Employee Health Insurance Small Business

Employee Health Insurance Small Business

Employee Health Insurance small business-How does health Insurance work for small Business? It is important to get your employees insured against any health challenge that may come their way in the course of working for you. This is because when your employees are healthy and can access quality health care when they need it, they will be happy and more dedicated to their duties.

In some countries like Nigeria, the law states that if you have up to ten employees, then you are required to enroll them into Employee Health Insurance small business plan to protect them against any work related hazards.

What is Health Insurance?

Health insurance is the type of insurance that covers an individual, family or organization from the cost of health related problems.

Employee Health Insurance Small Business

There are many reasons why you should consider getting Employee Health Insurance small business coverage for your staff.

Apart from reducing the cost of medical problems that may rise due to accident or illnesses, it also covers the cost of health tips that would prevent them from getting sick.

Read: The Easiest Way To Get NHIS Number For Your Staff

Health complications are usually on the rise especially for workers on the site. This is because they are always exposed to pollutions and some stressful activities.

These life-threatening circumstances can make you lose your best staff if you did not put a proper measure on ground that will protect them.

So it’s advisable to get an insurance coverage to protect your employees against any potential hazard or illness that may come.

Here are some major reasons why you Employee Health Insurance small business

1. Increase in productivity

When your employees are healthy and can access quality health care when they need it, they will put more efforts in their duty and so they will be increase in productivity.

 2. Reduce expenses.

The cost of treating an individual under health insurance coverage is cheaper compared to treating another individual with the same medical problem but without insurance coverage.

3. Pre and post hospitalization

In Nigeria, health insurance has gone beyond taking care of cost of treatment alone. There are some health insurance plans that covers tips and guides that would prevent your employees from falling a victim of some preventable health problems.

Prevention they say is better than cure, so you can get a health insurance coverage that would help your employees to be more productive.

4. Protection against medical emergencies

Anyone can be a victim of unexpected illnesses. Health challenge may come and it may come when you do not have enough money at hand.

So to be on a safer side, grab an insurance coverage that would protect your employees against any medical problem that may rise when you are not financially strong.

Types of Employee Health Insurance small business

Each insurance company have its own specialized designed plans. But there are standard policies covered under health insurance.

So no matter the name insurance company may decide to call their plan, it will all fall under these plans listed below.

1. Indemnity(Mediclaim)

Indemnity health insurance is the most popular health insurance in the market. This plan covers any medical expenses in the event of hospitalization, diagnoses or screening expenses.

2. Fixed benefit plan

This plan offers a fixed monetary compensation to the policyholder in the event of a pre-defined medical challenge that may rise due to accident, diagnosis or any critical illness.

Sometimes this plan will not only cover the expenses but also compensate you for your losses caused by the medical condition. Sub-plan under fixed health insurance policy are:

  • Critical illness plan
  • Surgical benefit plan
  • Accident Insurance plan

So with these been said, it is advisable you constantly study your employees, your financial plan and the type of health challenge that your staff are prone to, because those are the factors that will determine the health insurance plan you will sign up for.

How does Employee Health Insurance small business work?

Employee Health Insurance small business works in a way that you pay a little amount of money upfront called premium to an insurance company, that your little premium will allow you to share the same risk with a thousand or a million others who are also a subscriber to that insurance company.

Now, the possibility that all the subscribers will fall sick at the same time is zero; not possible. So, since most of the subscribers are healthy most of the time, the little money you paid to the insurance company as your premium can be used to care for the relatively low numbers of subscribers who may fall sick. This is how health insurance works.

Ways to Access Employee Health Insurance Small Business In Nigeria

As an employer, there are several ways you can access health insurance in Nigeria. Let’s talk on some accepted ways you can access health insurance in Nigeria.

Read: Life Insurance in Nigeria-What You Should Know

1. Preferred Provider Organization (PPO)

This is the type of insurance plan where you have the choice to use a group of preferred specialists or Doctors. They are usually your first point of call when you or your staff have any health challenge.

Because you choose them as your preferred choice of health providers, they will charge you less compare to other patients who may randomly need their service.

2. Health Maintenance Organization (HMO)

They are a group of health insurance providers who enters into contract agreement with doctors, hospitals or health specialist centers with the aim of directing patients to the hospital and the hospital will in turn give them a commission based on the number of patients they referred to them. Their services are usually cheap, compare to when you visit the hospital on your own.

3. Point Of Service (POS)

This type of health insurance plan combines the services of the preferred provider organization (PPO) and the health maintenance organization (HMO). Sometimes it requires an employee to choose his preferred doctor.

4. Exclusive Provider Organization (EPO)

This health insurance plan works more like the HMOs. The only different between them and HMOs is that while HMOs can provide a comprehensive health care, EPOs will only provide health care based on conditions. Example, EPOs do not provide health care on emergency cases.

5. Indemnity

This type of health insurance plan can be regarded as a “fee per service plan”. This implies that the amount of money you have will determine the quality of health care you will get.

6. Health Savings Account (HSA)

Health savings account as the name implies is a contribution made by some individuals specifically for health protection purposes.

Health savings account is usually tax-favored. If your company is a contributor of health savings account, whenever you or your employee have any health challenge, HSA Agent can use part of your contributions to solve your immediate health challenge.

7. Health Reimbursement Arrangements (HRA)

This is the type of health insurance plan where you as an employer will assist a member of your staff who do not have any insurance coverage.

This type of plan sometimes does not require the staff to contribute any fee at all. You as the employer is the policy holder.

Health care in Nigeria can be very expensive, especially in this period of economic inflation. Many things are expensive in the market, the health care sector is not left behind.

So it is advisable you guide the future of your employees today by getting a health insurance coverage.

There are some affordable and very reliable HMOs in Nigeria which you can sign up for today and you don’t have to worry about tomorrow again.

Read: How To Get Your Company Building Insured

What you should consider before buying Employee Health Insurance small business

Before you buy health insurance for members of your staff, there are some tips you should consider first so that you will not be on the loose end.

Let’s discus briefly on those tips so that you will be aware of what to expect ahead of your plan to buying that health insurance policy that will protect you and your beneficiaries against any potential health challenge that may come up.

1. Limit or sub-limit policy coverage

When you want to opt for health insurance coverage, you should be sure of the limit of the policy coverage. Know the limit to which the policy will cover you or your beneficiary. Know what and what that is covered under the policy.

Does the policy have specific disease coverage? What are the expenditure limit of that policy? These are some questions you need to ask before committing yourself into any health insurance contract.

Fair enough, here in Nigeria, if you buy a policy with no limit of coverage, your claims are usually easy to process, though such policies are usually expensive.

2. Shared or Co-payment policy

When opting for an insurance coverage, you should consider looking at the payment structure of that insurance policy.

How do I pay? What are the conditions of the payment? Some policy works in a way that you pay part of insurance fee and your employees pays the balance fee.

You can sign up for a co-payment or shared payment insurance coverage if you want another health insurance policy to supplement your existing policy.

3. Consider the premium price

People probably go for a lower sum insured because they want to save on premium or sometimes may be because they were not well informed. Here the best advice I will give you is to choose adequate sum insured.

Choose your plan according to your pocket. Don’t choose the plan that might lead you to financial crisis in future.

So before you buy Employee Health Insurance small business, make an informed choice, consider all your personal priorities and expenses.

Choose the policy by considering your age, and your beneficiaries age as well because age is one of the factors that determines your premium price.

4. Fill the Policy agreement form yourself

Each staff should fill the policy agreement form by themselves. Filling the policy agreement, yourself would require you to provide your personal information and as well share information about your health problem.

No one knows yourself better than you do. Some of the proposal form requires you to provide your medical history and pre-existing diseases. 

So in order to provide the right piece of information, one should always fill the policy agreement form themselves.

For your own good and the good of your potential insurance company, you should not hide or override any information about yourself. Wrong information can result to delay or sometimes no payment at all at the time you need your claim.

5. Hospital network of the insurance company

Before you buy health insurance coverage, you should first of all consider the basic operation of the selected hospital by the insurance company.

Research more on the list of hospitals on your policy agreement, get to know their responsiveness in case of emergency, their customer relation and their mode of treatment. If the hospital is not up to your standard, walk away.

6. What do you want?

This the question you should ask yourself first before signing that policy agreement. So, understand your needs. Do the policy covers what you want for your employees? Will it meet my employees’ health conditions? If not don’t sign the paper.

Remember you are talking about life here, so no one should sugar coat you with sweet tongues or force you into any contract that will not meet your needs.

7. Consider additional coverage.

Number 6. says you should understand your need, but if you like the insurance company’s services and it happened that there are just few of the things you needed which are not included in the policy agreement, you can always ask the company for additional coverage. But remember that extra coverage may increase your premium price.

8. Understand the policy wording.

It is important that you read and understand clearly the policy wordings so that you will know what you are entitled to. If you do not understand the policy clearly, you can always employ the service of your lawyer to clearly interpret the policy wordings for you.

9. Likely increase of the premium.

Due to unstable economy in Nigeria, medical inflation is on the rise which may affect the health care sector in the future and in turn affect the insurance industry and most likely affect health insurance premium price.

To this effect, it is advisable you understand the limit that the premium will reach and it will not increase again.

10. Clear your doubt

Be sure that you have cleared your doubt before you put that pen into the policy paper, because your decision today is what will determine the future of your company.

Before you make you final decision to buy health insurance coverage, you should read the policy wordings over and over again and be sure you understand everything the policy is saying about.

Meet an insurance advisor or better still visit your potential insurance company and ask as many question as possible to get yourself clarified before you sign the policy agreement.

Read: How To Get Your Company Vehicle Insured in Nigeria

Health Insurance HMO

Health Insurance HMO– What is Health Insurance HMO? Health Maintenance Organization are organization that partners with hospitals to provides health insurance coverage for individuals, families or corporate organizations.

I can say that the agreement between HMOs and hospitals is a win-win case. HMOs gets percentage from every patient they refer to the hospital they partnered with.

The top 4 Health Insurance HMOs in Nigeria and what make them best

A few years ago, I worked as an Administrative Assistant with one of the best construction companies in Nigeria, Abuja to be precise.

Initially we were under National Health Insurance scheme Coverage (NHIS) but due to unsatisfactory service with NHIS, our MD gave us the green light to switch to another health insurance organization that would provide the best service for his staff. At this point we were on the cross road, we didn’t know what to do.

The Admin and HR guys in our department were all confused of what to do next because in Nigeria, NHIS is widely recognized as one of the biggest health insurance providers with cheap premiums.
To cut my long story short, the Human Resources Manager instructed that we should go on a research. We gathered about 10 to 15 HMOs in Nigeria and began to sort them out according to the services they provide and according to the services we need as well. So finally we arrived at the four most outstanding HMOs that renders the best health care services.

Top 4 Health Insurance HMO in Nigeria

1. Reliance HMO

Reliance HMO is number on my list. They have the most flexible and affordable health insurance plans in Nigeria.

The best part is that even as cheap as their health insurance plans are, they still maintain the best and quality health care delivery to its subscribers.

If you read my introductory story, I told you of how we were on the crossroads about the HMO to choose for our company, right? Very good, we later decided to go for Reliance HMO and I must tell you that since then our staff never complained again.

Unlike many HMOs in Nigeria with rigid policies, Reliance tailors theirs to suit different kinds of people. Both the poor, the middle class and the rich, no matter your class in the society, you have a place in reliance HMO

With their various plans, you can pay according to your pocket. It can be yearly, quarterly, or monthly. In addition, you can extend the plan to your loved ones.

Their plans include:

  • Personal plan
  • Family plan
  • Parents plan
  • Business plan.


Hygeia is one of the top health maintenance organizations in Nigeria. They help individuals, large and small organizations to access comprehensive quality and affordable health care.

Hygeia HMO have network of health professionals that renders outstanding health care services ranging from primary health care services like general practitioners to secondary health services like specialists in dentists, pediatricians, therapists etc.

Since their inception in 1986, Hygeia have continued to deliver quality health care services not only to Nigerians but across the African content at large.

If you are a subscriber of Hygeia HMO, it is unlikely you will experience delay when you visit their network of hospital because they have developed a system called “No-auths”

Hygeia “No-auths” system is by far the best and the most flexible means of accessing health care when compared to other HMOs in Nigeria.

Hygeia “No auths” system works in a way that if you are a subscriber of Hygeia and you visit your proffered hospital and your health challenge falls under primary health care, then you do not need Hygeia authorization to be attended to.

But if your health challenge falls under secondary health care like surgery and other complex health challenges, then it will only take them 10mins to confirm if your premium is strong enough to take care of the medical bills. After confirmation, your treatment commences immediately.

Hygeia HMO Plans

Hygeia have developed some flexible health insurance policies that can contain anyone in the society, no matter your class in the society, Hygeia have got you covered with some amazing and affordable plans.

1. Personal plan

This plan is specially designed to cover the health challenge of a single person. Under this plan, they have:

  • Hybasic: Premium for a single person is below N100,000 for one year.
  • Hyprime: Under Hyprime personal plan, premium for a single person is N148,840 for one year.
  • Hyprime plus: Premium for a single person is from N150,000 and above for one year.

2. Family plan

This plan is designed for family. The man, the wife and the two children only

  • Hybasic family plan: Premium for family of four (4) is N163,480 for one year. Note: Additional number of a family member will increase the premium.
  • Hyprime family plan: premium for family of four (4) is N564,820 for one year. Increase in the number of family member will automatically increase the premium.

3. Senior citizen plan

This plan is designed for parents and older ones of the family.

  • Senior mini: premium for one person is N177,920 for one year
  • Senior midi: premium for one person is N394,490 for one year
  • Senior premium plan: premium for one person is N862,390 for one year

4. Pregnant women

This plan is for maternity purposes. It covers the mother and the child.

  • Hymat: Base on negotiations with Hygeia
  • Hymat plus: Base on negotiation with Hygeia

5. SMEs Plan

SMEs means small and medium enterprise. This plan covers small and medium scale business owners from any health related problem that may rise.

6. Corporate Plan

This plan is designed for big corporate organizations for their employees.

  • Hylite
  • Hybrid
  • Hyvalue
  • Hyenhanced
  • Hyleague

The above plan is available for big companies who may want to enroll their employees into health insurance coverage. The plans are available based on the employee’s levels and rank in the organization. 

Hygeia HMO Exclusions

Though Hygeia offers comprehensive health coverage to it subscribers, they also have some excluded health challenges which they do not cover.

The amount of health coverage they offer is totally depended on the risk and the amount attached to the plan you choose. So your premium plays a bigger role on the amount of health services you will get.

Below are some excluded health challenge areas, Hygeia do not cover.

  • Overseas treatment and transplant surgery
  • psychiatric treatment and illness
  • Home care and domiciliary services
  • Cancer care
  • HIV/AIDS Treatment
  • Plastic/ cosmetics surgery
  • Self-inflicted injuries
  • Covid-19 testing and treatment
  • Speech disorders
  • Any other treatments or diseases not listed in the policy agreement between them and the hospital.

Key Things To Know About Hygeia

  • Neonatal care service and immunization under maternal plan will not be covered immediately you enrolled. Your coverage starts after six months from the date you enrolled.
  • Optical care, dental care, and some chronic diseases will not be covered immediately you enrolled, your coverage will start after three months from the date you enrolled.
  • Any plan you purchase will be active after two weeks from the date of the purchase.
  • Family means, the man, the wife and two children. Additional family member will increase the premium you are supposed to pay per year.
  • Maternity benefits, surgeries benefits, critical illness and death benefits will not be accessed from the first year of enrollment.

Major Awards by Hygeia HMO

Hygeia HMO was founded in 1986 and has since then provided comprehensive health maintenance services to individuals, families and corporate organizations.

Hygeia HMO have won many outstanding awards which makes them stand out as one of the best health insurance providers including the award for:

  1. Nigeria leading world class HMO brand of the year 2018 by Made in Nigeria best brains awards.
  2. African most innovative leadership in quality health management company of the year by African quality achievement awards.
  3. Outstanding health management brand of the year 2014 by Marketing edge awards.
  4. Health maintenance organization of the year 2015 by Nigeria health excellence global awards.
  5. Commerce and industry awards 2015

Hygeia offers different health insurance plans which you can select from depending on your budget or the kind of service you need. Their plans include:

3. Redcare HMO

Redcare health service limited is a limited liability company incorporated in 2009 here in Nigeria and licensed by National Health Insurance Scheme (NHIS). Since then, they have focused on delivering quality health care to its subscribers.

Redcare HMO is one of the best in Nigeria with pocket-friendly options. Their packages would suit your personal needs if you are not buying for an organization or for a corporate body.
They have numerous health insurance plans available. Basically all their plans fall under corporate plans or Private plans. 

One major reason why many people in Nigeria do not consider getting a Health insurance is probably because they think it’s too expensive.

Today, even as low as N3500. You can get yourself insured and protect yourself from any emergency health challenge that may fall on you. Health Maintenance Organization in Nigeria have provided a lot of flexible options to choose from.

4. AXA Mansard HMO

AXA Mansard Health Limited is a Health Maintenance Organization (HMO) under the umbrella of AXA Mansard group of companies. The HMO core duty is to provide a health insurance coverage to its subscribers.

AXA Mansard Health Limited is fully accredited by the National Health Insurance Scheme (NHIS) which is the body responsible for HMO accreditation in Nigeria. Their head office is located in Lagos Nigeria with regional offices in Enugu, Abuja and Port-Harcourt.

Read: Insurance In Nigeria-What You Should Know

How AXA Mansard HMO Plan Work

Unlike most Health Maintenance Organizations in the country that provides health insurance to some selected health problems, AXA Mansard health limited provides unlimited health insurance coverage to it members with special focus on preventive medicine.

They provide special health insurance to individual willing to prevent themselves from any impending health related problems.

The HMO works in a way that you as a subscriber is required to pay a specified amount of money as a premium every year or every month as stated in your policy agreement.

Your premium contributions are combined with other subscriber’s contributions to serve as an insurance coverage to all subscribers of the scheme.

Because all the subscribers of the scheme cannot fall sick at the same time, you will be able to get a quality health care at a very low cost from the combined premium of all the subscribers.

AXA Mansard HMO is also the available for group health insurance coverage for corporates organizations who want to buy a health insurance coverage for their staff.

Here, a certain percentage of the staff’s salary is deducted on a monthly basis as a premium. Usually, 1.75% to 5% of the staff’s salary is deducted while the Organization will pay the remaining amount of money to complete the full premium.

Benefits Of AXA Mansard HMO

  • Nationwide emergency coverage
  • Very flexible and easy to access
  • Unlimited health services
  • Unlimited coverage
  • Low cost of health care
  • High quality health care

How to get AXA Mansard HMO plan?

  • Visit one of their physical offices located in Lagos, Abuja, port Harcourt or Enugu. But if that will be too stressful;
  • Contact them via their email address ccare@axamansard.com
  • You can just dial *987# on your mobile phone and follow the commands to buy new products or renew your existing plan.
  • Apply via their website or better still
  • You can connect online via the 24/7 online chat from their website

Health care services offered by AXA Mansard HMO

Below are services provided by AXA Mansard HMO

  • Nationwide ambulance services for emergency cases
  • In-patient admissions
  • Accident and emergency cases
  • drug prescriptions
  • Surgeries
  • x-rays
  • laboratory tests
  • Dental care
  • Psychiatric or mental health care
  • Maternal care and the list goes on and on….

myAXA Mobile App

The AXA Mansard mobile app is called myAXA. The App is available on play store, both android users and iOS users. with the help of the app, you can buy a new product, renew your existing plan or monitor the changes and the progress of your existing plan.

One thing you should understand is that the health care treatment you receive under health insurance coverage is cheaper than the treatment you receive on a normal hospital visit. AXA Mansard Health Limited is one of the top HMOs in Nigeria that can give you the best health insurance coverage.

What you should consider before you choose Health Insurance HMO for your employees

Health Insurance HMO. The only difference between HMOs and Insurance companies is that HMOs specializes only on providing health insurance coverage while insurance companies provides general insurance coverage.

HMOs mode of operation is more like an insurance company. Most people prefer their service to insurance companies because they narrowed their services on providing health insurance coverage. Unlike insurance companies that combines all the insurance services at a go.

How Does Health Insurance HMO work?

As stated above, HMOs mode of operation is closely related to that of insurance companies. They provide primary and auxiliary health services to its subscribers.

What they do is that they reach agreement with hospitals, specialists, doctors or any health care institutions that can provides excellent health care services up to their own standard.

The agreement between Hospitals and HMOs is usually a case of “help me, I help you” The HMOs will refer patients to the hospital and the hospital will pay the HMOs an agreed percentage based on the number of patient that came to the hospital through them. So basically, it’s usually a case of win-win for both parties.

Sometimes the Health care institution that enters contract agreement with HMOs will give them an agreed sum of money which will enable the HMOs to offer low premium than other form of health insurance coverage and at the same time maintain high quality health care delivery.

Things to consider before you choose an HMO

  • When you are on the cross road; confused on the HMO to sign up for, the first thing to consider is the quality of health care to be rendered.  Google or research more on their selected health care give. If their selected hospital is not up to your standard, then you should turn their offer down.
  • Another major thing to consider before you sign up for HMOs service is the premium rate. You should know your pocket before you subscribe HMOs service.
  • Area of specialization of the selected hospital. You may not need the kind of services that the selected hospital offers in such situation, you should consider looking elsewhere
  • You should also consider the hospital’s record on responsiveness in case of emergency. What time frame are they expected to arrive in the event of emergency.
  • High rating from experts. You should consider level and standard of the hospital as well
  • Have it in mind that a quality health insurance plan helps you to stay well as well as get better after treatment.
  • Check the exceptions of the policy, the exceptions i mean the does and don’ts attached to the policy
  • Check if they have quick claim and settlement or treatment process. Not when health challenges come they will start referring you from one section of the hospital to the other.

I hope this article helps you to understand what Employee Health Insurance Small Business is all about. If you find this article helpful or you have any question or contribution, kindly drop it in the comment box below.

Related Posts

Leave a Reply

Your email address will not be published. Required fields are marked *

%d bloggers like this: