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Buying Group Health Insurance: Play the game

Aug 29, 2007
Business coverage for group health insurance

Getting the best business coverage for group health insurance can be a very challenging task. There are many factors that impact pricing for your group health coverage. Depending upon the state in which your business is based, factors such as age, gender, health history and your industry will all affect your group health coverage for your business.

In many states, the pricing for group health insurance can vary widely based upon the factors detailed above. In addition, the type of plan and the deductible amounts along with the out of pocket maximum will drive your pricing. When you get health insurance quotes, make sure the pricing is inclusive of the health conditions in your group. You may not want to know all the details of your employee's health conditions so that you are not in violation of privacy laws and the Health Insurance Portability and Accountability Act (HIPAA).

In states where the rating is not fully community rated (or the same from one person to the other) rating swings can be dramatic. For example, an employer with 10 employees with no health conditions will be significantly cheaper than an employer with 10 employees and multiple health conditions.

It is important to check out the market annually or every other year so that your business coverage for group health insurance is being purchased at the most affordable price point.

The benefit structure such as the deductible, co-payments and out of pocket maximum all develop the actual pricing. For example, a $1,000 deductible plan that is 100% after the deductible is met will be at least 15% more expensive than a $1,000 deductible plan that has 80%/20% coinsurance and a $3,000 out of pocket liability after the deductible is met. So do your homework and compare.

Shopping for business coverage for group health insurance is not like buying a copier. The pricing can vary dramatically from the original quote you received so ask a lot of questions. When you are buying your copier, the price should not change once you have made a commitment to purchase. However, with health insurance your pricing may change once underwriting has been completed.

You should request to see your final rates and plan design and get in writing before signing off and accepting a group health insurance plan.
About the Author
Scott is a partner in ESP Benefit Design, an employee benefits insurance firm based in Westerville, Ohio. (614-882-8535) Scott has an MBA from Franklin University. Scott has worked with over 6,000 customers. Email Scott at scott@espbd.com

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