For many small businesses in Nigeria, the question of how to provide health insurance for their employees is a major concern.
With the cost of healthcare skyrocketing, many employers find themselves at a loss as to how they can afford such benefits without taking on significant risk and responsibility.
Health Maintenance Organization (HMO) offers a viable solution for this dilemma.
HMOs handle everything from managing care providers to negotiating rates with insurers so that employers don’t have to worry about anything but getting back to running their businesses.
In this article, I’ll walk you through:
- The role and benefits of HMO for Small Businesses
- How to choose the right healthcare provider for your business, and
- Affordable HMO services available to small businesses in Nigeria
Let’s get to it.
What is HMO (Health Maintenance Organization)?
Health Maintenance Organization (HMO) is a type of managed care organization that provides prepaid health coverage to its enrolled members for fixed periodic payments or premiums from those members or their employers.
An HMO works by offering their clients (businesses) a network of healthcare providers or hospitals, which employees (or families of employees) can access without paying any additional fee.
In addition, Health Maintenance Organizations (HMOs) are generally less expensive than traditional health insurance plans that reimburse expenses after they occur.
How does this work?
Ordinarily, businesses don’t automatically qualify for an HMO; they must apply and accept the terms of service before their employees can sign up for HMO packages.
Once accepted, the business must:
- Sign a contract with the HMO
- Pay an HMO premium (just like in insurance), and
- Abide by the policies outlined in the contract
The insured (employees) will receive medical treatment through the HMO network.
Also, depending on the plan, some out-of-network coverage may be available for certain services.
What does the HMO premium cover?
The services covered by an HMO will vary depending on your health plan for that period.
Meanwhile, it’s essential to read your HMO plan description to understand what each premium offers.
Regardless, HMO plans cover some of the following services:
- Dental care
- Prescription drugs
- Emergency medical care
- Ambulance transportation
- Domestic partner coverage
- Mental health care (therapy)
- Preventive maintenance (checkups, etc.)
- Medical care (surgery, tests, x-rays, physical therapy, etc.)
- Hospital care (room and board if admitted as an inpatient)
How do I choose the right HMO Services for my business?
Having the right healthcare coverage for your business (and employees) is an important decision.
To make sure you’re not leaving any stone unturned, here are some factors to consider:
- Understand your budget
First, before you look for an HMO service provider, it’s essential to know how much you’re willing to spend.
Once you know what is budget-friendly for you, you can narrow down your search to health plans that fit within your budget.
- Decide on your ideal payment plan
Second, every HMO has its billing cycles (monthly, quarterly, semi-annual, or annually).
Regardless of your business budget, an HMO can accommodate your needs.
For example, if you’re a business owner working with a tight budget, monthly can be beneficial.
On the other hand, if you have a large budget, then an annual payment cycle might be more ideal.
That said, you need to keep in mind that monthly payment plans are usually more expensive than annual plans.
- Look for an HMO provider with the correct licensing and credentials
The next step is to ensure that the provider you choose has the proper licensing and certifications to provide healthcare services.
To be on the safe side, ensure that the services offered by the HMO provider include coverage of all the benefits you need for your employees.
In Nigeria, the National Health Insurance Scheme (NHIS) licenses HMOs.
- Consider different HMO service providers
How do you differentiate one HMO service provider from the next?
Use these tips to streamline HMO services:
- Review HMO services to understand what each plan covers and what your company covers costs.
- Note their healthcare providers and facilities (how diverse are the options available to you?)
- Figure out the effectiveness of their customer service (are they easily accessible?)
Get as many quotes as possible.
- Choose the right health plan
Finally, look for an ideal health plan that’s a good fit for your organization.
For example, should you opt for an HMO or a PPO?
An HMO is a network of healthcare providers that gives clients access to medical care under one insurance plan.
Meanwhile, the PPO (Preferred Provider Organization) is a network of healthcare providers that don’t work together.
Employees can use other healthcare facilities other than those designated by the service providers.
What are the benefits of HMOs for small businesses?
Did you know you can also benefit from HMOs as a business owner?
In fact, HMOs can be a brilliant solution for keeping your employees healthy as well as boosting work performance.
Here are some benefits that are associated with Health Maintenance Organizations:
- HMO gives employees access to low-cost medical treatment
Health Maintenance Organization (HMO) offers employers an opportunity to provide comprehensive medical cover for their employees that is both affordable and convenient.
How does this work? An HMO utilizes an exclusive network of healthcare providers that are contracted to offer reduced prices on health care services.
- HMO provides employees access to an extensive network of health providers
Besides low-cost medical treatment, enrolling employees under an HMO gives them unrestricted access to healthcare professionals and facilities within the network.
This is because Health Maintenance organizations (HMOs) act as intermediaries between healthcare providers and businesses.
#Tips:
When choosing an HMO service provider, ensure they have access to an extensive network of health professionals.
- HMO plans are recognized as tax-deductible
Medical expenses and insurance premiums are tax-deductible. HMO falls under this category.
By subscribing to HMO plans, you can receive tax deductions if your expenses meet the criteria for allowable deductions.
This is undoubtedly a win-win for every business owner.
- Providing HMOs can lead to a healthier workforce
What’s more important than a paycheck to your employees? Their health.
Offering your employees access to health care packages can help reduce sick days, costly absenteeism and improve productivity.
HMO is a great way to show you care about your employees.
- HMO improves employee satisfaction
Providing HMO coverage for employees is a sound investment for business owners.
These benefits can help improve employee retention and satisfaction in the long run.
A recent study by Jobstreet Philippines revealed that salary, company benefits (such as HMO), and incentives are the top drivers of employee satisfaction.
Best HMO Services for SMEs and Startups in Nigeria
Nigeria has a thriving SME and startup ecosystem with high aspirations for success.
However, one of the main issues facing businesses in Nigeria is how to keep employees healthy without breaking the bank on medical insurance.
The following are some of the best HMO services for small businesses that can help you provide affordable health care coverage for your employees:
Mediplan Healthcare Limited
Mediplan Healthcare Limited is a health maintenance organization that offers corporate organizations and individuals low-cost medical treatment.
The National Health Insurance Scheme (NHIS) accredits Mediplan as a National Health Maintenance Organization.
The company’s goal is to provide quality and affordable health care services.
Hygeia HMO
Hygeia HMO is a medical insurance scheme that provides medical and life cover for:
- Individuals and families
- SMEs and large corporate organizations.
The medical cover includes hospital and specialist consultations, tests and procedures, medicines, and other approved services.
Reliance HMO
Reliance HMO is a health insurance company that offers affordable medical treatment to its members.
They make health care easy to access with the use of technology and telemedicine.
The health plan includes:
- For Family
- For Parents
- For Business
In addition, the Reliance Care App gives you access to low-cost health insurance at your fingertips.
Redcare Health Services Limited
Redcare offers qualitative and affordable healthcare services tailored for individuals, families, companies, and parastatals.
They provide these solutions with a network of 600+ healthcare facilities, so their clients can access health services anywhere in Nigeria.
The health plan includes:
- Pro
- Pro +
- Pro Max
- Standard
- Standard +
- Premium
RedCare Limited is a registered member of the National Health Insurance Scheme (NHIS).
Clearline Health Insurance
Clearline prides itself on being the most responsive HMO in Nigeria.
The company is registered with the National Health Insurance Scheme (NHIS) to underwrite health insurance in Nigeria.
They tailor their health services towards the needs of individuals and corporate organizations.
Total Health Trust
Total Health Trust is one of Nigeria’s leading health service providers with over 21years of industry experience.
Not only that, but the company also has one of the largest networks of independent service providers, made up of over 5000 NHIS-accredited clinics and hospitals throughout Nigeria.
IHMS HMO
IHMS has over 18years of experience in the health insurance sector in Nigeria.
The company is registered with the National Health Insurance Scheme (NHIS).
Their services include:
- Social Health Insurance
- Family Health Care
- Health Insurance Services
IHMS caters to private individuals, families, and corporate bodies.
Greenbay Healthcare Services
Greenbay Healthcare provides services as a Health Maintenance Organization.
With over 25 years of experience, the health insurance company works with employers and individuals to manage their healthcare expenditures and provide quality services.
Their services include:
- Corporate plans (freedom, school health plan, etc.)
- Individual projects (access, essentials, executive, etc.)
- Workplace solutions (fit2work, media-resource)
- Free solutions (street audit program)
Recommended Reading: The best places to launch a startup in 2021: Guide to Tech Hubs in Lagos
AIICO HMO
AIICO Multishield Healthcare is one of the Nation’s foremost Health Maintenance organizations (HMO).
The company provides medical guidance and comprehensive healthcare coverage coupled with an extensive network of healthcare centres.
AIICO’s category of health plans includes:
- Standard
- Executive
- Super Executive
- Magnum
Wrapping Up
Health Maintenance Organizations (HMOs) are changing the way businesses think about their employees’ well-being, making it easier to balance both finances and health in an organization.
With a health plan that manages medical bills, visits to doctors, pharmacy needs, and other expenses through one entity — instead of with separate providers — small business owners can focus on what matters most: their bottom line.
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