Offering California Group Health Insurance To Your Employees – Where to Start

The process of selecting California group health insurance coverage for your employees can be a very daunting task.  Insurance by nature tends to be very confusing, convoluted, and down right frustrating.  With today’s marketplace, and the present state of the economy, it has never been more important to offer proper benefits to both retain and attract employees. 

The easiest way to begin the process of choosing the right CA group health insurance plan is to gain a firm understanding of the three most important components of insurance:  benefits, providers, and price.

Benefits

Benefits can vary a great deal for group medical insurance in California.  You can narrow down your options a great deal by first deciding how much coverage you want to provide to your employees.  Determine what absolutely needs to be covered (preventative care, maternity care, routine screenings, etc.), and what other services could be covered (vision care, dental care, prescription drug coverage, etc.).  Once you have set your basic guidelines, you will then need to consider the benefit package details.  The most common options include:  a comprehensive plan that covers everything except for a patient co-pay, which can range from $5 to $20 per office visit; a plan that utilizes an “out of pocket maximum” per employee, which means each employee or person covered on the plan has to pay out of pocket a certain amount before the insurance picks up coverage; a hospital co-insurance plan, which can range from one hundred percent to eighty percent coverage for most services; or a plan that covers basic medical care and offers a prescription co-pay plan for generic and most brand named drugs.

Providers

This is often the step where things get complicated.  You should always try to choose a plan that includes the doctors that you and your employees want, and one that offers a large provider network.  Having CA group medical insurance does not do anyone any good if they cannot keep their primary care physician, or if the network doctors are inconvenient and out of the employee’s area of residence.

Price

Price is always a major factor when choosing a group health insurance plan.  While everyone wants the cheapest plan with most benefits, it is not always best to choose a plan simply because of a low cost.  Take a bit of time and compare each plan; how do the plans compare to each other on a monthly cost basis?   Are you sacrificing employee coverage and care just so you can save a few pennies?  This certainly does not have to be the case.  There are several ways you can lower the cost to you and your business, but still offer high quality health insurance to your employees.  Consider these plan options:  Stand Along Plans, Mix and Match Plans, Employee Buy Up Options, and Carve Out Plans. 

Stand along plans allow you to offer more than one option to your employees so they can choose the plan that is right for their specific needs.  For example, you may offer both a Health Net HMO plan and a Blue Cross Blue Shield PPO plan.  The two plans would then “stand along” each other, and allow for the two options to “wrap around” coverage.  This type of plan usually has minimum requirements.

Mix and match plans, sometimes referred to as an employee elect plan, offer more than one type of plan through a single insurance company.  For example, one insurance provider may allow a group to purchase both their HMO and PPO plans.  The company may supply employees with the less expensive HMO plan and give the employees the option of “buying up” (also known as an employee buy up option) to the more expensive PPO plan.

Carve out plans supply group health coverage only to certain types of employees (general workforce, managers, salaried employees, etc.).  This option still allows companies to get the benefits of a group plan, but only incur the expense for covering a few of their employees.  Businesses usually take on this type of plan to save money.  CA group health insurance companies allow this practice, but with some limitations such as not guaranteeing that such a plan will be accepted by the company.  California law allows insurance companies to decline coverage for carve-outs in order to protect the insurance companies from having to provide benefits only the sick people within a group.  If the people you want to “carve out” to insure in your company are relatively healthy, this option could be a good strategy.  It would provide some employees with health insurance yet keep the company’s total expenses to a minimum.

Selecting California group health insurance for your employees is not a process that should be rushed.  Talk to your employees, study your bottom line, and take your time to ensure you make the best choice possible for you and your company.