BY ROB SUMNER
Finding a health insurance plan that makes both financial sense for the bottom line and provides choice for plan participants is a huge challenge for employers.
BY ROB SUMNER
Finding a health insurance plan that makes both financial sense for the bottom line and provides choice for plan participants is a huge challenge for employers. This is why it pays to shop around at renewal time. In fact, the good news for companies who bought health insurance at an Affordable Care Act marketplace this year is that they may find things advantageous for them when it comes time to renew.
Are Rates Increasing or Decreasing?
Current data from the McKinsey Center for U.S. Health System Reform reveals interesting analysis. For many carriers, premiums for their most popular plans are climbing into double digits. Yet others are aggressively marketing their plans with a much lesser increase according to recent post on the New York Times website.
In addition to cost, choice of provider is also important to meet diverse employee needs. Giving an individual the opportunity to choose from a highly regarded provider base that includes natural health alternatives such as acupuncture, naturopathic and chiropractic care is now available for some select carriers. Oregon’s Health CO-OP is one of these and the only carrier that includes Naturopaths as primary care physicians at a primary care co-pay. Even better news for employers with Oregon’s Health is that the CO-OP received approval for an overall 9.9% rate decrease from 2014 premiums.
3 Ways to Evaluate a Health Plan
So outside of straight cost comparison, what is the best way to evaluate a group plan for your employees? Stephen L. Brown of NW Securities Advisors in Portland says there are three things to consider when choosing a carrier. The first area is the plan design. “What kind of provider base does the carrier offer and how current are the plan features when it comes to natural health options?”
A second area is cost for the employee. “It’s no secret that every employee likes low and no deductible plans.” Co-insurance is another feature that employees have trouble with. It’s very difficult for employees to know what their out-of-pocket costs will be until they receive a bill from the provider a month or two later. In light of this, the CO-OP this fall will introduce a suite of plans with no deductible and no co-insurance. Every service will have a fixed dollar co-pay that is the employee’s entire responsibility. Employees will know up front what their financial responsibility will be.
The third area Brown asks his clients to consider is the financial stability of the carrier. “If they don’t have adequate claims reserves set aside, then I suggest they scratch the carrier from their list.” At a minimum, Brown suggests 3 times the reserves required by the Oregon Insurance Department. Oregon’s Health CO-OP exceeds this amount with 5 times the reserves necessary and the strong financial backing through the federal ACA, which granted 23 CO-Ops with start-up and operating funds.
Oregon’s Health CO-OP meets or exceeds the criteria across all three areas. You will undoubtedly discover that if you are an employer who chooses to shop around in the next 90 days.
Rob Sumner is director of sales for Oregon’s Health CO-OP.
