What are ways employers can help their employees understand and make the most of their health plans? Let’s name a few.

  • Make a list of in-network providers. Additionally, you should make sure you keep a list readily available upon request. Educate employees on how to find and use providers who are in-network, and how they can find a provider in instances when they’re out of town. WGAT partners with Anthem, which offers some of the best negotiated rates. This means employees pay less for claims. If clients have employees or dependents outside of California or Arizona or are traveling outside of these states, they are still covered. They will have health care coverage through the First Health Network for non-emergency care. This will help mitigate out-of-network claims and higher out-of-pocket costs.


  • Remind employees that in non-life threatening situations, they can use Urgent Care or telehealth services instead of going to the emergency room. Emergency room visits can become extremely costly and in many instances, can be avoided completely. If an employee can’t get to a doctor or aren’t sure if they need to go – and if it’s not an emergency – they should make an appointment with their physician. Plus, it’s important for them to build a relationship with their family doctor or specialist so they’ll have someone they know and trust. For members of WGAT, telemedicine program Doctor on Demand is available for all plan participants. This program is an added benefit to their health plan and is less expensive than a normal doctor’s visit. WGAT also operates Cedar Health and Wellness Centers for the communities in Salinas, Watsonville, Santa Maria and Oxnard. These centers provide general and family practice services (primary care and preventive services) in rural areas at a low cost. The clinics offer deep discounts for regular office visits and convenient access to prescription medications. Bilingual providers and extended hours are available to accommodate the needs of the workforce.


  • Remind employees of the availability of any possible Care Management programs for chronic conditions and wellness services. Productivity losses from missed work due to poor health care and preventable chronic conditions cost employers $225.8 billion, or $1,685 per employee, each year, according to the Centers for Disease Control and Prevention (CDC). All WGAT plans have access to our Pinnacle Health Management program. Conditions offered under the program include asthma, diabetes, hypertension, hyperlipidemia (high cholesterol), weight management and depression. Our add-on programs include a Mom-to-Be Program, which supports expectant moms during pregnancy, delivery and post-natal care; and our Nicotine Cessation Program to assist participants in ending their nicotine dependence. These programs include educational and support materials and monthly coaching sessions from a health care professional.


  • Talk about benefits outside of open enrollment. Health care isn’t a once-a-year thing – it’s something that happens year ‘round. Employees will get sick, and in some instances, bigger issues will arise. By keeping benefits information readily available and in everyone’s mind, employees will make better decisions if there’s an illness or condition that needs to be addressed.


  • Communicate the availability of additional tools. Most employees are surprised to learn about additional tools, such as discounts or services that are available through their health plan. If you have an online portal, make sure your employees receive the necessary training so they can navigate it without any problems. For members who have a WGAT plan, they have access to our Healthview portal, which enables them to look up available providers, check their claims status, verify deductible and out-of-pocket maximums, request replacement ID cards, and more.