As a business owner, trying to balance various plan benefits with your budget — while navigating the complexities of the health care system — can be daunting. From tax credits to premiums and deductibles to specific health care needs, there are a lot of things to consider when choosing the right group health plan that will benefit your employees and your bottom line.

At Doeren Mayhew Insurance, we have time-tested experience in helping businesses find the most effective health plans. We guide business owners like you in gathering critical information from your employees that help you weigh your available options. Our trusted insurance agents have the specialized expertise to assist you in evaluating and securing a group health insurance plan that works for your business.

What is a Group Health Plan?

Group Health Insurance Plans help businesses with one or more employees pay for healthcare expenses. These plans are typically cost-effective for both business owners and their employees. Pre-taxed dollars are used to pay employee premiums which are generally less than those for individual health plans. Additionally, employees stand to pay lower payroll taxes and can deduct annual health care contributions when they calculate annual income taxes.

A large percentage of the plan’s premium is covered by the employer and is known as the “employer contribution.” Individual employees also pay a share that is determined by benefits and features unique to the group health plan. These premiums are offset by payments made by insurance companies that contribute to a portion of medical costs associated with wellness visits, treatments, and hospital stays.

What are the Different Types of Group Health Plans?

Higher-premium plans typically offer lower deductibles for care and are well-suited for employees with known healthcare issues, thus utilizing more healthcare services. Lower-premium plans are better suited for employees who generally need standard care.

Other Types of Group Health Plans
  • Fully-Insured: This traditional plan requires insurance companies to take on healthcare costs while charging an annual premium that is paid, in part, by business employees.
  • Self-Funded: The employer assumes healthcare costs with more affordable rates and control in this plan that is commonly selected by large businesses.
  • Level-Funded: This plan is based on monthly payment rates that are determined by census information curated by insurance carriers.
  • Health Maintenance Organizations (HMO): Group members pay for specific health services through monthly premiums in this plan that provides access to a large network of providers and locations.
  • Preferred Provider Organizations (PPO): This plan offers extensive access to a network of providers and location with higher co-pays and additional service costs.
  • High-Deductible Health Plan (HDHP) with a savings option (HDHP/SO): For groups that don’t use many health services, this plan offers higher deductibles and lower premiums so employees pay more out-of-pocket costs.

Considerations When Choosing a Group Health Plan

While each plan has both advantages and disadvantages, it’s important to consider the following:

  • ACA Compliance: The Affordable Care Act (ACA) requires business owners and employees to carry health care coverage that meets certain requirements.
  • Budget: Choose a plan that is flexible enough to fit your budget and that of your employees.
  • Employee’s Needs: In order to select a group health plan that best serves your employees, you need to consider the specific health needs of your employees as well as what plans they prefer and their opinions on plan trade-offs.
  • Benefits & Features: Look into the network of doctors available with each plan as well as specific information on coverage for prescription drugs, vision, and dental care.

Even though choosing a group health plan may be overwhelming, seasoned professionals can relieve the administrative burden of gathering all of the necessary information to make an informed choice. Contact the dedicated group of advisors at Doeren Mayhew Insurance for more information on how to select the right group health plan, or for a customized insurance quote today.