How to choose your California Group health
plan
As simple as the question is, the answers to
choosing your California group health insurance
plan are complex and many.
Since "it depends" doesn't really help much,
let's look at some key issues in the choice and
see if we can at least narrow the options.
As luck would have it, the best approach is
not to pick a plan at all but choose a carrier
and a great option that offers flexibility and
budgetary control.
The Small Group equivalent of a Cafeteria
plan
Anthem Blue Cross was the first to originate
the Small Group cafeteria with the unveiling of
their Employee Elect option.
Most of the major carriers offer a version of
this which allows employees to choose different
plans based on some fixed % or contribution.
These options are the perfect blend of
employee choice and flexibility combined with
employer control over group health benefits
cost. Essentially, these "cafeteria" options
allow the employer to offer all the plans to
each employee and establish a fixed company
contribution or % contribution (of a certain
plan).
Employees can match their health coverage
requirements with their own budgets while the
employer can fix his/her costs to a given
monthly budget. When an employer tries to choose
a "one size fits all" plan for their carriers,
it rarely works for everyone. Some people have
preferences for HMO's while other detest them.
The same can be true for PPO's where people
do not like the cost sharing aspect of them.
Some employees want to keep their cost to a
minimum while others have large health bills and
would rather contribute more and have richer
benefits. This option is hard to beat since it
offers a full suite of HMO, PPO, HSA, and Basic
Hospital plans.
It's hard to find a better choice for Small
Group health coverage in California than
Employee Elect or the equivalent with another
carrier.
Anthem Blue Cross also works well for out of
State employees because of their participation
in the Blue Card network for PPO plans. The
carrier has extensive networks throughout
California and is run by Wellpoint, which is
arguably one of the top two health carriers in
the Nation.
What if your Company decides on another
California health insurance carrier?
There are times when an employer requests a
carrier that does not offer an option such as
Employee Elect.
In this case, how does a company go
about analyzing and choosing a California group
health insurance plan.
There are a few ways to look at this.
Choosing a Small Group health plan based on
company budget
The easiest approach is to decide on your
monthly Company benefits budget and choose a
plan that fits within this budget.
You can either pick a plan that the company
will pay 100% of according to the monthly budget
or a plan in which a company will pay a
percentage (California Guaranteed issue mandates
at least 50% of the employee's premium) of that
plan.
Essentially, you are trying to choose the
richest plan that stays within your budget. This
works if you have designated budget that you
absolutely must stay within.
Choosing a Group health plan based on type
of industry and employees.
For some employers, the budget issue is not
so concrete as to narrow options.
In this case, it's important to look at the
type of industry your company is in and also,
the type of employees you are looking to acquire
and retain. The major health insurance carriers
typically have a suite of HMO, PPO, and HSA
plans with different price points and benefit
levels. For example, on the PPO side, there may
be a $10 Copay, $20 Copay, and so on down to the
high deductible plans.
The deductible, coinsurance percentage, max
out of pocket, prescription costs and of course,
monthly premium changes as you go up the scale.
The HMO's and HSA's usually have this graduated
approach as well.
The level you would choose depends on what type
of employee are trying to retain. If you are in
the high-tech arena, employees may expect richer
benefit packages as they are coming from larger
companies and are used to such a level.
We usually see $10 or $20 copay plans in this
situation.
For a small service or manufacturing company,
the $30 or $40 might be adequate. Some employers
wish to offer richer benefits to offset lower
wages in a given industry.
Completing the benefits package with dental
and/or vision.
An inexpensive way to complement your choice
of Group health insurance plan is to offer
dental and/or vision.
Dental and vision is actually quite
valued by employees even though health insurance
is covering the real risk. Dental and especially
vision benefits can be very inexpensive relative
to the perceived value from the employees.
The same requirements for participation and
contribution levels apply to Dental insurance.
Vision typically requires 100% participation.
The Employee Elect option above can also apply
to the dental suite of plans as well.
In the end, there are dozens of plans on the
market.
Since employers are typically not analyzing
and choosing Group health benefits all the time,
it can be confusing. In the end, it is probably
best to speak to your California group health
insurance broker regarding your particular
situation. With the above points, as least you
some important avenues to explore with your
health broker after you have run your California
group health insurance quote.
You can run your
California
Group Health Plans Quote
to view rates and plans side by side from the major carriers...Free.
Again, there is absolutely no
cost to you for our services. Call 800-320-6269 Today!