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Key factors to consider when choosing a healthcare plan

Choosing a health insurance plan can be a complex process, as it often involves different levels, options and quality of care. There are three main considerations when evaluating and comparing health insurance plans: plan benefits, costs and flexibility.

Plan benefits: Consider what services are covered under your selected plan. You will want to ensure that services most important to you and your employees are part of your selected plan. Similarly, it’s important to check if your current healthcare provider is considered in-network, meaning you or your employees won’t be paying extra to see their preferred doctors. Although this may be tricky and more difficult to control, it might be worth taking the extra time to figure out a way to choose a plan that covers your primary care physician (PCP) or find an alternative PCP in your new plan.

Plan costs: We know monthly premiums are a primary concern for most employers, which is why it’s important to recognize that there might be additional costs involved. Many plans have 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). In addition, both employers and employees should keep in mind deductibles and out-of-pocket maximums, which can greatly impact how much you end up paying at the end of your plan’s year.

Flexibility: If you’re looking for flexibility and choices in your health insurance plans, it will typically cost more. Some insurance carriers allow small businesses to choose from a variety of benefit packages where employees might choose a high-deductible PPO product, others a low-deductible PPO, and others an HMO. Insurance carriers that provide a choice of products may require that they be the only carrier offered in the group. Be sure to consider the quality of the insurer when evaluating plans. Is the company financially solvent? Does it provide quality care? Does it offer excellent customer service?