Small Employers
4. Decide What You Want.
Before you begin comparing plans, put together a list of what you want from your health plan. Think in terms of what you and your employees need and can afford. If budget is a major concern, think carefully about the tradeoffs between services, coverage, and price. Your agent or broker can be very helpful in this process.
Who Will Be Covered
Begin with a clear picture of who will be offered coverage. Will coverage be offered to employees, dependents, or both?
Scope of Services
What kinds of services do you and your employees really need? Do you and your employees highly value preventive and primary care services? Are maternity services a major factor? What about dental, prescriptions, eye care, and behavioral health care? Make sure that your type of health plan matches those service needs.
Choice of Providers
What kind of provider choice do you and your employees need? Are their certain providers who absolutely must be included in your health plan? This is an important point which should not be overlooked. Some of your employees may have strong feelings about the value of the plan based on exactly which providers are included.
Financial Coverage
What level of financial coverage do you and your employees desire? Look closely at the total lifetime maximum, annual maximum, and out-of-pocket maximum associated with any health plan you consider.
Total Cost
What total cost are you willing to pay for health coverage? Think in terms of total premium cost plus any additional out-of-pocket costs. Also be sure to factor in the tax benefits associated with purchasing small group coverage.
Cost Sharing
How much of the total cost are you willing to pay on behalf of your employees? Think in terms of what your firm can afford and what your employees can afford. Also think in terms of not only premiums, but also co-insurance, and co-payments. If you are offering dependent coverage, how much of the dependent's premiums are you willing to pay? Again, remember to factor the tax benefits of group health coverage into your cost equation.
Type of Plan
Based on all of the above, what kind of plan are you willing to consider? Do you want the freedom of a traditional plan? Are you willing to live with some restrictions under a Point of Service, Preferred Provider Organization, or Health Maintenance Organization type of plan? Or are you looking for a Health Savings Account plan with a high deductible health plan?
Strength of the Insurance Company
