The 3 Coverage Gaps
Out‑of‑Pocket Exposure Gaps — “The Surprise Bill”
What it is: Gaps that let employees get hit with unexpected deductibles, coinsurance, or non‑covered charges after care.
Why it matters: When even one employee gets a high bill, you absorb turnover, lost productivity, and the morale cost — and employers often end up covering more than they planned to avoid losing talent.
Income Replacement Gaps — “The Paycheck Hole”
What it is: Missing or inadequate short‑term disability, leave replacement, or wage‑continuation that leaves workers without income during recovery.
Why it matters: Without clear income replacement, employees either return too soon (risking relapse) or leave the company; both outcomes hurt operations and increase hidden payroll costs.
Ancillary Service Gaps — “The Missing Support”
What it is: Lack of coverage (or poor routing) for dental, vision, mental health, rehab, or vendor‑managed services that are critical to outcomes.
Why it matters: Gaps here multiply downstream medical costs and create administrative friction — forcing managers to spend time managing exceptions and employees to pay out of pocket or skip care.
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