Why Cheaper Health Insurance Isn’t Always The Best Choice

“You get what you pay for” is a timeworn adage that, while simple, conveys a profound truth: paying less often means getting less. When independent practice owners start to research health insurance options, price is often the biggest deciding factor--for valid reasons. But if you rely solely on price, when you have a medical emergency, you may find your insurance coverage is sorely lacking. The difficulty is finding the balance between obtaining comprehensive insurance coverage that will provide the kind of coverage you need and keeping the practice’s budget in check. It’s a balance that’s become even more crucial during the pandemic.

Keep Your Independent Practice Healthy

The health of a practice is largely dependent on the people employed by it. If you don’t offer quality insurance, you may:

• not attract the best qualified employees for your practice
• experience high employee turnover
• see increased absenteeism & reduced productivity due to employees not adequately caring for their health

As Open Enrollment begins, independent practice owners have an opportunity to offer broader, more inclusive insurance while keeping their budget and their practice stable during these uncertain times.

Better Coverage Within Your Budget

Two special insurance waivers are available that could provide you and your staff with better quality health insurance options for the coming year.

• The Participation Waiver: This waiver eliminates the requirement to cover at least 75% of your staff in order to enroll for group coverage. With this eligibility criteria removed, it now means that even if your employees choose to decline coverage, you may now qualify for group PPO coverage for just yourself as a “Group of One”. To determine eligibility, you only need to offer this coverage to your employees and have a tax ID number with at least one employee besides yourself paid under that number. Partnerships and LLC’s filing as a partnership with no employees may be eligible too. If you and your spouse have an LLC or establish an LLC, you may also be eligible for this coverage. You’ll need to supply partnership documentation and the company’s Schedule K-1 (Form 1065).
• The Contribution Waiver: Practice owners can opt to pay what they can afford instead of paying at least 50% of employee insurance premiums. Using this waiver gives you the option of paying a smaller percentage, or, nothing at all.

Being able to offer more coverage choices to your employees can make your practice more competitive at a time when many owners are struggling to retain experienced staff. These waivers could allow you to offer group PPO coverage as well as group HMO coverage while remaining within your practice’s budget.

Time is Limited, Coverage Doesn’t Have to Be

Practice owners must have their enrollment paperwork completed and submitted by December 15, 2021 in order to take advantage of these waivers. TMA Insurance Trust advisors are standing by to help you with enrollment and to make sure you’re fully informed about all the options available to you and your staff. We’ll make sure your budget is put to it’s best use and work hard to find the balance between cost and quality, so you and your staff have optimal coverage for 2022.

Call us today at 800-880-8181, Monday through Friday, 8:00 to 5:00 pm CST.

For over 60 years, TMA Insurance Trust advisors have been serving Texas physicians, their families and staff. TMA Insurance Trust prides itself on offering unbiased information and strategies to members, along with exclusive group rates on a range of the highest-rated plans in the industry.