COVERAGE APPROACHES
Organizations may provide dental and vision benefits through set dollar amounts (rather than a percentage of the premium) if they are able to demonstrate that the amount allotted to each employee meets the metric requirements for the corresponding performance level.
GOVERNMENTAL ROLE
If the government of a locale fulfills any of the requirements for an indicator level, those government benefits may be included in the percentage of the organization’s coverage. In areas where the government provides universal health coverage, organizations are eligible to achieve up to Level 3 for this Indicator even if the governmental coverage does not align with ILFI’s definition of comprehensive health care (i.e., inclusive of dental and vision). Achievement of Level 4 requires the provision of holistic health care benefits, either from the government or supplemented by the employer.
HEALTH CARE PLAN
For the purposes of Just, to be considered comprehensive, a health care plan must include medical, dental, and vision benefits.
To be considered holistic, a health care plan must include medical, dental, and vision benefits, as well as some alternative or non-western treatment options such as chiropractic, naturopathic, traditional Chinese medicine, homeopathy, and herbal medicine.
Health care offered to employees should not compromise other benefits or pay. Employers are encouraged to provide optional health care coverage to family members.
HEALTH REIMBURSEMENT ARRANGEMENT (HRA)
Organizations may use health reimbursement arrangements (HRAs) as a means of providing health care benefits to employees. Organizations must demonstrate that the HRA amount allotted to each employee meets the metric requirements for the corresponding performance level. Given the nature of HRAs, health care plans do not necessarily need to be comprehensive since individual employees use their HRA funds at their discretion.
PERCENT COVERAGE
Organizations may pay different percentages for the three specified types of healthcare coverage. For additional information on calculating the percentage, see the Calculations section for this Indicator.
SCOPE OF EMPLOYEES
Indicator metrics apply to all employees (see definition in the General Clarifications). For organizations pursuing Level 2 and above, health care benefits must be provided on a prorated basis for part-time employees who work at least 20 hours per week.
