Statistics show 80% of employers reported concern about their employees mental health (Coe). Surveys also indicate that there are continued opportunities for employers to support mental health by taking action in providing comprehensive employee benefits, making mental wellness a priority. In this article, we will dive deep into these topics, answering some of the most pressing questions that employers have about mental health and insurance in the workplace.

How Does Mental Health Affect the Workplace?

Mental health significantly impacts the workplace, affecting both individual well-being and the broader organizational climate. Challenges in mental health can lead to reduced productivity, increased absenteeism and heightened burnout, impacting employee performance, team dynamics, work quality and morale. It is crucial to enforce a supportive approach in order to negate these issues. Although employees have a lack of job security despite mental health absenteeism, employees are concerned about high turnover. Furthermore, accounting for disability and FMLA can quickly become expensive due to a lack of productivity.

What Insurance To Elect for Mental Health Concerns?

Sixty seven percent of employers expressed their difficulty in accessing mental healthcare (Coe). For addressing mental health concerns, selecting the right health insurance plan is crucial. It is advisable to consider plans with comprehensive coverage such as gold or platinum tiers if available. These plans, although more expensive in terms of monthly premiums, offer lower out-of-pocket costs and broader coverage, which is beneficial for recurring mental health services. Additionally, check if the plan covers telehealth services, as many mental health services are now offered remotely.

Best ACA Plan Overall

Kaiser Permanente offers better than average silver plan deductibles and excellent health insurance costs. They offer a comprehensive range of ACA metal tier plans—bronze, silver, gold, and platinum—with an average silver plan cost for a 40-year-old being $476 a month and an average deductible for a silver plan at $3,733 a year. They boast the best average ACA plan ratings among the insurers reviewed. However, its services are only available in eight states, and if you’re in an HMO plan and need to stay in-network, finding a provider outside these states might be challenging.

Maxed Out Your Out of Pocket?

Once you’ve maxed out your out-of-pocket expenses, your health insurance plan typically covers 100% of covered healthcare costs for the rest of the plan year. This feature is intrinsic to most health insurance plans, regardless of the metal tier. However, it’s important to understand the out-of-pocket maximums for your specific plan, as they can vary significantly. Higher-tier plans like gold or platinum generally have lower out-of-pocket maximums compared to bronze or silver plans.

The best carrier for low out of pocket costs would be UHC. UnitedHealthcare stands out with its vast provider network, encompassing 1.5 million providers and 7,000 hospitals and facilities. For a 40-year-old, the average cost of a silver plan is $551 per month, with a lower than average deductible of $3,619 a year compared to other insurers. In addition to health insurance, they offer dental, vision, accident and critical illness plans. However, it’s worth noting that UnitedHealthcare doesn’t provide as many metal tiers or types of health plans in the ACA marketplace as some competitors, and its health insurance premiums can be higher than those of other insurers.

Insurance With Out of State Coverage: Your Options

If you need health insurance with out-of-state coverage, a PPO (Preferred Provider Organization) plan is usually the best option. PPO plans allow you to receive care from out-of-network providers, although at a higher cost than in-network care. This flexibility is particularly useful for those who travel frequently or live in multiple states throughout the year. In contrast, HMOs and EPOs typically don’t offer out-of-network coverage, which can be limiting if you seek care outside your home state.

Blue Cross Blue Shield, renowned for having the best provider network with over 1.7 million healthcare providers, offers an extensive range of coverage options. For a 40-year-old, the average cost of a silver plan is $611 per month, with a slightly lower than average deductible of $3,759 a year. Comprising 34 independent insurers, Blue Cross Blue Shield is noted for its excellent quality ratings and provides three types of health plans (HMO, EPO, and PPO) across all four metal tiers (bronze, silver, gold and platinum) on the ACA marketplace. Their ACA marketplace premiums are generally higher compared to other insurers however, that is the price you pay for the network.

Will Your Monthly Premiums Raise Due to Mental Health Concerns?

If your group proves to be of risk to the carrier due to hospitalizations, rehab, and other expensive mental health treatment, they can inadvertently increase your total premium, since insurance premiums are calculated by the overall usage of the group plan.

How To Prevent Premiums From Increasing?

When it comes to your employees, it is important to reiterate the usage of any benefits provided by their plan such as wellness credits provided by carriers like Amerihealth. It is also important to install EAP programs in order to give employees a chance to prevent any mental health crisis. Most self-funded plans offer teledoc to promote easily accessible help.

How EAP Reduces Mental Health Concerns: Two Birds One Stone

Employee Assistance Programs (EAPs) offer a dynamic approach to workplace wellness, far beyond just managing stress. These programs serve as confidential havens where employees can explore and resolve a range of personal and professional issues. EAPs can include services like counseling for emotional distress, relationship issues, and substance abuse, as well as support for legal and financial concerns. By addressing these multifaceted aspects of an employee’s life, EAPs contribute to a more holistic approach to mental health. This not only nurtures a healthier, more resilient workforce but also fosters a supportive company culture where mental well-being is prioritized. In essence, EAPs are like a Swiss Army knife for mental health in the workplace, equipped with tools to tackle a variety of challenges, ultimately leading to a more productive and harmonious work environment saving money on mental health costs and insurance premiums in the long run.

Mark Herschlag, founder and CEO of Cosmo Insurance Agency, brings a wealth of knowledge in creating customized insurance solutions. Based in Ocean County, Cosmo Insurance Agency specializes in health, life, dental, long-term care, and disability insurance, tailored to individual and business needs.

Please note that insurance premium rates are dependent on the rating factors in insurance company filings with insurance regulatory authorities. Additional monthly fees (which are not insurance premiums) vary by the number of covered employees. Rates vary on many factors including but not limited to: age, county, number of employees, type of business, demographic, tax quarter. Please contact Mark Herschlag, a licensed insurance producer at Cosmo Insurance Agency, for a free consultation concerning your insurance needs.