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How to Choose a HMO or PPO Group Insurance for a Small Company

Many companies opt to offer insurance to their employees as a benefit. For most, health insurance is the second-largest expenditure in their budget, especially for a small company. Because of this, careful consideration and planning must go into the choice of medical coverage. If you are planning to provide health benefits to your employees, there are several things that need to be considered before selecting a plan for your business.

Review insurance plans and rates online. There are several websites that will allow you to identify and rank group health insurance plans. Plans can be ranked by state, costs and services offered. You can also sort results by plan needs.

Determine what type of coverage to offer. Talk to your employees and find out the types of coverage they need and how much they are willing to contribute. Analyze your employees: Are they older or younger workers? Are they single or do they have families? Are they healthy or do they have medical issues? Make a list of your findings.

Get bids from at least three companies that offer the services you are considering. Write a Request for Proposal (RFP) and send it to them. Your RFP should include a request for a price quote, network coverage information and any questions about the plans and services that you would like answered.

Educate yourself on the differences between a Health Management Organization (HMO) and a Preferred Provider Organization (PPO). Briefly, an HMO requires a gatekeeper; meaning that members must receive a referral from a general practitioner in order to see a specialist. A PPO does not have a gatekeeper, so its members can choose whatever doctor they feel they need to see.

Select a plan. If possible, speak with the insurance companies' references. Ask if they are happy with the companies' customer service and claims departments and the benefits in general. It is better that the reference(s) be from a group similar in size to your own. Choose the plan that offers the best coverage for the budget you have to work with.

Difficulty: Moderate

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