How does the employee health plan work? Why hire?

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How does the employee health plan work?  Why hire?

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O health plan has always been seen as a great attraction for many professionals. Now, with the recent global health crisis caused by the Covid-19 pandemic, interest in health insurance tends to increase even more. But you know how the health plan for employees works?

From the company's point of view, the offer of this benefit it is also worth it, after all, in addition to being one of the criteria most valued by employees, medical care becomes an essential factor for hiring and retaining talent.

In other words, he is no longer an expense to become an investment, as the return obtained in the medium and long term really pays off for the company.

Therefore, in this article you can see how health insurance for employees works, the reasons that justify their hiring and how to choose the most suitable option for your company.

Read on below!

How does the employee health plan work?

Before you know how the employee health plan can be a great differentiator for your company, it's important to understand how this benefit works.

Corporate health insurance plans are similar to those aimed at individuals, but they have some characteristics of their own. They are collectives, that is, the conditions are offered to all contributors, who can choose to participate or not in the benefit.

Therefore, it is noteworthy that the health plan for employees is an optional benefit, since there is no obligation, according to labor legislation, for the company to offer the same.

While not a mandatory benefit, it is a competitive advantage when it comes to attracting, to hire and retain talents, that's why many organizations invest in offering the health plan to their employees.

Health insurance can be offered to employees and their family members. Partners, managers, retirees, interns, temporary workers and minor apprentices can also have access to this benefit.

The cost to hire a health plan for employees varies according to several factors, such as the number of employees to be benefited, the network of hospitals and services chosen, among others.

One survey carried out by Small Businesses & Large Businesses demonstrated that a basic plan for an enterprise with 20 employees costs, on average, approximately BRL 5,000 per month.

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

Regarding the lack of the plan, the deadlines are the same as for agreements aimed at individuals, that is:

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

A precaution to be taken by companies is related to the so-called accident rate, which shows the total spent by the operator to meet the expenses provided for in the contract. When this rate exceeds 70% of the amount paid by the customer, there may be an adjustment.

What are the advantages of investing in this benefit?

From a business perspective, the reasons that justify the offer of this benefit are varied. Among them, we highlight:

Increased employee motivation

Employee health plans directly impact employees' sense of belonging to the company. They realize that the business is interested in their well-being and values ​​professionals. Therefore, the trend is that employees increase productivity and engagement.

health care

The Covid-19 pandemic has widened everyone's concerns about health. But it is a fact that every professional is more relaxed knowing that he can take care of health and has the support of the company, in case of any need.

Not being concerned about health is also another reason to encourage professionals to focus on their best performance and direct their creative actions to offer interesting and innovative solutions for the company.

Elevation of the company's competitive edge

Companies that offer a good health plan for employees, thus meeting the needs of their employees, are more likely to attract, hire and retain the best talent in the market.

Consequently, with the retention of good professionals, the company increases its competitiveness point, both for thehiring qualified professionals and to deliver quality results to customers and society.

Assistance in work accident situations

The company's effort is always to avoid unforeseen events, but they can happen to any professional. In such cases, the health plan covers such situations and helps to support the employee in whatever he/she needs.

This is another positive point to be taken into consideration when hiring a health plan for employees, after all, the benefit shows that the organization is concerned with the quality of life of its employees even if some problem occurs within the company itself.

Reduction of absenteeism and leaves

Professionals who have 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 lacking. They also become more productive because they are less concerned about the future.

In other words: offering a health plan helps employees stay healthy. And healthy employees don't miss work.

Read too: 5 actions to avoid absenteeism in companies.

How to choose the best health plan for small businesses?

To select the most suitable small business health plan, It is essential to know the profile of employees. That's because what matters is choosing a health plan that is attractive to the context in which your professionals are.

Just offering a health plan to employees is insufficient. The benefit must be really positive for all employees. Therefore, before deciding which plan to adopt, check out the tips below:

Evaluate coverages and shortages

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

As for the coverage itself, keep in mind that it is mandatory for the plan to offer:

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

Analyze the scope of the plan

The coverage of the plan refers to its physical coverage, that is, where it is valid. In this case, the company can opt for a municipal, state, regional or even national scope.

Although any modality can be contracted, it is clear that the national coverage option is the one that offers more security for employees. If the company has many external employees or employees who travel regularly, this option is mandatory.

Consider co-payment

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 usually being 20%, 30% or 50%.

For the company, this represents savings in monthly fees. As for the employee, it is an extra expense. However, professionals tend to become more aware of the use of the service, avoiding unnecessary consultations, for example.

To HR, there is a more complex process in this modality because the company will receive the co-participation invoice, and will need to make the discount on the employee's payroll. Therefore, it is necessary to balance the positive and negative points of this item in order to make the best choice for the company.

Assess the company's capacity

Organizations often resist offering an employee health plan due to the high cost, complexity and long term, as the company is unable to cancel the benefit. Realize that a future suspension harms the business by discouraging employees.

In this sense, the ideal is to consider a medium health insurance that fits in the business budget. An alternative are 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 employee profile matter?

During all the planning for choosing the health plan for employees, keep in mind that the main aspect to be taken into account is the profile of the employees. It should outweigh the price in your choice, precisely because it is a talent retention and loyalty tool.

That way you will be able to have an adequate health plan for employees that will have positive effects in the short, medium and long term.

How long can I use the health plan after dismissal?

According to the labor law, the dismissed employee can use the health plan after dismissal for 1/3 of the time he contributed the monthly fee. As a rule, the minimum limit is your months and the maximum is two years.

Innovate your HR with salary on demand

As we have seen, one of the main benefits of understanding how the employee health plan works is to increase the retention of talent in the company.

It is necessary to understand that the HR sector must assume, once and for all, its multifunctional and strategic side for the qualification of the workforce of their companies.

But, to ensure a reduction in turnover, it is necessary to demonstrate that the company cares about employees as a whole, not only with your health, but also with your financial well-being, for example.

In this regard, a new modality that has drawn attention is the salary on demand, which aims to add flexibility so that employees are paid for hours worked but not yet paid.

This alleviates many of the financial problems, especially those generated by the challenges of closing the month's accounts and which tend to snowball over time.

In the UK residents market, HR Consultant UKy is a software that is increasingly adopted by companies to carry out the salary payment process on demand to employees.


With it, in addition to reducing turnover, it is possible to improve team productivity, generate financial well-being for professionals and reduce financial stress, among other advantages.

Now that you know what to consider to offer a good employee health plan, and what other benefits can help lower your company's turnover, how about looking at other interesting tips?

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