A Supplemental Story

I sat across from two elementary school teachers, Andrew and Stacy, who were married and wanted to review their benefits. As a certified enroller for their school system, it was my job to look over their current insurance, see their needs, and see if there had been any changes from the previous year. Andrew looked tired, more than just an end-of-the-school-day tired; he looked beat. Stacy looked harried, and I sensed it was more than just a typical long school day. As we reviewed their health insurance and supplemental coverage, I asked if any changes had occurred. They both looked at each other and sighed.

    "I'm recovering from my cancer procedure and getting chemo," replied Andrew, whose job was as one of the PE coaches at the school. "I've used up all my sick time and paid time off. The cancer is responding to treatment, which is great," he responded. Stacy jumped in. 

    "We just can't afford to have him miss any more work. I know he's exhausted. Luckily, his student teacher is a huge help." 

    "Let's see what coverage you all have, and maybe there might be something we can do," I replied as I clicked on their benefit profile and let out a small gasp. 

    "What...what is it?" Andrew asked. "Are we no longer covered for health insurance because of the cancer?"  Stacy let out a larger, horrified gasp. 

    "No, no. I've actually got good news. You have supplemental cancer coverage and short-term disability insurance," I replied with a smile. 

    "What does that mean?" Andrew asked. 

    "It means that the insurers on both policies owe you money. Luckily, this carrier pays pretty quickly." I clicked into a PDF of their coverage. "From the looks of your policy, they owe you at least $6,000 for the cancer policy, and your short-term disability should pay you about 60% of your paycheck for the time you've already taken off. You opted for the six-month plan, so you can use it for that long if your doctor agrees and signs off on the paperwork."

    The surprised and relieved looks on their faces told me that they could get through this man's recovery financially and that they could focus on healing rather than hardship.  

    "My word, I had no idea. We've had these plans for years, and now...they will help our family...I mean, we're going to be able to catch our breath...you can get better at home," Stacy replied, her eyes welling up. Andrew put his arm around her and nodded. It took everything I had to not tear up as well. 

    "Let's check with the carrier and see what you all need to do to make a claim. Usually, they'll need the diagnosis, how long the doctor suggests that you take off work and any other documentation. I'd suggest faxing or scanning the forms, and then you can get your claim going." 

On my way

home, I thought I should have been riding a white horse instead of driving home in a blue SUV. It's not often that you get to make such a difference in someone's life, but I was able to facilitate the help they needed so that this family would have some financial stability. 

     In a workplace like a school system, the benefits offered often include health and life insurance as a minimum. They can offer more robust options because their staff is in the hundreds, just like other large corporations. According to the Affordable Care Act (ACA) employer mandate, if you have fifty or more full-time eligible employees, you must offer affordable health insurance and the minimum essential coverage. 

    But, for smaller businesses with less than fifty employees, offering benefits can often seem out of reach. They don't legally have to offer health insurance. However, at group rates, supplemental insurance can often be offered to three to five or more employees. It can help cover the high deductibles that health insurance plans with lower premiums that their employees might find on the Marketplace. Supplemental insurance is often affordable; most of the time, the cost of a real meal deal and Venti a week to get cancer coverage or short-term disability. The deductions for the premiums can be set up through a payroll service like ADP or software like Quickbooks and then paid to the provider by the business. 

 For most businesses, benefits are a huge recruitment tool. According to a 2022 Aflac WorkForces report, nearly half (47%) of all employers state that remaining competitive with their total compensation package is one of their biggest challenges — a sentiment shared across organizations of all sizes. Nine in ten employees believe the need for supplemental insurance is increasing. More than half of employees want to purchase at least one supplemental insurance plan, with dental, hospital, mental health, accident, and infectious disease as the most popular. Additionally, employees wanted access to a benefits counselor similar to the role I played at the school enrollment, and 82% of employees wanted to be able to manage their benefits online.  

    I've also worked with small employers who could completely subsidize a policy like short-term disability or offer twenty to thirty dollars monthly towards a supplemental policy of the employees' choice with the rest of the premium paid by the staff member. It does help the employee feel that the employer is looking out for them. In the case of the elementary school coach, Andrew, having that financial cushion helped him focus on his recovery without asking his employer for income assistance. Helping employees reduce their financial stress in a health crisis is a win/win for everyone. You don't need to sit atop a white horse to see that.