Tips for Selecting the Right Health insurance Plan for Your Small Group (US Life & Health)

Posted August 5 2014


Tips for Selecting the Right Health insurance Plan for Your Small GroupChoosing a health insurance plan for your small group or company is a weighty responsibility. Whether you are purchasing benefits for the first time or already have a group benefit plan in place and are looking for a more affordable alternative, your number one priority is keeping your employees safe and healthy. Since the decisions you make can have a profound effect on the physical and financial well-being of your employees, your co-workers, and yourself, the Insurance Specialists at MHG Insurance Brokers have provided these five tips for selecting the right health insurance plan for your small group in hopes of making your task a little easier.

  1. Pick an insurance carrier that is widely accepted.

    Recently carriers have introduced limited networks that are accepted by very few providers. Protect your employees by staying away from plans with names that include words like “Select”.

  2. Include plans with various prices and benefit levels.

     Plans with higher deductibles have lower premiums, making them more affordable. Since your employees have different financial circumstances, be certain to include a plan that includes copays for physician visits, prescriptions, urgent care, and emergency room visits (if possible).

  3. Understand the difference between copays and coinsurance.

    Copays are a fixed dollar amount, while coinsurance is in the form of a percentage.

  4. Verify what each plan includes in the out of pocket maximum.

    For plans purchased from 2014 onward, the out of pocket maximum includes the deductible, copays, coinsurance, and prescriptions. Some of these may have been excluded in previous years and on current plans that were purchased prior to 2014.

  5. Make sure your employees understand HMOs, PPOs, and POS plans.

    These plans have similar benefits, but some distinct differences greatly affect coverage. The key differences are as follows:

    1. HMO plans require that the members use in network providers only.

      Generally less expensive than similar PPO or POS plans, HMOs require members to select a Primary Care Physician (PCP); before members can see a Specialist, they must get a referral from their PCP. In recent years, Open Access HMOs that do not require PCP selection or referrals have become more prevalent. HMO benefits are restricted to a particular geographic region.

    2. POS plans are HMO derivatives that include out of network benefits.

      POS plans resemble HMOs for in-network services; services received outside of the network are usually reimbursed based on a fee schedule, or what is considered to be reasonable and customary charges.

    3. PPO plans have in and out of network benefits.

      Referrals are never required with a PPO. Members have the option of seeing any doctor they choose, although benefits paid for visits to out of network doctors can be considerably lower.

    4. HSA (Health Savings Accounts) work with HDHP (High Deductible Health Plans) but generally do not pay benefits until the plan deductible is met.

      Once the deductible is met, members usually do not have copays for routine benefits like physicians’ visits, prescriptions, etc.
Selecting the right health insurance plan for your business is an important responsibility. The experienced insurance brokers at MHG will help you sort through the terminology and key features to determine the best group health insurance plan for your business, taking into account your employees’ circumstances, coverage requirements, and budgets. MHG Insurance Brokers offers a wide range of insurance coverage for businesses and individuals including disability insurance, life insurance, travel insurance, and more. 

Call MHG Insurance Brokers today at 954-828-1819 or visit us online at mhginsurance.com for help in selecting the ideal group health insurance policies for your business.