In short, the answer is ABSOLUTELY, and we can do this through telemedicine!
Most who have worked with us for a while are familiar with telemedicine in some way, shape, or form. Most health insurance providers offer it for enrolled members but typically with a copay/fee associated with it when it’s used. Alternatively, stand-alone telemedicine offers a fee-based service where there’s usually some sort of monthly upfront fee (less than $10/$15 a month depending on who is funding and group size) but there is no usage fee for medical or mental virtual visits.
With more and more services going the virtual route these days, it was only a matter of time until medicine jumped on board. With the surging opportunity for companies to provide a telemedicine option, and the affordability of these services came our next question. Can a 1099, volunteer, and part-time employee receive access to these types of benefits?
Health benefits alone are something we don’t see offered for these employee categories. With many Americans working multiple part-time jobs or working as a 1099 employee they often go uninsured by their employers due to the lack of full-time status. Here at HBC we wanted to offer up telemedicine today as a way to help get $0 copay doctor access and mental health access to these overlooked individuals.
Two issues that you run into and why so many insurance companies charge copays when someone uses telemedicine are
(1) Because they can.. Fully insured companies, especially in the small space, don’t really want to be paying for all of anything, so in that approach, they are looking out for their bottom line and not the value something like this brings to the member. In short, they charge copays because they can.
(2) Another issue here is that fully insured health plans are heavily regulated by the state in which they are filed and at the federal level. When you have a telemedicine program bundled in with your health plan, then by default, your telemedicine program that the insurance company is “giving” to you also immediately falls under regulatory scrutiny, think copays when you call in vs being able to use this service for free.
It’s good to have telemedicine available whether there’s a cost to use it or not, simply because in many situations it’s the most convenient and cost-effective way to talk to a doctor and in most situations, it is also the quickest. Most telemedicine providers when you call in let you make an appointment for later that day or get in the queue to speak to a doctor on their “next available” list which in most cases will translate to a call from a physician within an hour or 2. That’s the value for anyone who has access to these types of programs.
Telemedicine is a perfect benefit that can get something of value to a population that is typically overlooked and it’s very low cost compared to most other types of benefits. It’s also something that when offered as a stand-alone can be opted in/out of. This will vary to a certain degree depending on the provider you are working with, but an opt-in/opt-out for a population of this type is 100% doable. Remember, when the benefit is NOT tied to an insurance health plan, it is not subject to all the State/Federal regulations. You as a business owner are simply negotiating what you would like to offer to your population, whatever it may be, with the telemedicine provider, ideally through your broker.
I personally like this for a number of reasons –
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This is a super affordable benefit, so the organization is not spending a ton of money
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With the opt-in/opt-out setup, the organization is not spending on a benefit that people don’t want/will not use. This is a problem with a more traditional 100% employer-paid program.
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There are a TON of underinsured/uninsured individuals still in this country. Many work multiple part-time jobs and don’t get benefits anywhere, many can only afford a super high deductible plan that is catastrophic, so there are high costs for everything. $0 access to doctors and mental health providers could be a HUGE financial assist for people in this situation.
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From a 10,000-foot level, being able to offer any type of benefit to any of these underserved populations is going to automatically set your organization apart from your competitors which ultimately is why many organizations, especially smaller organizations/businesses, offer benefits in the first place. Is there value in being able to do this at a price point of $10 – $15 per individual?
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One thing that I find is the BIGGEST value when talking stand-alone telemedicine is the fact that this benefit doesn’t just cover the single individual, it is available to their immediate household/family members as well. It is not like insurance where there’s an extra increased monthly premium, the fee that is negotiated upfront covers the individual AND their family members, all at a $0 fee for use.
I hope this article today gets your wheels turning a little about some benefits that can help several populations that 90% of the time are not even getting access to any sort of benefit. In the right situation, a standalone telemedicine setup can offer a ton of value to the organization that is offering the program AND the population that is getting the doctor access.
There are many great telemedicine vendors out there, but Holloway Benefit Concepts has specifically partnered with First Stop Health to bring large group pricing and benefits to their small group employers. Through this partnership, H|BC does a lot of the heavy lifting/admin in exchange for the ability to get our small group clients (under 50 employees/enrollees) access to large group access to benefits and price levels that otherwise they would not be able to get.
If any of the above sounds intriguing and you would like to discuss it further, please do not hesitate to reach out. I would love to discuss. I’m a huge fan of getting creative to help underserved individuals & populations. Thanks for the read!!!
Ryan
As a reminder, Holloway Benefit Concepts is an SDVOSB certified business and a Texas HUBzone certified business. We are veteran owned and operated.
