If you’re like a lot of employers, your group health benefit plan is up for renewal in the fall. Have you considered what you might do if the increase in premiums is more than you can afford?
It never hurts to shop around. Just make sure you’re not focusing only on price. An inexpensive plan might cost you and your employees more in the long run. Here are a few questions you should ask your broker about your plan options.
Q. What benefits does this plan provide?
A. There are many different types of plans, ranging from a Preferred Provider Organization (PPO), which requires members to use certain providers; to a qualified high-deductible health plan with a savings option (like a Health Savings Account). To determine which plan is best for your organization, ask to see the Summary of Benefits and Coverage (SBC). This document lists the medical services and supplies a health insurance plan covers, as well as the associated costs, including information about medication costs, copayments and deductibles.
Q. What is the deductible?
A. A deductible is how much a member must pay in claims before the insurance company pays anything and before coinsurance goes into effect. This does not include the cost of premiums. So, if your plan has a $1,200 deductible, then you must pay the first $1,200 in covered medical bills before insurance kicks in.
Q. Which doctors and hospitals are in the plan?
A. If you’re interested in allowing your employees to keep their same providers, check to see if the plan includes their current providers. PPOs usually can provide a list of providers that are in their plan.
However, if you want more freedom than that, consider purchasing a plan that eliminates the restrictive PPO network requirements and penalties. The purpose of a PPO is to provide you with a
pre-negotiated discount for your medical services when you see a provider in the network. Fortunately, there are new alternatives to PPOs. With reference-based pricing plans, providers are paid the going rate for the area or a rate based on a percentage above Medicare allowable reimbursement. For instance, Allied National’s Funding Advantage Freedom plan members can see any provider (no network, no penalties). Instead of a PPO contract, providers are paid a Medicare “plus” reimbursement that is accepted by almost all providers.
Q. How much of my employees’ benefits should I pay?
A. According to the Kaiser Family Foundation, small employers with fewer than 200 employees usually cover 82% of employees’ costs. The advantages of paying the majority of employees’ health plan costs is that it’s an easy way to increase participation in the plan. Having more and healthier employees helps “spread the risk” of your health plan costs across more people and can lower overall costs.
Q. What do I do if I don’t have a broker or want to explore other options?
A. Check with similar businesses and ask for recommendations. You also can go online to find free quotes. Allied National has more than 50 years’ experience working with small groups. Just fill out a few questions and we can show you some outstanding plans. If the plans are not a fit, we’ll be glad to show you plans from other carriers. Visit www.alliednational.com/allieddirect.
Founded in 1970, Allied National is one of the nation's oldest and most experienced third-party administrators. We're the small group benefit experts working to provide unique and affordable group health benefits to small business employers.
3/15/2021 02:27:30 pm
I appreciate that this post enlightened us that when applying for group health insurance, it is important for us to be aware of that the insurance covers. It is crucial for us to be aware of the coverage and premium as it will ensure us that we are choosing a comprehensive group insurance. The other my sister mentioned that she is looking to apply for health insurance for her company. I will look into helping her choose the best insurance coverage.
7/21/2021 12:30:53 am
Thanks for getting me back into reading again. I really enjoyed the stuff you shared in the form of blogs. Keep writing.
10/26/2021 12:24:48 am
Great post! Thanks for sharing.
10/26/2021 12:26:11 am
Well described! Keep up the good writing.
11/15/2021 07:22:09 am
Thanks for sharing such an amazing blog. I must say you are doing a great job. Keep doing such hard work. Your blogs are very informative. Keep posting! Good Luck with your upcoming updates.
Thanks for pointing out that there would be a document wherein the list of the medical services and supplies covered are stated. I will make sure that I read that first before buying health insurance for my family this year. I just plan to get a group health insurance since I have a limited budget, so I hope this tip would be able to help be get the best deal.
12/1/2021 11:07:54 am
My friend wants to start insuring his workers, but he's not sure how to do it. It makes sense that he might want to start setting up a group health benefit plan for that! That seems like a good way to ensure that everything is put together properly.
1/15/2022 04:46:54 am
I liked how you mentioned that if you want more flexibility than that, recognize purchasing a plan that eradicates the restrictive PPO network requirements and penalties. My brother just went for an ankle dislocation surgery and is currently in his healing process. I will look into home health care services for my uncle so that he can recover faster.
1/17/2022 11:15:44 pm
This is a good read. And great information especially for business owners likes me. I like your point on checking employees' providers to see if they're included in the list of providers before getting the plan.
1/28/2022 02:46:47 am
I liked it the most when you mentioned that the advantage of paying the majority of employees’ health plan costs is that it’s an easy way to increase participation in the plan. I think that's why group health insurance is best for businesses whether it's small or big. With that said, it's best to consult an insurance provider to know more about group health insurance.
1/28/2022 10:23:55 pm
I like that you said that it is important to consider what is the best coverage plan for your employees. My parent's colleagues are hoping to find an insurance service that can help them with creating health insurance plans for their employees and asked if I have any idea what is the best option to do. Thanks to this informative article, I'll be sure to tell him that it will be much better if they consult trusted insurance services as they can help them with all their concerns.
2/8/2022 09:23:07 pm
Very interesting and thanks for sharing such a good blog. Your article is so convincing that I never stop myself from saying something about it. You’re doing a great job. Keep it up.
2/16/2022 11:15:00 pm
I'm glad that you talked about the benefit of covering the bulk of an employee's healthcare expenditures is that it's a simple approach to boost plan participation. One of my parents' friends needs to know this article because they are trying to find specific information about it in a couple of days. Thank you for the tips about insurance benefits.
5/5/2022 05:43:41 am
Thank you so much for letting me express my feelings about your post. You write every blog post so well. Keep the hard work going and good luck. Hope to see such a beneficial post ahead too.
5/26/2022 07:59:19 pm
I like your insurance tips. I need a new plan. I don't have enough coverage.
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Allied National is a 90 Degree Benefits Company, a subsidiary of Blue Cross Blue Shield of Alabama. Founded in 1970, Allied National is one of the nation's oldest and most experienced third-party administrators. We're the small group benefit experts working to provide unique and affordable group health benefits to small business employers.
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