reportedly the largest network in Alaska, Premera has more than 2,900 physicians and practitioners contracted across the state and 90 percent of the hospitals. The breadth of the company's network enables employers to give their employees access to health care coverage at lower costs, according to Jim Grazko, president of Premera Blue Cross Blue Shield of Alaska. "Our goal is to provide the most cost-effective options, security to employees through a wide network to protect them against balance billing, ease of doing business, and top-flight service," Grazko says.

Premera features various plans for small groups (with two to fifty employees) and large groups (with fifty-one or more employees). Medical coverage, for instance, is offered under Select and Plus options. With larger groups, the plans have wider variance with deductibles and out-of-pocket maximums, as well as more benefit design flexibility.

Here's how they work: Select plans are the "preferred hospital, any doctor" plans. They typically pay the higher level of benefits when members seek non-emergency care from preferred in-network hospitals and ambulance providers. Members can see physicians and practitioners of their choice, but providers outside the Premera network may "balance bill" the member for the difference between the Premera allowed amount and the billed charge.

The Plus option, on the...