Thinking about finding a health insurance provider for your business and employees? There are a few key questions you’ll want to ask before making a decision.
But first, here’s why picking the right partner – and the right health plan – are critical:
- It can help you manage your business expenses.
- It keeps your employees happy and taken care of.
- It ensures you’re following all state and federal rules.
So, what are the five questions to ask when choosing a health plan and provider for your business? Let’s take a closer look.
How to Pick the Right Health Insurance
1: What are the total costs beyond the plan premium?
Premiums are the most visible cost for both you and your employees, but they’re just one piece of the puzzle. You also need to factor in deductibles, copays, coinsurance, and out-of-pocket maximums. Knowing all the costs will help you decide if a plan fits your budget, while still providing good value to your employees.
2: What Types of Health Insurance Coverage and Benefits Are Offered?
Talk to your broker, insurance representative, or salesperson to get details about each plan you’re considering. Is it a PPO, HMO, High-Deductible Health Plans (HDHP) with a Health Savings Account, or something else? HMOs typically require referrals to see specialists and offer limited out-of-network coverage. PPOs allow you to see specialists without referrals and may offer some out-of-network coverage at a higher cost. High-Deductible Health Plans typically offer lower premiums in exchange for higher out-of-pockets costs when you’re receiving care. It’s important to know what’s available in-network and out-of-network, and what your costs will be.
Here are other questions you’ll want answered before making a decision.
- What does the health plan cover?
- What sort of preventive care, mental health services, prescription drug coverage, and specialist visits are included?
- What participation is required?
- What about added benefits? Are they part of the base premium or an upgrade?
- Does coverage include access to an Employee Assistance Plan (EAP) or similar program?
- Is coverage limited to full-time employees only?
3: Does the plan’s provider network meet the needs of you, your employers, and any dependents?
When reviewing health plans, take a close look at the provider network. A larger network can offer more options, but it’s not always better if your preferred doctors or facilities aren’t included. Check which doctors, hospitals, and specialists are in-network. Are they conveniently located for you and your employees? What are their ratings and reviews? You can find provider accreditation, certification, and licensing details online through insurer websites, state regulators, or platforms like Healthgrades and WebMD. Whenever possible, aim to offer a plan that includes access to your employees’ preferred providers.
4: How will the plan support employee wellness?
Many health plans include wellness or fitness programs (including discounted gym memberships), an EAP, travel and medical assistance (emergency medical evacuation and related services), and care via telemedicine. Check if any providers in your proposed health plan offer these extra benefits.
5: What level of support can you and your employees expect?
Customer service and support can significantly impact your experience and employee satisfaction. Be sure to ask about the team available to help with service, claims, billing, and other inquiries. Are forms, benefit summaries, and related information easily accessible online? What are the customer service hours and your representative’s availability? Will your questions be answered quickly? What is the expected response time for inquiries?
Asking these questions ahead of time can help you choose a health plan that works for both your budget and your employees’ needs. Another great tip? Work with a broker during your search. Using a broker doesn’t cost more and it could even save you money. Brokers have insights on health plans in your area and can help you find the right providers within each plan’s network.
