How it Works the Corporate Health Plan

How the Corporate Health Plan Works

A health plan is one of the best benefits a company can offer its employees. This is because health is one of the greatest assets an individual can have, and taking care of it shows that the employer cares about its employees.

 According to a 2014 survey, approximately 74.61% of employees believe that the company health plan is a decisive factor in choosing a job, in addition to being the most important benefit.

However, many people don't know how a corporate health plan works or why it's important. With that in mind, we've created this content to explain everything you need to know about a corporate health plan and how to choose the best option for your company.

What is a company health plan?

A corporate health plan is one that is intended for employees of a company and, for this reason, has exclusive benefits when compared to other plans.

These advantages may be linked to the cost, which is generally more affordable than other plans, and to the resources that this type of plan offers, such as, better conditions in dental plans.

Some companies may pay the full monthly fee, but most pay partially or choose a business plan with co-payment.

What is the advantage of a corporate health plan?

The benefits of health plans extend to both employees and the company itself. Here are some of the benefits:

Helps you pay less taxes

When declaring the health plan on their income tax, the employee and employer can obtain a tax deduction. 

Values the team

There are several ways to help keep your company on the market, and one of them is a corporate health plan. This way, you're demonstrating that you care about your customers by taking care of those who deal directly with them: your employees.

By valuing your team, employees will be more motivated and happy.

Reduces absence rates from work

In addition to demonstrating that you care about your employees, which in itself helps improve job satisfaction, improving each employee's health reduces absences from work.

The reason for this is quite simple: they will have easier access to a quality medical care network, meaning they will take better care of their health and, therefore, reduce absences due to illness.

Helps increase productivity at work

Workplace productivity is closely linked to employee satisfaction and health. Therefore, by purchasing a health plan, you can improve employee performance and, consequently, achieve better results.

Therefore, taking care of employees' physical and mental health by providing quality medical care is an excellent way to increase company productivity.

Serves as an incentive for small businesses

Did you know that small and medium-sized businesses can also sign up for corporate plans? Many carriers offer plans that require at least two lives.

Furthermore, they may even benefit more than large companies. Because there are fewer employees, the environment is more intimate, and so if employees are unhappy, the impact will certainly be greater.

How does the corporate health plan work?

Who can hire?

Corporate health plans are purchased by legal entities, i.e., entrepreneurs, unions, or associations that want to offer quality health care to employees and collaborators of a given company.

But, in addition to employees, the corporate plan can cover their dependents and other individuals, such as temporary employees, interns, apprentices, and even retirees. However, this will depend on the contract signed.

Coverages offered

Corporate plans can offer different types of coverage, just like individual or family plans. These plans can include:

• Reference plan: the most complete, as it provides all hospital medical care services (consultations, exams, treatments, hospitalizations, surgeries and obstetrics);
• Outpatient plan: covers only consultations and exams, in addition to allowing hospitalizations lasting up to 12 hours and some treatments, such as chemotherapy;
• Hospital plan: covers complete hospital care, including unlimited hospitalization, surgeries and other procedures within the hospital;
• Obstetric hospital plan: in addition to the hospital plan coverage, it covers obstetric care, such as prenatal, delivery and postpartum care, as well as newborn care for up to one month after birth;
• Dental plan: covers dental procedures such as consultations, emergencies, examinations and surgical procedures involving this area.

Dependents

Companies often offer plans that allow employees' dependents to be included in their plans. This means that people up to a third-degree relative of the plan holder can benefit from the plan's offerings.

Values

One of the biggest advantages of corporate health plans over other types is the lower monthly premiums. This allows greater access for those who would often not be able to afford this expense on their own, as with an individual or family plan.

Typically, if the company only pays part of the monthly fee or if the plan is co-participatory, these amounts will be deducted from the payroll.

Shortages

THE lack of plans The coverage of corporate plans will depend on the number of beneficiaries who signed up to the contract. This means that for corporate plans with 30 or more employees, beneficiaries will not need to meet the waiting period or Temporary Partial Coverage (CPT). 

However, for contracts with fewer than 30 lives, 24 hours after the plan's purchase, coverage will be provided for emergencies or urgent cases, subject to the plan's limitations and segments (outpatient, inpatient, and referral). Therefore, the waiting period follows the limits established by the National Supplementary Health Agency (ANS), which are:

• Childbirth: 300 days and includes prenatal exams. However, emergency births or situations that put the mother's or baby's life at risk must be attended to regardless of the waiting period. In these cases, only the 24 hours after purchasing the plan count;
• Consultations, exams, hospitalizations and surgeries: 180 days;
• Pre-existing illnesses or injuries: 24 months.

However, the company can negotiate with the health plan operator and request an exemption or shorter waiting period.

What happens to the health plan after dismissal or retirement?

The company plan is valid until the employee remains with the company. When the employee leaves, they also receive the benefits offered by the company. However, it is possible to keep the plan even after dismissal or retirement. 

How to choose a good corporate health plan?

Now that you understand how corporate health plans work, you might be wondering how to choose the best one among so many options. Don't worry, just follow these tips and you'll be able to choose a good health plan for you and your employees:

Pay attention to the contract

Read all the clauses carefully and make sure you're signing exactly what you agreed to with the carrier. Only then will you be able to understand all your rights and responsibilities as a consumer.

Check if there is a claim charge

The more dangerous a job is, the higher the accident rate and the higher the fee. This fee isn't always disclosed at the beginning of the contract.

Know your employees

You can't choose the ideal plan for your company if you don't understand your employees and their needs. To determine demand, you can conduct internal surveys, questionnaires, or obtain information from the Human Resources team.

This way, you'll be able to profile your employees and decide which plan is best for them.

Prioritize comprehensive referral networks

There's no point in purchasing a plan that doesn't have many referral networks and is also of low quality. Therefore, before closing a deal, research the establishments and doctors that support the plan you're interested in.

Choose a plan that's favorable for both men and women

Men and women have unique needs, so you should consider each of them when purchasing a corporate health plan. For example, choose plans that offer quality obstetric, gynecological, and urological services.

Check the operator's reputation in the market

You can check either through the ANS website (Dissatisfaction Ranking or Operator Qualification Program) or on the Reclame Aqui website, which has user opinions.

Therefore, investing in a corporate health plan ensures a better quality of life for employees and, therefore, improves your company's productivity.

How the Corporate Health Plan Works