A feel good health insurance story

Discussion in 'Too Hot for Swamp Gas' started by OklahomaGator, Feb 22, 2014.

  1. OklahomaGator
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    OklahomaGator Moderator VIP Member

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    My company is self funded for out health insurance plan. So the incentive is for people to get healthy and stay healthy. We have structured the benefits to favor those who do things the right way. Lower deductibles for not smoking, annual physicals, well baby care, immunizations, generic drugs all have $0 deductible. We also do an annual "health fair" where we get the local hospital to come to our place of employment for an annual checkup. It can include flu shots, blood tests, mammograms, blood pressure check and bone density. We try to rotate some of the tests and checks so we don't do the same thing every year.

    Wednesday I had an employee come in and thank me and the company saying the annual health fair probably saved his life. As a result of the check up the doctor found a heart murmur and sent him for a stress test. The cardiologist picked up a heart condition, his lower part of his heart was enlarged, which caused him to have irregular heart beats several times a day. They are going to implant a pacemaker type device in him next week where if he would have an actual heart attack it will shock his heart and get it beating properly again. He said his out of pocket cost for this was less than $500. He was very grateful to the company for providing the coverage we do and especially grateful that we prodded him into going to the health fair, which he didn't originally want to do.
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  2. chemgator
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    chemgator Well-Known Member

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    It is a good story. Unfortunately, Obama's minions will probably be shutting down your health care plan at the end of the year because it doesn't meet their "minimum standards".
  3. GatorFanCF
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    GatorFanCF Premium Member

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    Congrats to you, Oklahoma, for providing these benefits and having the foresight to offer the additional services.
    Hopefully, the employee who thanked you will also "preach the gospel" of participation in the health fair and improve everyone's chances for wellness. Human beings typically do not "dig their well before they get thirsty;" so, my hat's off to you and your company. Besides offering employment you may have saved a life and changed a family forever for the better....not a bad day at the office.
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  4. ArtDeco
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    ArtDeco Well-Known Member

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    Wow, glad to hear your company is successful enough to afford this.
    I want to be sure I understand your definition of "self funded". Do you mean you are your own insurance company for your employees? That is exceedingly rare. Some of the bigger hospitals fund their own insurance plans but you can only use their services and not an outside facility or doctor.
    What do you do if an employee has something chronic and expensive, like breast cancer? How on Earth do you cover those costs in this day and age? Are you a hospital CEO?
  5. OklahomaGator
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    OklahomaGator Moderator VIP Member

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    We have specific coverage of 30,000 per employee and aggregate of 300,000. We hit the aggregate about once every 6-7 years and usually have one or two employees hit their specific every year. We had a terminal brain cancer last year, sad. We negotiate deals with hospitals and doctor groups.
  6. JBufgogators
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    JBufgogators Active Member

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    That fair sounds great Ok. Maybe in the future you could add a BMI test, and a VO2 test/sports performance. Those are hard to get for a regular person. May inspire employees to work out more in whatever sport they do.
  7. icequeen
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    icequeen Well-Known Member

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    Awesome story :) my husband's policy has been self funded for a while and it's great. And, yes, it's actually already O-care compliant other than the elective abortion portion.

    As for measuring BMI at the health fair, it might be a good guide, but it can be misleading.
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  8. g8orbill
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    g8orbill Gators VIP Member

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    my wife's company is self insured
    they have an actual clinic on premise so if an employee feels ill they can see a Dr right away and a pharmacy to get their scripts filled to boot
  9. wygator
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    wygator Well-Known Member

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    Most larger companies are self-insured. However, they usually hire insurance companies to administer the plan. For this reason, some may not realize their company is self-insured.
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