Espanol
Part One: Getting Started
Part Two: Getting Covered
Reference Guide
Benefits, Providers, and Costs
Coverage Types
Eligibility and Enrollment
Purchasing Coverage
Laws and Rights
Other Resources
Helpful Tools
Register for Updates

Reference Guide
Purchasing Coverage
  back  print friendly

Related Topics
Evaluating Health Coverage
Plan Value: Balancing Benefits and Costs
Other Resources
Insurer Rating Companies
Quality of Health Care

Evaluating Insurers and Health Plans

Financial Stability
Quality of Health Care
Customer Service

A plan may look good, but if the insurer turns out to be hard to deal with—or if it goes bankrupt, for that matter—you'll likely wish you had picked a different plan. Do a little research to make sure that your potential insurer:
  • Is financially stable.
  • Gets high marks in quality from an unbiased source.
  • Makes customer service a priority.

Financial Stability

You can find out if your insurer is financially stable by researching its financial rating. A number of companies provide this service, usually for free, though some companies may offer more information at a price.

See "Insurer Rating Companies" in the tool box.

Quality of Health Care

The quality of health care varies widely. In addition to doctors, hospitals, and medical groups, insurers play an important role in seeing that you receive high-quality health services. Be sure to look into the insurer's reputation and ratings for the quality of care provided under their plan.

In the tool box, find out more about the "Quality of Health Care" and how to factor this into health coverage decisions.

Customer Service

Look for an insurer who makes it easy for you to pay the bill and get help when you need it. Your broker can advise you on which insurers provide great service, and which give employers health care headaches. The best insurers also make it easy for employees to:
  • Find provider information. Most insurers have printed provider directories that customer service representatives can mail to participants upon request. Some also offer provider directories online.
  • Resolve claims quickly and efficiently. There's nothing more annoying for employees and employers alike than dealing with an insurer who incorrectly processes claims, or processes them so long after a service that it makes it difficult to fix errors.
  • Reach someone who can help them resolve a problem. Look for insurer customer service representatives who can handle both claims and member service requests, such as ordering a member ID card or changing primary care physicians.
Other documents in the Purchasing Coverage section:

Brokers
Budgeting and Cash Flow
Employee Census
Evaluating Health Coverage
Evaluating Insurers and Health Plans
Plan Contract and Implementation
Plan Value: Balancing Benefits and Costs
Preparing to Purchase Group Coverage
Purchasing Alliances
Purchasing Strategies
Purchasing Without a Broker
Trade Associations

 

 
1438 Webster Street Suite 400, Oakland, CA 94612
Privacy Policy Terms of Use