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Tips on choosing health insurance for employees

Gough, David TIf you have full-time employees, you’ve probably faced the question: Which health plan should I offer? Navigating the ins and outs of choosing a health plan can seem time-consuming, confusing, and frustrating.

Fortunately, it doesn’t have to be.

Simplify the process by asking your prospective health insurance company a few vital questions about the plans they offer. These questions can help you decide on a plan that saves your business time and money by maximizing your employee’s health – which reduces absenteeism, increases productivity, and keeps the premiums low. Here are five basic questions to get you started:

• What’s the cost? The key here is the price per employee – but it goes deeper than just the premium’s price tag. Remember that the future health of your employees will have bearing on your premiums in the long run, so be sure to choose a plan that incentivizes them to be healthy.

• What’s covered? Look at the services for diabetes, cancer, or shoulder injury – but also examine how many provider and facility choices the plan offers. Numerous insurance plans now offer directed networks of doctors, providers, and facilities that coordinate health records, quality standards, and data to keep prices lower and premiums down. Choose a plan that leverages the value of these directed networks.

• How healthy are my employees? Choose a plan that will work with you to keep a pulse on the overall health of your employees by providing useful metrics and data. Health plans that include networks provide Health Risk Assessments for employees to gather data about risk factors for disease – and help you plan and avoid those risks appropriately by providing real-time monitoring, treatment and measurements.

• What’s the track record? One major local employer, with a plan that included the Saint Alphonsus Health System, reduced yearly spending on employee health by around 3.6 percent last year alone – against a local trend of 6.9 percent increases in employee health costs. Talk to physicians, other reputable organizations, and multiple health plans about what they offer to get a better sense about what works best.

• What are the extras? Look for a plan with a network that includes extra programs like smoking cessation, blood draws, diagnostic testing, nutrition counselors, and system navigators. All of these additions will help keep your employees accountable for their own health, while also decreasing the likelihood that they will use services or providers incorrectly, racking up unintentional costs and potentially increasing premiums. Instead, your employees should be offered a health plan and a network that works personally with them and their individual needs.

It’s important to remember that what works for one employer may not work for another. Your health plan should be customized to fit you and your company’s needs – so at the end of the day, your employees are healthy and happy, and you’ll be seeing the benefits of increased productivity and a better balance sheet.

Dr. David Gough is president of the Saint Alphonsus Health Alliance, a network based on bringing employed and independent physicians together to build a better healthcare system for patients and the local community.



About David Gough OD