Why Don’t My Employees Enroll in Our Group Health Coverage

Health benefits are highly desired, yet not all employees enroll in your plan. Discover 4 common reasons why this happens, and what you can do about it.

Four reasons why employees don’t enroll in group coverage

Employees consider health insurance more important than any other workplace benefit, making it a powerful tool for recruiting and retention.1 Yet, after you research and select a plan, only a handful of employees actually enroll. Let’s look at some common causes for why this happens, and what you can do about it.

Issue 1: Employee preferences. Depending on their age and family-size, workers may care more about catastrophic coverage than access to regular doctor visits with low co-pays, or vice versa. For example, employees under the age of 26 are eligible to remain on their parents’ health insurance plan, meaning they’re less likely to purchase insurance from their employer.2

Suggestion: Gauge your employees’ health needs with a company-wide survey or questionnaire, ideally making it anonymous to help ensure a higher response rate. This will give you an idea of what factors influence their enrollment decision.

Issue 2: Your network. If your plan’s in-network provider list doesn’t include the specialists or facilities your employees prefer, they may forego enrolling.

Suggestion: This is another area where a survey can help. Include questions to determine what kinds of doctors, facilities, or hospitals your employees want in network, and what prescription drugs they’d like covered.

Issue 3: The costs. Even when employers and employees share the premium cost, health coverage can take a substantial chunk out workers’ paychecks. There are also costs beyond monthly premium to consider. Eighty-one percent of covered workers have an annual deductible that must be met before their plan kicks in and pays for services.3 In addition to their deductible, 68 percent of covered workers pay a copayment for office visits.4

Suggestion: Consider putting money into a tax-advantaged savings account to help employees do more with their health care dollars.

  • Health Reimbursement Account (HRA): Employees use money in this employer-funded account to cover pre-deductible, out-of-pocket healthcare expenses and receive pre-tax payroll reimbursement. Employers benefit by reducing their Federal Insurance Contributions Act (FICA) tax with this strategy.
  • Flexible Spending Account (FSA): Employees – and employers — can make pre-tax contributions via payroll deductions to FSAs that can be used during the year to pay for medical expenses. An FSA is compatible with any type of health plan, but the contributions are “use it or lose it” meaning money in an FSA expires at the end of the year and reverts to the employer.

Issue 4: Your PTO Policy. Without paid time off (PTO) health insurance can only go so far to support employees. A doctor may prescribe medicine and rest, but if someone can’t afford to stay home when they’re ill, they may struggle to get well.

Suggestion: Enable employees to prioritize their health with either a tenure-based PTO policy, where the number of PTO days increase for each year of service, or an accrual-based model where employees earn paid time off based on their hours worked. Keep in mind that for either approach to work, you need create a work atmosphere where it’s acceptable to take sick days.

As a small business owner, you make many important decisions on a daily basis that impact your employees. Offering the right health benefits to satisfy your employees is no exception. With a little research and a well-placed survey, you can find the answers you need to make the best decision for your business, and your employees.

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