Group health insurance is one of the most expensive items for employee benefits. Sometimes to save dollars, employers select inferior policies, increase deductibles to outrageous amounts or cut vital parts from the program. Selecting the right plan is what it takes to create the most cost-efficient health insurance program for your employees.
- Look at your history of claims and the age of your workers and their needs when you select a group health policy. Some policies fit healthy groups with few claims and are a way to save money. Other types of policies, like managed care policies, might not be right for your group if few local health care providers are offerend on the list.
- You'll only find the best policy if you know what types are available: traditional indemnity coverage (known as fee for service plans), partially or wholly self-insured and managed care plans. The partially or wholly self-insured can be either managed care or indemnity.
- Self-insurance isn't just for huge companies. Smaller companies can use a form of partial self-insurance. The plan offers a traditional health plan with a high deductible and a side fund to offset the smaller claims. Many times insurance companies offer these as packages and include the option of managed care. If you have a healthy workforce, this is a true cost savings since you keep all the money not used in the side fund for future years.
- Some people love managed care, while others hate it. The original managed care, HMOs, were rigid and required the primary care physician to give permission for a consult to a specialist. No provisions were included for alternative health care providers. PPOs and POS plans offer the options of other providers but include incentives in the form of lower co-pays and deductibles when you use network providers. Indemnity policies allow your workers to use any health care providers. Look carefully at the network of doctors if you choose managed care plans. Make certain the list contains easily accessible hospitals and physicians.
- If you make a few changes to a present plan or look for the most feasible deductible and co-pay combination, you'll save money and still offer a good plan for your employees. Most plans with managed care features have co-pays. All types of plans have deductibles. The higher the deductible, the lower the plan's cost. This is also true for co-pays. When you look for plans, make certain you compare apples to apples. Ask for several quotes with varying amounts of deductibles and co-pays.
- Most plans set a limit for the amount that your employees pay out of pocket. Without this and even with the best plan, an employee could be bankrupt with a catastrophic claim. The higher the out-of-pocket maximum, the lower the cost is for the health plan. Find a reasonable amount that won't break the budget of your workers. Lifetime maximum coverage should be at least a million dollars. Some plans offer as low as $50,000, which isn't enough to cover a few weeks stay in intensive care. Increased maximum lifetime coverage isn't a huge cost increase, so make it a priority.
评论