Considerations When Setting Up a Group Health Insurance Plan

Whether you are the owner of a small business or a large corporation, finding affordable group health coverage can be tough, especially if you are unaware of the facts and fallacies of group health insurance plans. To make smart decisions, you need to understand how group health insurance works.

  • Protecting the Finances of Employees
    The employees who fall under the group health insurance coverage are entitled to discounted rates for medical care. Insurance shields them from unexpected costs and can protect them from ACA tax penalties (people who can maintain qualifying coverage without an unpermitted gap will not face the affordable health care act tax penalty).
  • Protecting the Health of Employees
    As a member of a health insurance plan, an employee has access to quality healthcare. In the case of medical emergencies and chronic health conditions, they have access to a number of doctors and healthcare providers. When covered under group health insurance plans, employees are likely to take advantage of regular check-ups. This keeps them healthy and increases employee productivity.
  • Protecting Employer’s Business
    Entrepreneurs may face unexpected medical expenses that could cripple their businesses. The requirements for group health insurance limits their personal liability for medical costs, thus keeping their businesses afloat. Group health insurance is an added perk for employees.

In a group health insurance plan, the costs are typically divided between the employer and the employee. The group insurance coverage may also be extended to dependents. Sometimes employers may be eligible for special tax incentives for providing group insurance coverage to employees.
According to the data released by the Employee Benefit Research Institute, group health insurance is the most important employee benefit that a company can offer. To meet the group health insurance eligibility requirements, there is the process that every employer must follow…

Evaluate Your Requirements

Selecting a group health insurance plan means you need to know your priorities well as those of your employees. Consider the following factors when making an informed choice:

  • People to be Covered: It is important to opt for an affordable group health insurance plan if you are planning to cover yourself and your family, as well as your employees and their dependants. Select a plan that is tailored to meet various medical and financial needs. Also, it is important to find out the number of employees who are interested in the plan. Some may already have coverage through spouses and other members of the family. This means a lesser number of employees will be interested in participating in a plan.
  • Knowing Your Affordability: Although group health insurance is employer-sponsored, the monthly premiums are paid by both the employer and employees. So, the employer needs to keep in mind his employees’ budget.
  • Choosing the Right Plan: Group health insurance plans can come with a low premium yet a higher annual deductible, or lower deductibles with higher monthly premiums. It is important for the employer to opt for a plan where there is a balance between the monthly premium and deductibles that will work for most employees.
  • Plan Benefits: Although the federal policies prevent the employers from asking their employees about the personal medical histories, the employer may still ask them about the types of health insurance benefits they consider essential. When employers are aware of the benefits that are most valued by employees, they can opt for a plan that is more likely to meet everyone’s needs.
  • Anonymous Survey: It may be helpful to create an anonymous survey to collect necessary information from your employees. This way you can get the information you need without violating their privacy.

Knowing Medical Provider Networks

If you and most of your employees have a preferred doctor or hospital, make sure to find out that they are in-network for the group health insurance plan that you choose. If claims are denied it will create dissatisfaction among your staff.

Covering Prescription Drugs

Different group health insurance plans cover different prescription drugs. When considering the insurance coverage, find out what you’re estimated to pay for the prescriptions.

Considering Voluntary Benefits

Vision care, dental care, and accident insurance are considered essential voluntary benefits. Does your group health insurance plan cover these benefits? Every employer should consider offering these added benefits when selecting a group health insurance plan.

Applying for Coverage

The application process requires that you answer all the questions honestly to the best of your knowledge. Remember, if your business legally qualifies in your state, you are automatically eligible for group health insurance.

Adding & Removing Coverage

Employees may leave a company and new employees may take their places. Dependants may change from time to time. As such, employers need to periodically review the group health insurance plan to make changes to the number of people covered in the plan. The agent of a reputed health insurance company will help you make these changes.
The best group insurance plan is the one that meets the needs of both the employer and the staff. If the employees have any concerns or questions regarding the plan, the insurance providers must address those concerns. Providers must address all issues whether they are about a change in coverage, deductibles, or co-payments.

Obtaining Professional Assistance

Setting up a group health insurance plan can be a complex process. The analysis that needs to be performed in order to choose a fiscally prudent group health insurance plan is vast and complicated. At CREST Insurance Group, we work closely with you to analyze your business needs and then determine the group health insurance coverage options that are most suitable for you. Contact our advisors today!