Picking the right Group Plan

What to look for when picking a Group Benefits or Group Insurance Plan;

First, there are a lot of things to consider when you are exploring Group Plans, or in the selection phase of a Group Benefits Package.  One of the toughest things you will need to ask your self is this, does this cover all my bases, or do we have atypical concerns that wont be addressed?  If you think you may have a special case, please send us an email, call or submit a request for some time to talk.  There are some special cases that are really difficult to anticipate, and those should be addressed on a case by case basis.

The Common Metrics of Selecting a Benefits Plan

These are the areas that everyone will want to know about selecting the right Group Insurance Plan and Benefits Compensation Package.  Please take some time to overlook these main bullet points to help you zero in on the best Insurance Coverage for your business. 

Some questions you should ask, or statements you might consider

  • Start with the service area, does the plan have service providers or is it available where all of your employees reside?
  • How will the coverage feel when your employees use their plan, do they have reasonable Co-Pays, is their Deductible very high, and where is their Out of Pocket Maximum (OOP) in the plan?
  • What type of Co-Insurance is involved in the plan?
  • Are your Co-Pays preempted before any Deductible or Co-Insurance (which is a good thing), if so what procedures or visits does this apply too?
  • Do the plans you are looking at have the Doctors, Drugs and Hospitals that matter to you and your employees, you can use our Search Tool Here to check.
  • Is the Insurance Company customer friendly, and do they work well with your Broker?
  • What are the Participation Guidelines and Underwriting Requirements? 
  • Will you be allowed to have multiple Insurance Carriers alongside each other with the Plan?
  • Do you want the flexibility of a PPO or an EPO which generally allows your employees to see providers and physicians without a referral.
  • Are HMO's best for you, do you prefer a Managed Care Plan that provides you referrals to see and treat you as needed.
  • Do you want to pay for a Broad Network, or is a more Local Network all you need?
  • What are your Urgent Care Options, and do you have Tele-Medicine Services included?
  • Is Covered California Shop, Covered CA the best option for you, or are we better applying directly through your Insurance Carrier of Choice?
  • What type of Out of State Coverage are you offered, and what do you really need?
  • Which Plans or Companies are going to offer you the lowest rates that will meet your goals?
  •  Please pay attention to the Deductibles, Co-Insurance and Co-Pays more so than the Metal Levels like; Bronze Silver Gold or Platinum.

What Next?

Now that you are familiar with what to look for, you will also need to know what to do, and what you are required to provide for both your Employees from a Compliance Standard.  Please Click Here.

If you have any questions, or would prefer to talk over the phone or meet in person, Contact us Here, or call for a time to talk at 424-263-4699.  We are located at 716 Yarmouth Rd. Suite 210, Palos Verdes Estates CA 90274.