High out-of-pocket costs are the number one source of employee dissatisfaction with their health benefits. When employees avoid care because they can’t afford it, everyone loses — including your productivity and claims trends. Here’s how to address it strategically.
The Out-of-Pocket Problem
The average deductible for employer-sponsored single coverage now exceeds $1,500 — and family deductibles are often $3,000 or more. For employees earning median wages, this represents a meaningful financial barrier to care. Benefits that employees can’t afford to use aren’t really benefits at all.
Plan Design Strategies to Reduce Exposure
- Lower out-of-pocket maximums — particularly for single coverage
- Add first-dollar coverage for preventive and primary care services
- Seed HSA accounts with employer contributions to offset the deductible gap
- Consider copay-based plans for employees with predictable healthcare needs
- Add direct primary care (DPC) to eliminate copays for routine visits
Supplemental Benefits That Fill the Gaps
- Hospital indemnity insurance — cash benefit when employees are admitted
- Accident insurance — lump-sum payment for covered injuries
- Critical illness insurance — benefit at diagnosis of serious conditions
- These voluntary products are often employee-paid but dramatically reduce financial exposure
The Communication Component
Many employees don’t understand how their plan’s cost-sharing works until they receive a bill. Remedy Advisors helps employers build year-round benefits education that prepares employees for what healthcare actually costs — and shows them how to use their benefits to minimize that cost.