In Conversation with Mayer Majer to Bring His Insights on Navigating Benefits and Coverage for Home Care Agencies

Successfully managing benefits and coverage is essential for home care agencies aiming to build a strong, reliable caregiving team while staying compliant with legal standards. For agencies, offering competitive health insurance and comprehensive benefits can be challenging due to high costs, participation requirements, and the unique needs of caregivers, many of whom may already have Medicaid.

Ensuring access to Minimum Value plans and exploring alternatives like ICHRA plans are vital steps agencies can take to offer essential health coverage. Further, securing appropriate workers’ compensation is crucial, as it is one of the highest expenses for agencies after payroll and protects both caregivers and the organization from the risks associated with workplace injuries.

Ancillary benefits, like critical illness coverage or flex cards, add value for caregivers and help attract and retain talent. Moreover, National Family Caregivers Month offers an opportunity to enhance caregiver well-being by promoting the significance of these benefits, recognizing caregivers’ contributions, and reinforcing a culture of support within the agency.

Ultimately, well-structured benefits empower agencies to cultivate loyal, motivated caregiving teams.

To shed some light on the same, we interviewed a home care industry expert to bring his perspective on navigating benefits and coverage for home care agencies.

Let us now delve into what he has to say about navigating benefits and coverage for home care agencies:

Question 1: How can home care agencies assess the best health insurance options, considering the unique challenges they face?

If your company is an ALE (applicable large employer), you are required to offer your aides a Minimum Value plan. However, all health insurance carriers have a participation requirement which home care agencies will not meet.

There are options that we offer our clients. We have access to carriers who will allow a Minimum Value plan to be offered without any participation requirements as long as everyone receives a Minimal Essential Coverage plan.

Another option we offer our clients is an ICHRA plan.

Question 2: Can you explain the process of obtaining workers’ compensation for caregivers, and how can agencies ensure they’re properly covered?

Workers’ compensation is probably the largest expense after payroll. Home care agencies need to ensure that their broker is familiar with home care.

There can be a 20% difference in premium from one carrier to the next.
Another thing to make certain is that your broker has a claims management team.

Unfortunately, there are too many fraudulent claims, and you want to ensure that you have someone keeping an eye on your claims and fighting those that aren’t legitimate claims.

Question 3: What ancillary benefits (e.g., dental, vision, disability) would you recommend home care agencies offer to attract and retain talent, and why?

Many, if not most home health aides are on Medicaid. They don’t need dental and vision, they have it covered through Medicaid.

There are ancillary benefits that are attractive, those that aren’t covered by their Medicaid. For example, many of our clients provide their aides with Aflac Critical Illness benefits, others like our discount benefits package, which offers discounts on many procedures that aren’t covered by Medicaid.

Most of our clients provide their aides with our flex card benefits.

Question 4: How can home care agencies leverage National Family Caregivers Month to highlight the importance of offering comprehensive benefits to family caregivers, and what role do you see benefits playing in supporting their well-being?

National Family Caregivers Month is the perfect time to increase your caregiver’s benefits. Whether it’s offering a Minimum Value plan or any ancillary benefits, it goes a long way in showing your aides that you care about them.

In Conclusion

Mayer Majer’s insights highlight the essential role that thoughtfully structured benefits play in fortifying home care agencies. By implementing tailored health coverage options, such as Minimum Value or ICHRA plans, agencies can comply with legal standards while nurturing caregiver loyalty.

Mayer’s expertise also underscores the need for adaptable workers’ compensation plans to manage safety risks and reduce costs—an especially vital consideration in this industry.

Further, offering ancillary benefits like critical illness coverage or flex cards can boost caregiver satisfaction and commitment.

Together, these strategies promote caregiver well-being and build dedicated, resilient teams that contribute to the agency’s long-term success.