Choosing the right group health plan: Tips for employers

Consider these tips when navigating health insurance plans for your employees

The right health plan is an investment critical to every business’ future, especially at a time when companies of all sizes and across industries are managing unprecedented challenges. As COVID-19 lingers, it continues to stress physical and mental health—and dynamics of the workplace. The fact that people are leaving their jobs and looking for new opportunities—and better benefits—further complicates things for employers.

Not sure where to start? Follow these easy steps for selecting a health insurance plan for your employees

Steps to evaluating the best health insurance plan for your employees

Step 1: Evaluate your current plan design and carrier

Even if you are confident in your current plan, it’s always worthwhile to reevaluate it. A lot may have changed since last year, including your company’s structure, your employees’ working arrangements, and even the features and benefits of your plan. You and your employees need to have end-to-end satisfaction with these key areas of your plan:

Network and cost – A plan’s network size impacts how many options employees have in selecting their care and how much they pay out-of-pocket. Some plans offer narrower networks of “preferred” providers—doctors, hospitals, and specialty care. Choosing a plan that offers access to a large network of high-quality providers helps ensure that your covered employees always have access to outstanding health care and support.
Digital tools – In today’s environment of hybrid, on-site, and remote work arrangements, having access to innovative digital tools that help employees understand their current health and provide ways for them to improve their health—anytime and anywhere—is key for business.
Member services – Having a skilled member services team readily available gives your employees knowledgeable people they can contact for quick answers to all their benefit questions.

Step 2: Evaluate the makeup of your company

Assessing the makeup of your company every year will give you the up-to-date information you need to make an informed decision.

Here are some questions that can help assess the needs of your business:

What is your employee population’s health like?
What kind of claims costs are occurring frequently?
Where are your employees located in relation to where their doctors are?
What are the costs associated with your plan, and is it affordable for your employees?
What plan features and benefits do your employees want?
- Bonus tip: You can conduct an anonymous survey to request this information from your employees. Many online survey tools are available for free.

Step 3: Research additional health plan features and benefits

Looking into plan features and add-on benefits can make your overall benefit plan richer. Here are areas that you should consider:

Dental and vision – Can benefit employees’ health—and can even help to identify certain diseases in the early stages, when they are more likely to be treatable.
Employee assistance programs (EAPs) – Provide employees with the resources they need to handle challenges that come their way, showing them that you are committed to their overall well-being—including their emotional, physical, and other needs.
Wellness programs – Such as offering access to a health coach may better improve employee health; enable a healthier workplace; and cultivate a more engaged, motivated workforce.
Telehealth – Ensures that whether your employees are working onsite or traveling, they have 24/7 access to care and receive a rapid response to their health needs no matter where they are located.
Pharmacy integration – Allow for whole-person, team-based care. Separating out pharmacy benefits can fragment the care model and hamper efforts to manage employees’ total health.
Stop loss coverage – Provides catastrophic coverage for your business, protecting you from large, unpredictable claims.

Step 4: Connect with your producer

A broker can help you think through choosing a plan design.

Questions to ask your producer

How will the plan keep my employees healthy?
Are integrated benefits an option?
What kind of pharmacy benefits does the plan offer?
Are my employees covered when they travel?
Are there financial benefits for a healthy workforce?
What kind of funding arrangement is right for my business?

Step 5: Make your decision

Choosing a health plan is a big decision that impacts your company and your employees. Start early so you have enough time to carefully think through the entire process, including the transition. An experienced carrier will work with you and your employees to ensure that the transition is as smooth as possible.

Choose the right health insurance partner

When you choose UPMC Health Plan, you get quality, access, choice, and value for you and your employees. Partnering with an integrated health care system like ours will allow you to:

Manage your company’s health care costs through flexible, affordable medical plans.
Give your employees access to the high-quality care they want and need.
Support your employees’ wellness with tools that give them access to behavioral health services and 24/7 virtual urgent care visits to help them understand and improve their overall health.
Let your employees access care through a nationwide network while traveling.

94% of businesses who choose UPMC Health Plan stay with us
Find out more about our employer group coverage and why 94% of businesses who choose UPMC Health Plan stay with us.

Contact your producer or call 1-833-825-2696.