“We offer the best health insurance we could find” is what we promise in our job postings. On paper, this is accurate: the health insurance Oxide offers is the best plan we can find that is offered to small businesses.
What we left unsaid until now is that the best health insurance offered to small businesses is, in fact, not very good at all if you don’t neatly fit into a narrow demographic; the bitter irony is that the US healthcare system isn’t designed for those of us who rely on it the most. And life-saving treatments that aren’t needed by able-bodied cisgender people are, more often than not, deemed “not medically necessary” in off-the-shelf insurance policies simply because there is no law to require their coverage. In our society’s bizarre and accidental system, we rely on employers to provide benefits everyone should have, including healthcare, retirement plans, and dependent care.
When I came out as trans and started seeking medical care, I worked at a large employer that directly paid for the medical costs of its employees and dictated how their insurance networks process claims. I had the benefits I needed because other trans people fought for them and the company could unilaterally choose to provide them. Startups don’t have this luxury and are at the whims of insurance companies to keep the cost of hiring and retaining employees manageable. Meanwhile, insurers put profit over care, and won’t budge on off-the-shelf benefits plans unless Congress forces the issue – yet as I write this, lawmakers across the country are either ignoring us or actively stripping away our right to get the healthcare we need, so we’re not holding our breath.
With this in mind, I was initially uneasy about applying to Oxide because we didn’t make our benefits clear to prospective applicants. But I still applied — not out of blind faith, but because I felt a company built on these values would put its people first and work to provide what I needed. Shortly after I started, despite insurance companies not budging even an inch, our CEO Steve announced a reimbursement arrangement that would cover $10,000 of out-of-pocket healthcare expenses for gender-related healthcare per year. This isn’t perfect, but it’s a damn good start.
Future applicants shouldn’t need to put this much faith in us upholding our values in order to be comfortable about applying, though. Here’s a much clearer summary of our benefits:
We offer the best medical, dental, and vision insurance plans we can find as a small employer; premiums are 100% paid by Oxide for both employees and dependents.
We offer an optional FSA plan for out-of-pocket healthcare and dependent care expenses.
We reimburse (through an HRA) up to $17,000 annually: $10,000 annually for gender affirmation or infertility expenses, $5,000 annually for hearing and laser eye surgery expenses, and $2,000 annually for dental and miscellaneous healthcare expenses. The HRAs cover out-of-pocket expenses regardless of whether insurance covers them partially or not at all.
The bottom line: Where our insurers fall short, we will work to meet our employees where they need us to be.
As with our compensation model, the benefits we provide embody our mission, principles, and values: We can’t focus on our mission if we’re distracted by healthcare expenses. Our principles of integrity, honesty, and decency compel us to care for our teammates and their families. And our approach to benefits intersects with several of our values:
It is driven by our empathy. Even if we don’t have the context for someone else’s needs, we don’t need it: none of us ever want to have to worry about healthcare expenses for ourselves, our partners, or our families, and we wouldn’t wish it on each other. We understand that this approach is necessary and important, even if some of us don’t directly benefit.
It is a step toward building a more diverse team. In this regard, we are not meeting the same standard to which we hold ourselves with our other values. We strive to change that by embracing the needs of our current team as well as those of prospective future teammates. Benefits are a critical part of what employers bring to the table for candidates, and we don’t want to inhibit people from applying to Oxide because of the perception that small companies can only provide meager coverage that doesn’t work for them. While our compensation model ensures we have no pay gap, our approach ensures that people relying more on these vital benefits are still getting paid the same as their peers. Every member of the team has different needs, and we will do our best to address as many of them as we can.
It is a reflection of our resilience. We will do everything within our power to take care of our employees. We will continue to fight our insurers to provide for basic healthcare needs, and when they fall short, we will find other ways to provide for those needs (such as offering HRAs) while we continue to fight. We will never stop advocating for our employees.
It is a fundamental responsibility to our teammates. We don’t treat healthcare benefits as a “perk”: it is a basic need for all of us. And while it is tiring to continue to fight against an uncaring and unwavering healthcare system only to make incremental progress, we know that we must do so to keep our mission in sight.
Finally, in the spirit of transparency: we’ve made our benefits information public starting today. These are close to the same documents employees see when signing up for benefits (with some information only relevant for employees removed). We’re working to provide additional information for specific situations that we’re aware of — and we know that our benefits are not complete; there are innumerable needs none of us have experienced or thought of.
We share our benefits information for two important reasons: first, we want applicants to be able to learn everything we know about our benefits so that they feel confident in applying even in the face of a healthcare need that is not commonly covered; second, we want to give employees at other similarly-situated companies tools (such as suggesting HRAs) to help fight for the healthcare coverage they need. We have a responsibility to take care of our employees, but we also have a responsibility to make our industry a better place to work for everyone.