Key questions employers should ask before choosing group health coverage

By Richard Argentieri, Senior Vice President of Sales | Independent Health

Health coverage is widely considered to be the most important employee benefit. As a result, employers often find that offering health insurance helps them better attract and retain top talent.

When it comes to selecting a health plan, health benefit managers want to find one that best meets the needs of their organization as well as their employees. However, health insurance can be complex and complicated. Plus, one must first make sense of the options, and there are lots of them.

It’s important for employers to understand that not all health insurance companies are the same. There’s a wide array of plans, providers and coverage options to choose from. Navigating among them can be difficult. In order to make a choice that is right for your business and employees, look at the full picture when making health coverage decisions.

Health care decision makers should keep these three questions in mind when researching and comparing health plans:

Question 1: What plan provides the best value for your health care dollar?

With health care being among the fastest-growing costs for businesses across the nation, employers must look beyond premiums and deeper into the value-added benefits, copayments, coinsurance and deductibles of the plan options. While the premium of a plan is certainly a factor that has to be weighed, quality and value should be considered as well. Lower premium plans tend to have higher out-of-pocket costs. On the other hand, higher premium plans often offer enhanced services and greater value.

Make sure a plan has a proven track record of delivering new products and benefits that meet the ever-changing needs and lifestyles of its members. Also, check if it offers programs, resources and innovative engagement tools to help keep its members as healthy and productive as possible.

A report by Integrated Benefits Institute released late last year found that lost productivity from illness costs employers $530 billion annually, or 60 cents for every dollar they spend on health coverage. Some health plans do a better job than others of helping members take charge of their health and better manage prevalent and costly chronic illnesses, such as diabetes, hypertension, obesity and heart disease. This should definitely be a key factor for every health benefit manager since there’s such a strong link between better health and better job performance.

Question 2: How well does the plan collaborate or coordinate with physicians?

Poorly managed chronic conditions can lead to unnecessary health care costs in terms of unmet medical needs and complications. Health plans that provide physicians with the right information, support and care coordination can lead to more proactive management of medical conditions, better communication among doctors and better outcomes. Provider perspectives and opinions on which plans work better with providers can be a helpful guide to the right health plan.

Choosing a plan that has a strong, collaborative relationship with providers can result in better coordinated care for your employees and lower overall costs.


Question 3: Is the plan known for providing excellent customer service?

Due to the complexity of the health care industry, employers and their employees will have questions and need help somewhere along the way. Pick a plan that understands the local market and has a reputation for excellence in member service and satisfaction so when you have questions, getting answers is easy.

The fewer customer service issues your employees have, the fewer issues you’ll have to deal from a human resources perspective. You can often rely on annual third-party rankings and customer satisfaction survey results – such as the NCQA Health Insurance Plan Ratings and J.D. Power’s Commercial Member Health Plan StudySM – to learn how pleased a membership is with a plan’s overall performance. This is a good indication of how satisfied you and your employees will be, and how well they may be taken care of when they need services.

Choosing the right health plan is an important decision for employees and businesses alike. By asking a few simple questions and doing a little homework, health benefit managers will be well-positioned to make the right choice for everyone.

About The Author

As senior vice president of sales at Independent Health, Richard Argentieri is currently responsible for developing and successfully implementing sales strategies to retain and grow membership in the small and large group commercial health insurance market for both fully insured and self-funded segments. He was originally hired by Independent Health in 2003 to oversee the initiation, development and successful execution of sales, marketing and operations strategies for the company’s IRS-qualified reimbursement account products and services, including flexible spending accounts (FSA) and health reimbursement accounts (HRA). Argentieri earned his bachelor’s degree in marketing and management from Canisius College.



Disclaimer: The above commentary entails the views of the author and not necessarily the views of the Buffalo Niagara Partnership.