Choosing that company health insurance plan (without the headache)

So as you may have found out the hard way, choosing a company health insurance plan can be rough.  There are thousands of options to choose from.  Getting quotes back can be overwhelming.  And if you aren’t sure what you’re looking at, or even what you’re looking for, it’s even worse.  

So let’s break it down nice and easy, shall we?

The options

There are four health plan options:

You’ll find different features, benefits and price points across all of these. Now let’s discuss the significance of all of them and why they differentiate in price.

The features

There are 2 main variables across all plans which determine the price point. The first variable: do you need to go through a referral doctor (your primary care physician) in order to coordinate the rest of your health services? The second variable: does the plan cover out-of-network coverage (at a premium cost, with a separate deductible)?

Now you may think these variables aren’t significant or don’t play a major role in your personal coverage but that is definitely not the case. It can be extremely frustrating and time consuming to call your primary care physician and coordinate an appointment with a hard-to-book specialist. At the same time, it can be extremely expensive to see a doctor that is not in your network and leave you stuck with a headache-inducing bill.

Here’s a breakdown of how these factors play out:

As you can see, the most affordable plan (the HMO) requires you to go through a PCP and does not provide out-of-network coverage while the PPO does not require the referral and allows you to go out-of-network. The EPO and POS plans fall in the middle since they each offer one benefit.

Making a choice

Determining which of these plans is better for you is a personal preference. Some individuals may actually prefer to go through a PCP so they can develop a more personal relationship with their doctor while others care strictly about the convenience of going to any doctor whenever they want.

On the other hand, some people would rather know they are covered within their network and are diligent about staying within that network, while others want the flexibility of seeing any doctor they want.

These decisions are ultimately up to you. Choosing the right company health insurance plan should be a matter of comfort and personal preference, knowing that you are covered properly for your medical expenses, in a way that works for you.

Talk to us to help choose the best plan & benefits structure for yourself and your company.

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  • Thanks for explaining how there are four health plan options, including point of service and preferred provider organization, that offer different features, benefits, and price. Since this is the case, it could help to consider your business and how it runs as well as the types of service you offer so that you can find a plan that works best for your situation. Once you’ve determined the kind you need, you’d probably want to research and meet with the different providers in order to talk to them about their services and your situation to make sure they can give you the features and benefits you want at an affordable price.

  • Currently, my sister is developing business plans for her future company. She is also going to be busier the coming weeks because she will also meet up with experts and be educated about hiring employees. She mentioned that she will also look for an insurance company to help her understand the benefits of getting group benefit plans. So to help her find a good insurance company, I initiated to research for tips which made her really thankful. And I agree that, when looking for a company, it is important to feel comfortable and make sure that it fits their personal preference. Thanks!

  • I liked that you said that one thing to consider when you are planning to buy insurance is to look at the benefits that teach plan features and find one plan that will meet your needs at the cost you are willing to spend. I have been thinking about getting better insurance coverage but I have been worried about the cost. I will be sure to research my options in order to find one that will meet my most important needs and in my price range so that I can receive help and be able to afford the help.

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