How does the employee health plan work?

The business health insurance are similar to those facing individuals but have certain characteristics. They are collective, that is, conditions are offered to all employees – and the employee can choose to participate or not.

This is an optional benefit, as there is no obligation under labor law. However, it is a competitive advantage when it comes to attracting , hiring and retaining talent . For this reason, many organizations invest in offering health insurance.

The medical plan can be offered to employees and their family members. Partners, managers, retirees, interns, temporary workers and apprentices may also have access to this benefit.

The cost varies according to the total number of employees and the chosen service and hospital network. A survey carried out by Pequenas Empresas & Grandes Negócios showed that a basic plan for a 20-person enterprise costs around R $ 5,000 per month. The article also indicated that the average cost per employee corresponds to approximately 11.5% of the payroll.

In addition, there may or may not be so-called co-participation. If it exists, the employee pays a percentage of all consultations, exams and procedures performed. The rest is included in the plan contracted by the company.

Regarding the grace period, the terms are the same as those for agreements aimed at individuals, that is:

  • 24 hours for urgent and emergency cases;
  • 300 days for delivery;
  • 24 months to cover pre-existing injuries and illnesses;
  • 180 days for the rest of the cases.

A precaution to be taken by the companies is related to the loss ratio, which shows the total spent by the operator to meet the expenses provided for in the contract. When it exceeds 70% of the amount paid by the customer, there may be an adjustment.

Why should your company hire them?

The reasons that justify offering this benefit are varied. Check out the main ones:


Increased employee motivation

Health plans for employees directly impact their sense of belonging. They realize that the company is interested in their well-being and values ​​them. Therefore, the tendency is for them to increase productivity and work focused to return this benefit.

Motivated professionals, want to stay in the company! Understand how to do this in practice. We recommend you the free Talent Retention eBook. Answer the form and receive:

Health care

Employees are more relaxed when they know they can take care of their health and have the support of the company, if they need it. With this, they can focus on their best performance and direct their creative actions to offer interesting and innovative solutions.


Raising the company’s competitive edge

The company that offers a good health plan, which matches the needs of its employees, is more likely to attract, hire and retain talent. This is a point of competitiveness, both for the admission of qualified professionals and for customers and society.


Assistance in situations of occupational accidents

The company’s effort is always to avoid unforeseen events, but they can happen. The health plan, therefore, serves to solve an unforeseen situation and support the employee in what he needs. This is another positive point, because it shows that the organization is concerned with the quality of life at work.


Reduction of absenteeism and leave

Professionals with corporate plans do more routine exams and monitor their health carefully. The result is that they are more available to the company and, consequently, less are missing . They also become more productive because they have less worries about the future.

How to choose the best health plan?

The selection of the most appropriate medical insurance depends a lot on the profile of the employees. What counts is to choose one that is attractive for the context in which your company is. Therefore, just offering a plan is insufficient. He must be really positive for the team.

So, what to evaluate? See below the tips we have prepared.


Assess coverage and needs

These aspects are especially important for employees. Ideally, the grace period is the one we have already presented, as determined by the National Health Agency (ANS). However, it is possible to reduce this time or even eliminate it.

When it comes to coverage, keep in mind that it is mandatory to offer:

  • exams;
  • consultations;
  • treatments;
  • laboratories;
  • hospitals;
  • prostheses.


Analyze the scope

In this case, you can choose between municipal, state, regional or even national scope. You can choose any mode, but the latter offers more security for employees. If your company has many outside or traveling employees, this option is mandatory.


Consider co-participation

This is one of the criteria that will make the plan cheaper or more expensive for the organization. The idea is that the employee is responsible for paying a specific percentage of each procedure performed, the percentage being generally 20%, 30% or 50%.

For the company, it represents savings in monthly fees. For the employee, an extra expense. However, he tends to become more aware of the use of the service and avoid unnecessary consultations.

For HR, there is a more complex process, because the company will receive the co-participation invoice and will need to discount the employee’s payroll. Therefore, it is necessary to balance the positive and negative points.


Assess company capacity

Organizations generally resist the offer of a health plan due to the high cost, complexity and long term, since the company is prevented from canceling the benefit. Realize that a future suspension harms the business by discouraging employees.

In this sense, the ideal is to consider an average agreement that fits the business budget . An alternative is compulsory plans, which cover all employees, except those who already have private assistance. This is a way to reduce the amount paid monthly.

Why does the employee profile matter?

During the entire planning for choosing the health plan, keep in mind that the main aspect is the profile of employees. It must weigh more than the price in your choice, precisely because it is a talent retention and loyalty tool . This is how you will be able to have an adequate health plan for employees and which will have positive effects in the short, medium and long terms.

Bonus: new benefit that promises to reduce turnover and increase talent attraction and retention

We live in a time when HR must take on, once and for all, its multifunctional and strategic side for the qualification of the workforce of its companies.

Often, taking the reins of conditions external to the work environment, but which impact on the professional routine. This is the case with financial well-being for employees .

And as an example of this practice, a new modality reached the Brazilian market – wages on demand .

The CareerBuilder survey, conducted in 2017, attested that 78% of respondents are barely able to settle accounts with their salary .

In addition, of the more than 3,000 respondents, about ¾ of them also attested that they have one or more accumulated debts. Clear sign that something needs to be changed, agree?

On- demand pay is a modality that has been gaining momentum in the market and aims to add flexibility so that employees receive for hours worked, but not yet paid. Something that alleviates many of the financial problems – and those generated by the challenges of closing accounts.

Let’s look at a simple example: if the company has the habit of making payments for its human resources only on the 30th, or on the fifth business day of each month, professionals are limited to that .

If a pending account will earn interest in that period when there is no more money in the account, the debts will accumulate. However, with the offer of the salary on demand, the professional can receive the payment of the days already worked whenever he wants. Best of all, he has the flexibility to plan his month.

We recommend that you read this article to better understand on-demand pay . In it you will understand the features of Xerpay , a corporate benefit of payments on demand.


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