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5 Questions To Ask When Choosing A Group Health Insurance Plan

April 19, 2021, by New City Insurance

Group Health Insurance- Office Employees Hugging Each otherGroup health insurance can be convenient and cost-effective for businesses in need of comprehensive health coverage. According to recent data published by the Kaiser Family Foundation, approximately 49 percent of the total population in the U.S. receive employer-sponsored health insurance.

Questions To Ask When Choosing A Group Health Insurance Plan

With group health insurance, employee premiums are generally less expensive than with an individual health plan, and premiums are paid using pre-tax funds that help workers pay less on their taxes. Employers also pay lower payroll taxes and can deduct annual contributions.

However, not everything about group health insurance is cut-and-dried. Before choosing a group health insurance plan, ask the following important questions:

1. What Types Of Group Health Insurance Are Available?

Group health plans can differ significantly in terms of cost and coverage. There are several main types of group health insurance plans available, including:
HMO – A health maintenance organization (HMO) plan offers healthcare services through a network of healthcare providers that agree to provide services to members. HMO’s offer a variety of perks, such as lower premiums and out-of-pocket expenses.

PPO – A preferred provider organization (PPO) plan is one of the most popular options. It allows plan participants to visit any in-network physician or provider they would like without a referral. In addition, a portion of out-of-pocket claims may be covered by the insurance company.

EPO – An exclusive provider organization (EPO) plan enables plan participants to use doctors and hospitals within an EPO network. There are no out-of-network benefits, but members do have the freedom to see a specialist without a referral. The negotiated rates under an EPO plan are generally lower than with an HMO or PPO plan.

2. Will Group Health Insurance Save Money?

Hands Holding Money and Heart for people with group health insurance plan

With the rapidly increasing costs of individual health plans, many employees find it more cost-effective to switch to a group health insurance plan offered by their employer. Group health insurance plans generally have a lower per-person cost than individual plans in terms of both premiums and deductibles.

There are several reasons why group health insurance is usually less costly, including employer contributions. Most employers cover at least half of the premium, making the premium cost for employees considerably lower. Premiums are also usually paid with pre-tax money, adding to significant savings.

Employers can enjoy certain tax savings when they deduct the amount paid towards employees’ premiums from their business taxes. In some cases, employers may receive special tax credits.

3. Are All Employees Covered By Group Health?

The answer to this question is different for everyone. Some employers may choose to offer group health insurance to all their employees, while others only cover full-time employees. Who will be covered is dependent on how much the business can afford to pay towards these benefits.

When deciding how best to provide coverage to employees, consider the needs of the workers and how frequently they may need to visit a doctor or hospital. Consider sending a survey to all employees to see how many would be interested in having insurance.

4. Is The Plan’s Prescription Drug Coverage Sufficient?

Capsules, Injections on the Table for group health insurance

According to the Health Policy Institute at Georgetown University, more than 131 million people, or approximately 66 percent of U.S. adults, use prescription drugs. The group health insurance plan is chosen must offer adequate coverage for prescription drug costs.

When reviewing this section of the plan, determine if the cost of prescriptions will be affordable and whether an employee requires approval from the health plan provider before filling a prescription.

Also, consider which pharmacies are in-network and if their locations are convenient. If certain prescriptions are not covered, think about alternative options.

5. Will Family Members Be Covered By The Plan?

Many employees rely on group health insurance to provide coverage for their spouses and children. Employers must consider if the plan they are choosing extends to an employee’s dependents, and if so, how much coverage is available for family members.

When deciding whether to choose a plan that covers dependents, employers should consider the age of their employees. If the business hires mostly very young adults without children or older adults with grown children, then an insurance plan that covers dependents may not be a necessary expense.

Speak With An Experienced Benefits Consulting Firm

Choosing the right insurance plan for a business and its employees is paramount to ensure that workers remain healthy and content with their benefit offerings. Do not hesitate to ask plenty of questions about plan options before making a decision.

To learn more about the different types of insurance plans available or speak with an experienced benefits consulting firm, contact New City Insurance’s employee benefits professionals.

Have Additional Questions?
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Filed Under: Group Health Insurance,  Insurance

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Carol Zhang
Carol Zhang
04:29 06 Mar 22
As a rapidly expanding national media organization, the employee benefits strategy and administration that New City has provided us during our growth has been invaluable. They have been proactive about informing us of the different benefit strategies available to us as we grow as well as managing the additional compliance laws and reporting requirements at each stage of our growth.
Claudia Villalobos
Claudia Villalobos
20:14 03 Mar 22
New City Insurance made navigating through all the health insurances super EASY. Their documents are highly informative, professional, and easy to work with. Thank you for making the process of choosing a health plan so simple. You guys are THE BEST!
Philippe Salas
Philippe Salas
17:02 22 Feb 22
I never expected to have a good time talking to an insurance salesman, but let me tell you Brendan was quite the treat. He was very helpful explaining the options and has a wonderful sense of humor. I hope to speak with him every time I call.
Jennifer Polito
Jennifer Polito
17:15 09 Feb 22
Super easy enrollment process. Fast and friendly customer service. If you are looking for an insurance company that is there for you every step of the way I highly recommend New City Insurance.
Rocky Salas
Rocky Salas
23:46 07 Jan 22
So friendly, I hope to speak to him again in all my future insurance needs.
Rocky Salas
Rocky Salas
23:38 07 Jan 22
So friendly and soft spoken. I hope to speak to him again in all my future insurance needs.
Jose Brena
Jose Brena
13:20 06 Jan 22
Eric Calciano has been extremely helpful in finding and selecting the right insurance coverage for our company. With many options out there Eric assisted us on getting a low cost provider saving more than 20% than from our competitors and providing excellent coverage for our employees.
Anastasia Beaverhousen
Anastasia Beaverhousen
17:05 28 Dec 21
Signing up for insurance was quick and easy. Felicity Sundsboe
SFCC
SFCC
22:08 29 Nov 21
Jeff Stoltey and his team provide excellent customer service. Jeff has always provided my company SFCC with straightforward options. I went to a larger insurance company only to RUN BACK to Jeff at New City Insurance. I recommend them to anyone needing insurance without hesitation.
Kevin Luby
Kevin Luby
19:13 22 Oct 21
Quick, easy & informative. We were able to secure quality insurance for our small business on a tight deadline. Thanks for the help New City.
Theresa Ruybol
Theresa Ruybol
19:30 01 Jul 21
Eric was so great with us. He was very patient and kind as we are a newer smaller organization who is growing rapidly. With that said, we had made our inquiry, he had great rapid response and mostly had to wait on me. Any request that we made and/or questions we had, he was great answering and helping us understand. Then when we were ready for all documents and to move forward, Brendan helped with getting that together and the two of them worked their magic on New City's end to notify me of what was needed, assist me in that process and confirming that all was complete and approved for the coverage. I just want to say thank you all again so much, as insurance has always been confusing to me, and you all made that process go a lot smoother.Thank you
Andrea Ordendorff
Andrea Ordendorff
21:06 07 May 21
I've been working with both Clayton and Brendan for well over a year. As the purchase of our dental practice was delayed well over 14 months they both patiently supported me and continued to make themselves available. When we were officially ready to sign up they made the whole process seamless and super easy. This team is highly knowledgeable, professional, supportive, and efficient! I can't thank them enough for everything they've done.
T W
T W
22:32 30 Aug 20
I love New City Insurance. I never had a good experience dealing with insurance brokers until I started working with Brendan. He’s awesome! He is patient with me and takes the time to answer all my questions. I’m very grateful for all his help and hard work!
Mary Jane Deyette
Mary Jane Deyette
00:57 11 May 20
Jeff Stoltey is so awesome...even thru my company had only two employees, he took the time each year to research and find the best plan for us. The only reason I am leaving New City Insurance is because we no longer have any employees. Thank you Jeff
Alma Ortiz
Alma Ortiz
22:25 23 Feb 20
Brendan was awesome! I couldn't figure out how to pick my plan and he returned my call on a weekend to help me. Outstansing service!
jessica kavanagh
jessica kavanagh
19:53 13 Feb 20
Brendan was so helpful I definitely recommend him if you’re in need of good help and getting it done promptly. Thankyou so much again.
Tricia DeYoung
Tricia DeYoung
19:49 13 Feb 20
I was very thankful I inquired about this info. with Brendan. He was very helpful so I understand the benefits available much better now. Thank you Brendan.
B Bayer
B Bayer
17:43 24 Sep 19
NCI handled almost everything from start to finish. Clayton and Brendan made the plans easy to understand and walked me through the application process. They got me my ID numbers before my cards arrived so that I could keep an appointment I had already scheduled. My last broker wouldn't have done that. 5 stars!
Jessica Lehr
Jessica Lehr
03:36 07 Jun 19
Our staff was interested in a health plan, but we didn't know how beneficial a solid employee benefits package would be for our business to expand. We'd lose prospective employees because they had more options for their medical insurance which was sometimes more valuable than more pay. The New City team was amazing and gave us as many affordable options as possible so that everyone had their needs met.
Mike McClay
Mike McClay
19:36 03 May 19
My employer uses New City as their insurance broker, and I'm always amazed when I call in for assistance by how knowledgeable and attentive their staff is with my requests. Their online benefits platform makes selecting insurance plans pretty darn easy. I would highly recommend their services.
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