Selecting a group health insurance plan to offer to employees is a major decision. It will affect both how well employees are covered for medical issues and, as a result, how highly they value their compensation package. If you’re in the process of comparing group health plans that your Massachusetts business might offer to employees, here are some questions to help you find the best option.
When Comparing Group Health Insurance Plans That My Business Might Offer, What Questions Should I Ask?
What Are the Premiums of Each Group Health Insurance Plan?
You’ll, of course, need to know how much each group health insurance plan you’re looking at costs. Premiums will make a significant different for your business and employees (assuming the premiums will be split). You’ll have to limit your selection to a plan that fits within both your business’ and employees budgets, so it makes sense to use this as one of the first criteria you consider when comparing plans.
What Providers Participate in Each Group Health Plan’s Network?
Shortly after (if not before) your business’ group health plan goes into effect, employees will receive information on how they can obtain a list of in-network providers. You don’t have to wait until after you select a plan to see this list, though. When comparing plans, request a list of in-network providers for each plan you’re considering. If possible, get a list that’s delineated by county so you can specifically look at providers in your part of Massachusetts.
Laws likely prevent you from asking employees what doctors they see, so you won’t be able to make sure every employee can keep their doctor under a new plan. You can, however, make sure employees have lots of local doctors to choose from. Place each list side-by-side and see how the number of in-network providers that they have compares.
This, of course, won’t be your only consideration when choosing a health plan for your employees. It should be a significant one, though, so this should be among the first questions you ask about each plan after you find out how much the plans cost.
What Are Each Group Health Plan’s Deductibles, Copayments, Coinsurances, and Limits?
A group health plan’s deductibles, copayments, coinsurances, and limits determine how much employees will pay out-of-pocket for the medical services they use. These should be carefully compared, as they can be intricate and they may vary significantly. It’s also important to consider all of these different aspects together, for they work together to determine how much coverage employees have and how much employees have to pay.
When comparing deductibles, copayments, coinsurances, limits, and similar factors, it’s sometimes hard to conceptualize how these different factors actually impact employees. If you’re having trouble reconciling all of these, it may be helpful to create personas. You shouldn’t characterize specific employees, but you might be able to use examples of imaginary figures to help determine how each plan would affect the imaginary people’s pocketbooks and access to care.
For example, you might want to apply each plan’s different factors to the following characters:
A generally healthy individual who rarely sees their doctor
A healthy individual who actively makes all recommended appointments for preventative care
An individual who has a large family and wants good medical care for all their family members
An individual who is healthy overall but sees a medical provider regularly for an ongoing issue, like allergies
An individual who suffers from multiple chronic illnesses that require frequent appointments
An individual who’s hospitalized often
(You may want to create different examples of people to use.)
Ask an Advisor for Assistance Selecting a Group Health Plan
To get help answering these and other questions, contact an advisor who specializes in group health insurance plans. A knowledgeable advisor will be able to find the answers to these questions for you, and they may also suggest other questions that you should be asking. With their insights and assistance, you should be able to select the right plan that your Massachusetts business should offer.