Now that you've decided to offer group insurance to your employees, you're ready to start pricing out options and offerings. This article will help you sort through the important factors to consider—beyond premium cost.

What employees will pay

Beyond the monthly premium payments, how will your employees be paying for care and services? Determine if the plan requires simple co-pays, which allow employees to “pay as they go” for using the plan's services, or if they have to pay more money up front in a deductible before insurance coverage kicks in.

  • Why it matters: You want your employees to use their health plan, otherwise, what are you paying for? For many employees, planning their budget around a copay is preferable to a estimating for a higher cost deductible.

In-network and/or out-network doctors and hospitals

Your plan's network determines which doctors you and your employees can see. When you're looking at several plans that all share the same base price, take a closer look at the network, and consider what your employees would find most valuable. If you'll be offering a narrow network plan, make sure there are a sufficient number of doctors, health care facilities, or hospitals in the network your employees would use.

  • Why it matters: The ability to use providers outside the network is important to some healthcare consumers. But when going outside the network is an option, employees often pay a higher price for services provided by an out-of-network doctor.

Dental and vision coverage

Some plans may include voluntary benefits like dental and vision to provide employees with more choice—without incurring any additional costs to your budget.

How? Employees often pay the full cost of these benefits, but enjoy the advantage of group rates when offered through their workplace. Wellness incentive programs (e.g. smoking cessation or weight loss programs) are another potential component of a plan that may not cost more, but provide added value and encourage your employees to maintain their health.

  • Why it matters: Providing voluntary benefits helps attract, and retain, the best : 88 percent of employees want some kind of voluntary health benefits.1

Prescription drug coverage

Most employer-sponsored health plans have a prescription drug benefit, so as you’re researching or comparing plans take time to understand how the plan(s) you’re considering covers prescriptions.

For example, prescription coverage with a copay means the member doesn't have to meet a deductible before receiving drug coverage, but each prescription is typically subject to a co-payment. On the other hand, prescription coverage after meeting a deductible requires the member to meet the plan's annual deductible before insurance covers any of the cost for prescription drugs.

  • Why it matters: If your employees or their insured family members rely on prescription drugs to maintain health, consider which type of plan will make a meaningful difference among your employee base.

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