|
|
|
|
|
|
|
|
Evaluating Health Coverage
Health coverage is complex. It's often loaded with so many details that it can be very difficult to focus on the issues that are most important for you as a small business owner. Very generally speaking, the main considerations to worry about boil down to the plan's benefits, cost, and choice. Say it again: benefits, cost, and choice. Remember these three main issues when evaluating and comparing plans.
Taking it a step further, be sure to answer the following questions when considering a plan:
- What services does the plan cover? You'll want to make sure the plan benefits include the services most important to you and your employees. (Also keep in mind that, typically, the more that's covered, the more the plan will cost.)
- What physicians and hospitals can participants use? Managed care plans typically limit participants to a network of providers, and charge more if participants visit providers outside the network.
- How much will the plan cost per month? The monthly premium is a primary concern for most employers.
- How much will the participants be charged at the time of service? Besides the monthly premium, many plans involve what's known as "cost-sharing," in which participants pay a fee at the time of service (a copayment) or a percentage of the total cost (called co-insurance).
- Can participants choose among more than one health plan or benefit package? Choice among health plans is a feature of purchasing through a purchasing alliance, which we discuss in Part Two: Getting Covered. Increased choice is generally preferable, but may cost more. Some carriers (for example, Blue Cross of California) allow small businesses to offer their employees choice among multiple benefit packages. Under such an arrangement, some employees might choose a high-deductible PPO product, others a low-deductible PPO, and still others an HMO. Carriers that provide choice of products may require that they be the only carrier offered in the group.
- Is the insurer a quality company? Be sure to consider the insurer when evaluating plans. Is the company financially solvent? Does it monitor quality? Does it offer excellent customer service?
 |
For help in thinking about how specific health coverage options stack up against your needs, see the "Plan Type Comparison" chart, the "Plan Type/Price Range Generator" tool, and the "Cost Estimator" in the tool box. |
|
|