5 Tips When You’re Shopping for Group Health Insurance

Do you own a small business and employ a group of people? If so, you are likely interested in finding a group health insurance broker to help you find insurance plans that meet the needs of you and your employees. When choosing group health insurance, it’s important to know what you’re looking for and how to get the best deals. Luckily, there are plenty of tips to help you do just that.



Talk to a Group Health Insurance Broker

Hiring a group health insurance broker to help you
find the right group health insurance plan could save you money in the long run. They know which plans are most popular in your local market as well as which providers are included within each network. Insurance brokers work for you. Since their goal isn’t to please an insurance company, they focus on finding the right group plan to meet your needs and the needs of your employees. Additionally, if you work with a broker, you’ll receive help during enrollment and as needed throughout the year.

Finding the right broker is essential, though. The right one will not only be licensed but will have experience in providing group health insurance plans, including managing them, comparing them, and making changes when needed. Look for a broker that has a strong and positive reputation within your community. Finally, be sure that you hire someone who you feel comfortable with.

Consider Whether You’re an Applicable Large Employer (ALE)

If you started as a small business and have grown to the point that you need group health insurance plans, then you may be considered an applicable large employer or ALE. This means that you have certain responsibilities to uphold. When the Affordable Care Act came to be, it designated ALEs as any employer that has at least 50 full-time employees or the equivalent.

Whether you’re considered an ALE depends on the average number of employees you had in the previous year. If you are an ALE, you are responsible for employer-shared responsibilities. This means you have to provide minimum coverage to at least 95% of employees and their dependents. You may be subject to penalties if you don’t. Understanding how your business must operate ensures you find the right plan.

Compare the Plans Thoroughly

When comparing group health insurance plans with your group health insurance broker, consider the types of coverage, copays required, and providers in the network. There are several types of plans available, including health maintenance organizations (HMOs), preferred provider organizations (PPOs), high-deductible health plans (HDHPs), health savings accounts (HSAs), and exclusive provider organizations (EPOs). Each one has its own advantages and disadvantages and
healthcare.gov provides more information on them.

The first thing to consider is which providers are in the networks you’re considering. Each plan has its own network of providers. If you use an HMO or EPO, using providers outside of the network can be quite expensive. Most plans provide no out-of-network coverage unless it’s an emergency, which means it’s important to choose a plan that includes a wide variety of providers. Keep in mind that HMOs and some EPOs also require each member to choose a primary care provider who is responsible for referring the patient to specialists as needed. Some EPOs allow clients to make their own referrals within the network. PPOs typically allow members to refer in our out of the network, but keep in mind that out-of-network care costs more in terms of copay and coinsurance.

The next thing to consider is costs. Out-of-pocket costs vary greatly depending on the plan you choose. Most include a deductible. This is the amount you need to pay out of pocket before your coverage kicks in. Copays are important as well. Typically, this means paying anywhere from $25-$100 per visit before insurance kicks in to cover any other costs. Coinsurance is also common. This means that you pay a percentage of the cost of an office visit and the provider pays the rest. Consider deductibles, copays, and coinsurance requirements when choosing your group health insurance plans.

Look For Extra Benefits

Group health insurance plans provide benefits beyond medical ones. Many of them offer discounted or free gym memberships, savings on prescription drugs, and a number of other benefits related to health, fitness, and well-being. You might even save money on going to the movies, seeing sporting events, or attending other entertainment venues. When comparing plans with your group health insurance broker, if you have two that offer the same medical benefits, consider whether there are added benefits such as travel savings, food delivery options, online learning choices, or warehouse club memberships.

Think About Exchange Options

There are also options called private or public health exchanges. These exchanges used to be known as the Small Business Health Options Program. When you use an exchange, you and your employees will have access to multiple health plans and coverage options. You decide how much you want to contribute to their insurance via a fixed percentage or dollar amount.

Schedule a Consultation With a Group Health Insurance Broker

Are you reading to talk to a group health insurance broker about finding the right health insurance plans to meet your company’s needs?
Contact the professionals at Sackett & Associates Insurance Services. We are ready to help!