APPLICABILITY
Indicator metrics apply to all employees (see definition in General Clarifications). For organizations pursuing Level 2 and above, health care benefits must be provided on a prorated basis to part-time employees who work at least 20 hours per week.
COMPREHENSIVE HEALTH INSURANCE PLAN
For the purposes of Just, to be considered comprehensive, a health insurance plan must include medical, dental, and vision benefits that meet or exceed government rules and regulations regarding the provision of health care insurance to employees and their dependents. For example, in the U.S., the government has stipulated 10 essential health benefits.73 Plans must also include coverage for access to preventive care.
Living Future also encourages organizations to provide plans that include coverage for alternative or non-Western treatment options such as chiropractic, naturopathic, traditional Chinese medicine, and herbal medicine.
An organization’s percent coverage of a comprehensive health insurance plan refers to the percentage of the premiums associated with the plan. Health care benefits offered to employees must not compromise other benefits or pay.
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 a given metric, 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 Living Future’s definition of comprehensive health care (i.e., inclusive of dental and vision) since the determination of covered services is outside of the organization’s direct control. Organizations in this context must provide access to comprehensive health care in order to achieve Level 4 recognition. Living Future recognizes there is wide variation on how countries choose to approach universal health care provision and welcomes conversation from international organizations on how best to adapt Indicator metrics.
HEALTH CARE POLICY
If an organization with part-time employees is pursuing Level 2 or above, the Health Care policy must specify that the benefits are accessible regardless of employee type (i.e., full-time or part-time). Note that this policy must be separate from the health insurance plan documents themselves and meet the Just program’s written policy requirements.
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.
MULTIPLE HEALTH INSURANCE PLAN OPTIONS
Organizations offering employees multiple health insurance plan options to choose from can achieve a given performance level as long as at least one of the plan options that is available to all employees meets the metric requirements.
PERCENT COVERAGE
Organizations may pay different percentages for the three specified types of health care coverage (i.e., medical, dental, and vision) noted in these Clarifications, so long as the aggregate percentage value meets the minimum required for the targeted level. For additional information on calculating the percentage, see the Calculations section for this Indicator.
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73 U.S. Centers for Medicare & Medicaid Services. (n.d.). What Marketplace Health Insurance Plans Cover. Retrieved February 16, 2023, from https://www.healthcare.gov/coverage/what-marketplace-plans-cover/.
