Según la Oficina de Estadísticas Laborales, los beneficios para los empleados representan casi el 32 por ciento de los costos por empleado para el empleador. Esos beneficios, naturalmente, incluyen los costos de atención médica. Como resultado, opciones como los planes de salud con deducibles altos se están volviendo cada vez más populares entre los empleadores.
Una ventaja adicional es la Cuenta de Reembolso de Gastos Médicos (HRA, por sus siglas en inglés). Al combinarlas, los empleadores pueden compensar los costos de seguro médico que se disparan y, al mismo tiempo, mantener una fuerza laboral feliz y saludable.
Pero, ¿cómo funciona una cuenta de reembolso de gastos médicos (HRA)? ¿Cuáles son los beneficios de ofrecer una HRA junto con un plan con franquicia elevada? ¿Debería reducir realmente sus primas para reducir los costos? ¿Qué piensan los empleados sobre el cambio de una cobertura total a tener que pagar de su bolsillo?
Let’s take a look at those questions by turning our attention to how an HRA works with your high deductible Plan.
Cómo funciona una HRA
Un acuerdo de reembolso de gastos de salud (HRA) es una forma aprobada por el gobierno para que los empleadores financien un plan de salud con ventajas impositivas que reembolsa a los empleados cualquier gasto de bolsillo, además de las primas del plan de salud.
When employers opt for health insurance plans that come with high deductibles, they often choose an HRA to offset costs for employees. It works as a simple account system that allows employers to contribute to employee’s insurance accounts should they be eligible for added expenses.
HRA plans are highly sought-after by employers because it gives employee’s greater flexibility in choosing providers and healthcare services that are right for their needs. Many of these aren’t covered by their insurance, but the HRA contributions give them a cushion to make those decisions if they so desire.
However, HRA funds aren’t disbursed unless and until the payments have already been made. Employees still pay out of pocket for the medical expenses they want, but they receive an agreed-upon reimbursement based on their plan. The medical expense must be covered under the HRA as well.
Best of all, HRA’s are 100% deductible for employers and always tax-free for the employee. Employers also have total control over what expenses are eligible for HRA funds. Thanks to their flexibility, HRAs can offer added benefits to both the employee and the employer. Additionally, they are one of the more straightforward health plan options and offer clear-cut direction for both employees and employers.
Finally, employees tend to take a strategic and careful approach to their healthcare with an HRA and high deductible plan. As more conscious consumers, they reduce health care costs for employers who would traditionally pay higher premiums for healthcare coverage their employees weren’t using.
Expectativas para los empleadores
Setting up a high deductible health plan with your HRA is relatively simple. As the employer, you’ll need to set aside a pre-tax dollar amount for employees to cover health care costs each year. Developing this number can be tricky, but we can help with that process.
The two most important requirements you must meet are, 1) fully fund your plan and never reduce your employee’s salary based on the plan, and 2) you can only offer benefits through this plan for substantiated medical expenses.
Dependiendo del diseño del plan, su HRA puede ayudar a reducir los costos significativamente.
¿Por qué combinarlo con un plan de salud con deducible alto?
High Deductible Plans are a no-brainer for most employers. Saving money on health care costs while still meeting Affordable Healthcare Act compliance isn’t a tough decision to make for most. However, a lack of coverage for employees could cause key talent to look elsewhere for employment.
Para cerrar la brecha entre lo que podría ser un plan de atención médica muy costoso para los empleadores y una mayor cobertura para los empleados, muchas empresas integran una HRA.
Your HRA will serve as a savings account for your employees. While most of them are likely to never even dip into the fund, some will. If your basic insurance plan doesn’t cover your employee’s healthcare costs in a given year, the HRA will make up the difference.
Existen múltiples opciones de planes para HRA, entre ellas:
- Copago, coaseguro y deducibles. (Eligible medical expenses, co-payments, and co-insurance payments are reimbursable based on the agreement. Employees must provide an Explanation of Benefits (EOB) statement to be reimbursed for theirs or their family’s medical costs.)
- Todos los gastos médicos no asegurados. This plan covers all of your employee’s out-of-pocket expenses. This includes all of the aforementioned plan’s coverage in addition to dental and vision care costs.
- Seleccionar gastos. Esta es una versión más limitada de la HRA donde los empleadores compensan los costos asociados con la atención dental o algún otro servicio muy específico a través de una cuenta de ahorros.
Si desea mantener el costo de atención médica por empleado en un nivel manejable, en particular si tiene una pequeña empresa, una de las mejores opciones es un HRA integrado con un plan de salud con deducible alto.
Beneficios de los planes de salud con deducibles altos
For employers, High Deductible Health plans are the perfect solution when paired with an HRA. They offer flexibility that few other compliant plans provide. As an employer, you have total control over the plan’s structure and reap a host of benefits along the way. Some of these benefits include the following.
Primas reducidas
Because you’re pairing your HRA with a high deductible plan, your premium per employee is far lower. Many employees save hundreds per employee by switching to this plan design.
Muchas opciones de red
Employees don’t have to worry about added fees when they shop out of network for health care coverage. This is an added benefit that’s similar to an HMO plan.
Ideal para grupos saludables
The healthier your group is, the better this option is. Employees who aren’t on expensive medications can benefit from the plan option without worrying about higher monthly bills.
La flexibilidad le permite ofrecer más beneficios
En lugar de pagar primas elevadas por empleado, puede anunciar múltiples opciones de beneficios sin los altos costos. Los planes con deducible alto brindan a los empleados y empleadores la flexibilidad que necesitan para mantenerse cubiertos.
Gastos de bolsillo negociados
Al pagar de su bolsillo, los empleados pueden negociar con su proveedor y obtener costos reducidos para sus necesidades de atención médica. El seguro suele estar configurado para pagar a una tasa predeterminada, pero pagar en efectivo por la atención médica puede reducir drásticamente los costos para los empleados y los empleadores a través del plan HRA.
The greatest benefit of HRA’s and High Deductible Health Plans to employers is the flexibility and control they offer over costs.
Cómo configurarlo
Configurar su HRA para compensar los costos de un plan de salud con deducible alto es un proceso sencillo. Sin embargo, hay varios factores que debe tener en cuenta antes de realizar el cambio.
Our team of Primary Care Insurance Solutions can set up your HRA to reduce your company’s health care costs. Contact our team to learn more about this process and how we can get started today.
ES 
EN