Benefits 101
Enrolling in benefits for the first time? Just need a quick refresh on how it all works? Benefits can be tricky, but they don’t have to be. Take some time to learn the basic terminology, how different plans work, and take the guesswork out of benefits enrollment.
Turning 26?
Under the Affordable Care Act (ACA), you can stay on your parent’s healthcare plan until you turn 26, regardless of whether you live with them or not. Depending on your parent’s plan, you may lose healthcare coverage on your 26th birthday. Some plans allow young adults to stay on their parent’s plan throughout the end of the plan year, and others drop coverage on the day you turn 26. Since all plans are different, it’s important to plan ahead to ensure that when the time comes you are covered.
If you’ve had healthcare coverage through a parent’s employer, ask them about these details to confirm.
Some important terms you should know
Looking over health plan options for the first time can be intimidating, and it’s also easy to forget some of the terminology. Below are some of the primary elements of a health plan. Of course there are more, but here are some of the basic terms you should know before diving in:
- Premium: The amount you pay each pay period, in the form of payroll deductions, to have insurance coverage.
- Deductible: The amount you pay before the insurance company covers a cost.
- Copayment (Copay): A fixed amount you pay to cover the costs of certain medical services.
- Coinsurance: The percentage you pay of the total cost of covered services.
- Out-of-pocket maximum: This number is the maximum amount you’ll pay for covered health services in a single calendar year, including your deductible, copay, and coinsurance. The Affordable Care Act restricts insurance carriers from charging you more than this amount.
- Beneficiary: An individual who may become eligible to receive payment due to will, life insurance policy, retirement plan, annuity, trust, or other contract.
Things to consider before choosing a health plan
Do you prefer certain doctors or hospitals?
If you want to keep seeing your current provider(s), you should make sure they are in a plan’s network. You can find out by visiting the plan’s website, calling the insurance carrier, or even checking with your doctor’s office to see if they accept a particular insurance plan. If your preferred doctors are not in-network and you’re comfortable paying a bit more to see them, you may want to consider a PPO or HDHP style plan.
What are your usual healthcare needs?
Do you visit a chiropractor or get acupuncture? Do you have frequent doctor or urgent care visits? Do you have a condition that requires the care of a specialist? Do you take prescription medications? Look at your benefits materials and plan documents to compare how each plan covers the services you need the most.
Consider the bottom line
How much is your share of the monthly premium? Do you have to meet a deductible before the plan will pay? Can you offset expenses with a tax-free account such as an HSA or FSA? These factors can impact your true healthcare costs. The lowest premium plan may not be the least expensive plan for you, and conversely, the highest cost plan is not always the “best” plan for your needs.
Need some help?
If you’re struggling to decide the right benefits to enroll in, try out these helpful resources.
ALEX
Meet ALEX! An interactive online tool that will walk you through your benefit options and provide personalized assistance along the way. When you talk to ALEX, he’ll ask you a few questions about your healthcare needs, explain different aspects of each benefit, and point out what options may make the most sense for you.
Benefit Advocate
Snowflake has teamed up with Alliant Employee Benefits to provide you with a personal Benefit Advocate to help you and your family any time you have benefits-related questions or issues.
(925) 378-6485
snowflake@alliant.com
8:00 a.m. – 5:00 p.m. PT, M-Th
8:00 a.m. – 4:30 p.m. PT, Fri
Your benefit advocate is an experienced benefit professional committed to assisting you with things such as verifying eligibility or coverage, finding in-network providers, resolving claims or billing issues, and much more.
