Health Plans

2-49 Employees
The Health Insurance Portability and Accountability Act (HIPAA), enacted in 1997, dictates that all insurance carriers must “guarantee issue” insurance for any small employee group requesting it. This ensures that your company will have access to health care coverage regardless of the health conditions of your employees. However, it drastically reduces your ability to “shop” for a good rate because all groups are now placed into community or pool-rated tiers based on the medical histories of their employees.

 

In general, claims experience has minimal impact on rates in the small group market regardless of how your group performs. Some carriers do, however, use a system of loads and credits such that they can add to or subtract from the average rate within a tier based on the ages and genders represented in a group. For example, a group with a high number of females may have a load added onto the average rate, while a group that is predominantly comprised of young, single males may have an adjustment downward.

 

The first and most important decision you can in make addressing your insurance needs is selecting a broker. As a strategic partner, United Financial Solutions will provide the information and insight you need to make educated decisions.

 

Then you must determine:

• What your plan design will be—what level of benefits you want to provide, what percentage of costs you want to pay, and what percentage you expect your employees to pay.
• Which network of hospitals and providers you want to use.
• What level of employee satisfaction you need to maintain in order to attract and retain desirable personnel in a competitive job market.

 

In general, the insurers with the largest market share in your region will provide the best fit. Standard plans—with fixed benefit levels and little or no customization of plan design—typically provide the most manageable solution for small businesses. However, as you shop for rates, remember that your initial price quotation is not final. Many things, including the outcome of your employee pre-screening medical questionnaires, will influence your final rate.

 

How United Financial Solutions Can Help:
Our knowledge and expertise will guide you through an analysis of your needs so that we can find the best solution for your company. This includes assistance with the pre-screening process as well as helping you understanding your options. We will work with you to develop a plan that meets both your coverage and fiscal needs.