For decades, rising healthcare costs have been a consistent topic of conversation, particularly for employers concerned with enhancing worker productivity, reducing medical costs and meeting occupational health and safety needs. One solution which has arisen with increasing frequency is the establishment of employer-sponsored clinics (or “onsite/near-site” clinics). With this solution, however, comes many considerations and challenges for employers.
Employers can also utilize similar healthcare services:
One of the many benefits of onsite and near-site clinics is the employer’s opportunity to offer a variety of services to employees and (if eligible) their dependents, including:
It is imperative for employers to understand that onsite and near-site clinics are not a “one size fits all” model. Indeed, the manner in which an employer structures its onsite or near-site clinic will be based on a multitude of factors, including the employer’s business objectives, the employer’s clinic objectives and the nature of clinic services made available to eligible participants.
One of the initial determinations for the employer will be whether to have the clinic located onsite or nearby. Further considerations will include selection of the following:
1. Participant population
3. Staffing and management
Another consideration an employer will have to address is the reimbursement of medical services and the implications on health savings account (HSA) eligibility. In most cases, employees are only eligible to receive HSA reimbursements for services covered by the employer’s high deductible health plan (HDHP). However, when an employer provides substantial medical services for free or at a significant discount, such services are considered non-HDHP coverage, which may disqualify the employee from making or receiving HSA contributions or reimbursements. Consequently, some employers will opt to limit their clinic services to preventative care or charge the employee the fair market value for services rendered, so as to eliminate any adverse impact on an employee’s HSA eligibility.
Each factor considered by an employer will be accompanied by legal and compliance concerns or obligations. For example, depending on the clinic type, employers may have to comply with HIPAA in securing Protected Health Information (PHI) against exposure or data breach. Employers may also be subject to certain COBRA or ERISA obligations, again, depending on clinic type. Download our eBook, “On-site clinic compliance considerations for employers,” for more information about the compliance issues raised by employer-sponsored clinics.
Anissa works with employers to provide practical solutions to employment law and compliance matters. She provides employers with guidance pertaining to all aspects of employment law, including employee benefits, insurance, and HR policies and procedures.
Anissa works with employers to provide practical solutions to employment law and compliance matters. She provides employers with guidance pertaining to all aspects of employment law, including employee benefits, insurance, and HR policies and procedures. As a litigator, Anissa previously represented insurers and insureds in numerous aspects of insurance defense practices and insurance companies on coverage issues. Anissa now focuses her career in the corporate setting, with an emphasis on employment contracts, insurance, HR management, risk management and regulatory compliance. As part of the HR Solutions Team, Anissa is dedicated to educating employers of all sizes on employment law and compliance matters.
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