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May 21, 2021
In general, think about:
Health insurance products are complicated, and getting more so. When shopping for plans, you’ll want to look carefully at coverage for the services your employees will use most, such as office visits and prescription drugs. Even though it’s used less frequently, coverage for hospitalization is also critical.
In addition to these basics, below we list some specific benefit categories that may be worth a careful review. Depending on your employees’ circumstances, some or all of these may make a big difference for your business.
As we mentioned earlier, choice of providers may be an important issue to you and your employees. Make sure you understand which providers, hospitals and medical groups are available to plan participants. If you or your employees aren’t comfortable with the choices offered, you may want to consider a different plan.
A plan may look good, but if the insurer turns out to be hard to deal with—or if the insurer goes bankrupt, for that matter—you’ll likely wish you had picked a different plan. Do a little research to make sure that your potential insurer:
Financial Stability
You can find out if your insurer is financially stable by researching its financial rating. A number of companies provide this service, usually for free, though some companies may offer more information at a price.
Quality of Healthcare
The quality of healthcare varies widely. In addition to doctors, hospitals and medical groups, insurers play an important role in seeing that you receive high-quality health services. Be sure to look into the insurer’s reputation and ratings for the quality of care provided under their plan.
Customer Service
Look for an insurer who makes it easy for you to pay the bill and get help when you need it. Your broker can advise you on which insurers provide great service, and which give employers health care headaches.
The best insurers also make it easy for employees to:
If you’ve found a plan that suits your needs, it’s time to move to the next step, which involves signing a contract and implementing the plan. You can skip the rest of this section and move to Step 6: Close the Deal.
If, on the other hand, after evaluating several plans you decide that none of the options look affordable, you’ll need to put some thought into what to do next. If you’re way off your target budget, it may not be the right time to purchase group coverage (especially considering that the costs will likely increase each year). If you’re in the ballpark, however, there may be ways to shave the costs down.
If it really looks like you won’t be able to afford group coverage, you should consider some alternatives.
Once you’ve reviewed your options and made your decision, it’s time to sign your contract and make your first payment. Remember that the rates you are quoted will be available for only a limited time—usually 30 days—so if you find a plan that will work for your business, don’t delay too long.
You need to tell employees some critical details about how the health plan will work for them, such as:
Employees typically need to complete an enrollment form, and may need to choose a primary care physician (PCP) from the provider directory (typically with HMO and POS plans). Some insurers are moving to online enrollment to minimize errors and speed up coverage.
After employees enroll, they will receive an ID card to present at the doctor’s office or hospital. Sometimes the ID cards do not arrive for a month or so after coverage begins. You will want to let employees know when they can expect it, and whether it will be mailed to their home or to the office. In the meantime, the insurer can provide you with the group and member numbers, as well as how to get prescriptions filled or receive care before the card arrives.
It’s a good idea to hold an employee meeting to answer questions and to explain how to fill out enrollment forms, choose the primary care physician, and file claims. An agent can assist you before, during, and after the meeting.
Offering group coverage requires a lot of paperwork. You’ll need to pay attention to:
Congratulations!
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