Special benefits to consider during open enrollment

Good Morning CT at Nine

(WTNH) — Now is the time to look over your options during open enrollment. Benefits expert Peter Nieves, Chief Commercial Officer with WINFertility breaks down the special benefits you may not know are available.

What should anyone be looking for in their insurance benefits?

If you’re looking for a job or If you’re in a job, this is what you want to look for: 

If you expect to have a lot of health care costs during the year (having a baby, surgery, etc.), you may want to opt for a plan with a lower deductible even if the premiums you have to pay yourself are higher.

On the flip side, if you expect to have few health care costs, you can save money by going with a low-premium plan with a higher deductible. That high-deductible plan (HDHP) might also come with a health savings account (HSA) that your employer might contribute some money to on your behalf.

If you regularly take a prescription medication, pay close attention to this coverage, down to the exact formulation of the drug that you take. Finding out exactly what your co-pays would be for your specific medications could make a big difference in your out-of-pocket costs for the year, even if the plans have very similar premium.

There are plenty of medical events you can’t budget for, but want covered, such as emergency room visits, hospitalization, mental health treatments and rehabilitation. Costs, quantity, and scope of these benefits vary by plan, so be mindful when determining what level of coverage you’re comfortable with.

If you’re self-insured, these are the top 3 things to keep in mind:

The most common types of health insurance policies are HMOs, PPOs, EPOs or POS plans. The kind you choose will help determine your out-of-pocket costs and which doctors you can see.

Costs are lower when you go to an in-network doctor because insurance companies contract lower rates with in-network providers. When you go out of network, those doctors don’t have agreed-upon rates, and you’re typically on the hook for a higher portion of the cost.

Out-of-pocket costs are nearly as important as the network. Any plan’s summary of benefits should clearly lay out how much you’ll have to pay out of pocket for services. The federal marketplace website offers snapshots of these costs for comparison, as do many state marketplaces.

What are important questions to ask your employer about Open Enrollment?

Do I choose my plan or does my employer choose for me?

Is there a monthly premium?

What is the policy’s out of pocket expense limit?

Is my doctor or hospital part of the plan’s network?

Is there a deductible? Does a deductible apply to prescription drugs?

Do I need additional coverage such as dental or vision?

What are the top three trending benefits companies are offering now and why?

Fertility/family-building/egg freezing

Millennials are putting off child bearing over career and having children later in life. As women age, reproductive assistant services are often needed. 

Egg freezing can cost up to $10,000, and storage can run as high as $500 per year.

IVF treatment can cost anywhere from $12,000 to $30,000, depending on the location of treatment, medications used, and testing required.

Adoption can cost nearly $50,000and the average cost of surrogacy can range from $90,000 to $130,000.

Wellness benefits like stress managemen

Work stress costs U.S. companies more than $300 billion annually in absenteeism, turnover and lower productivity, as well as medical, legal and insurance costs.

Consequently, helping employees to be happier, healthier and more in control is paramount to achieving organizational goals.

Onsite healthcare clinics

Mental health is one area in which onsite care can be particularly beneficial as employers can utilize onsite care to give employees direct access to resources like counseling and therapy from licensed counselors, addressing barriers to mental health care like long waits for appointments and poor quality of care.

According to the National Association of Worksite Health Clinics, today, 50% of employers with over 5,000 employees have onsite or near-site clinics. 

For more information, watch the interview above.

Copyright 2019 Nexstar Broadcasting, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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