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.
It was unique among carriers then
and still is seldom duplicated now
although the other carriers are
attempting to match the option.
Employee Elect is the perfect blend
of employee choice and flexibility
combined with employer control over
group
health benefits cost.
Essentially, Employee Elect and
Health Net's option allows 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 especially
since Blue Cross tends to be
well-priced relative to other
carriers and 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.
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 $40 Copay. 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.
Small
Group
RAFF
Why
offer
Small
Group
health
insurance
Guide to
Group
health
insurance
in
California
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