The Details That Create a Quality
Limited-Benefit Health Plan
What is a limited-benefit health plan?
A limited-benefit health plan provides access to health care for the working
uninsured—those workers who don’t have a comprehensive medical plan available
through their employer or spouse. A limited-benefit plan provides the right
amount of benefit at the right price for part-time or hourly workers,
who often make between $8 and $12 per hour.
While a limited-benefit plan, as the name implies, has limits on the
amount of benefit available, it should not mean the type of benefits are
limited. A quality plan will offer benefits such as wellness, outpatient,
inpatient (lump-sum as opposed to daily caps), accident and employee-assistance programs, as well as supplemental benefits such as dental,
vision and term life (see “The Elite Eight” on page 32).
In a Market of Its Own
Limited-benefit health plans are tailored to industries with high turnover that have been a challenge
for traditional major-medical plans. The hotel, retail
and restaurant industries are often deemed
headaches by many brokers, but are satisfied customers of limited-benefit health plans. CIGNA
HealthCare research estimates that over one million
people are covered by limited-benefit plans. From
Fortune 500 businesses to mom-and-pop shops,
more companies in the hotel, retail and restaurant industries have begun making them available to their
employees. The staffing, construction, manufacturing and landscaping industries also provide limited-benefit health plans to their employees.
The satisfaction from these industries originates
from their employees’ access to benefits of true value.
It’s not enough to simply look at premium, benefits or
the network—that is merely an introduction to the limited-benefit product. One must look at how all three
variables work together to provide the greatest value to
employees to determine the true value of the plan.
