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Evaluating Your Organization’s Health Plan Design and its Impact on Health Equity


For employers, health insurance plans are too often a question of cost and budget, without equal consideration and understanding of how their health plan may impact employee health and well-being. The COVID-19 pandemic only made things worse in that it highlighted the many struggles of working-class families that, despite being covered under their employer-sponsored health insurance, still found healthcare to be unaffordable and inaccessible when truly needed. Nonprofit leaders can begin assessing the impact of their health plan’s design by following the below five tips.

  1. Become Educated on Health Equity. Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination and their consequences – including powerlessness and lack of access to good jobs with fair pay, quality education/housing, safe environments and health care.
  2. Consider the Impact your Health Plan Design has on Health Equity. The plan design of your employer-sponsored health insurance might be discouraging or even disabling access/use of health care benefits known to benefit healthy living and wellbeing. High deductible plans or plans with higher copays might be barriers to employees using benefits when needed.
  3. Evaluate Across Salary Ranges. Consider employee salaries when determining staff contributions to premiums. Enabling staff earning lower wages to have the same coverage as staff earning higher wages is key. This might mean reimagining standard cost share approaches where you might implement novel changes such as premium contributions that are scaled to employee salary.
  4. Evaluate Across Life Circumstances. Create and/or invest in a Diversity, Equity and Inclusion council or committee within your organization to help with evaluating your plan’s impact on Health Equity. This will enable voices from across the organization at different levels to provide much needed insight.
  5. Explore Innovative Approaches to Health Plan Design. Consider novel plan design changes that incorporate first-dollar coverage elements. In its simplest terms, first-dollar coverage is an approach to healthcare plan design whereby the plan pays first. This allows employees and their families to access care without fear of being unable to pay upfront costs such as copayments or deductibles. Where high deductible health plans are offered, the use of employer contributions into a health savings account or the use of a health reimbursement arrangement will significantly enhance your employees’ ability to more easily access health benefits.

To download a white paper further examining the imperative for organizations to examine their health benefits through the equity lens, please visit www.nonprofithr.com/healthequity.

Authored by Eric Salyers and Antonio Cortes, Senior Consultants at Nonprofit HR. For more information about how Nonprofit HR can leverage your talent for mission outcomes, please contact Sidney Abrams, Vice President of Business Development, at sidneya@nonprofithr.com.



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