I’m a decision maker for a small (about 30 employees) company located in Alabama. We pay 100% for employees and about 83% of the total premium for family coverage. We have a platinum plan and want to maintain comparable coverage ($100/$200 deductible, $20-$30 copays, $0 generic drugs). It’s amazing, and employees know it’s amazing and appreciate it. We want to keep it impressive / attractive (and for what the company pays, it sure as hell better be).
We have a broker who gets prices from a few insurance companies, coverage summaries, and formularies. In addition to comparing those three items, I call a local primary care clinic and ask if they accept the coverage, if it’s a good company, if it pays on time, if there are billing issues, etc. I ensure there’s a “Tier 1” drug available for all known health conditions of covered individuals (we’re small enough I can do that).
Am I doing this right?
What else should I be doing?
I think I understand how a “rate-based plan” works, but I don’t understand why they cost less. Why? What’s the trade-off? Why shouldn’t I get one of those with comparable coverage?
How do I know I’ve shopped all good companies available to me? The plan we have now is amazing, pays doctors on time, never declines things it should cover, etc., and yet it’s a company I’d never heard of before working here.
submitted by /u/_Z_A_C_
[link] [comments]I’m a decision maker for a small (about 30 employees) company located in Alabama. We pay 100% for employees and about 83% of the total premium for family coverage. We have a platinum plan and want to maintain comparable coverage ($100/$200 deductible, $20-$30 copays, $0 generic drugs). It’s amazing, and employees know it’s amazing and appreciate it. We want to keep it impressive / attractive (and for what the company pays, it sure as hell better be). We have a broker who gets prices from a few insurance companies, coverage summaries, and formularies. In addition to comparing those three items, I call a local primary care clinic and ask if they accept the coverage, if it’s a good company, if it pays on time, if there are billing issues, etc. I ensure there’s a “Tier 1” drug available for all known health conditions of covered individuals (we’re small enough I can do that). Am I doing this right? What else should I be doing? I think I understand how a “rate-based plan” works, but I don’t understand why they cost less. Why? What’s the trade-off? Why shouldn’t I get one of those with comparable coverage? How do I know I’ve shopped all good companies available to me? The plan we have now is amazing, pays doctors on time, never declines things it should cover, etc., and yet it’s a company I’d never heard of before working here. submitted by /u/_Z_A_C_ [link] [comments]Read Morer/HealthInsurance