Friday, February 15, 2008
Navigating health insurance could be easier with an agent at your side
Tampa Bay Business Journal - by Tom Brinkmoeller Special to the Business Journal
Some employers use a health-insurance benefit as a tool to attract and keep employees. Some provide it out of a sense of responsibility to the workers who make the business run.
And some just don’t know how to deal with it — how to find a plan or how to evaluate whether the plan they have is the right one — so they just don’t.
But ignoring the problem isn’t likely to solve it. With more than 47 million Americans living without health insurance, according to the National Coalition on Health Care, and the run for the presidency heating up, the issue is staying in the forefront. All of which makes the issue of providing health insurance to employees more prominent than ever.
Many questions have to be answered before a health plan can be devised, including:
What benefits do you want to offer?
What benefits can you afford?
Will you contribute more of the cost for your key employees?
Do you offer a PPO, an HMO a Health Savings Account or a combination of these?
How can you make the plan attractive enough to those you want to include so that they will buy into it?
The answers aren’t easily found as the result of a little do-it-yourself research on the Web, several experts agree.
“It’s not like buying airline tickets on Travelocity,” said Janet Trautwein, CEO and executive VP of the Arlington, Va.-based National Association of Health Underwriters. “You’re going to need the expertise of somebody who knows what they’re doing.”
Trautwein is quick to point out that an agent’s service is free to the employer, since the insurance company pays the agent a commission. Not every company that is writing coverage in an area is listed on the Web, she said, and an agent not only knows all the available insurers but also has a pretty good idea what other companies in the area are using to attract and keep their employees. Such input can save a lot of wheel-spinning, false starts and dead ends.
Finding the best agent isn’t a matter to be left to chance either, said Bill Foudy, a board member of the Association of Health Insurance Advisors, which is headquartered in Falls Church, Va.
Foudy, who owns an agency in Los Angeles, advises asking business associates for the name of the agent they use and recommend. He also says asking the person who handles your car, home and life insurance also often results in good recommendations.
An agent will be able to look at the amount you want to spend, help you optimize that money and search out an insurance company that will complete the deal, these experts say. In coming to that point, the agent will help you evaluate what types of coverage (HMO, PPO, HSA, dental, vision, etc.) you should consider and what percentage of the cost you will contribute to the cost of each employee.
Key employees often are offered better packages, Trautwein said. Often key employees are top executives, but in a very competitive market where skilled hourly workers are in demand, the advantage could tip in their direction.
Another area an agent can assist in is tailoring coverage that complies with state and federal regulations, said Foudy. Often it’s the number of employees in a company that regulates where a provision like the Federal Medical Leave Act is applicable.
Your agent wants your initial business, as well as your annual renewals, he said, so helping in many aspects of health coverage is beneficial to both sides.
The percent of your eligible employees who choose to participate in a health-insurance plan sometimes is the difference between an insurance company issuing a policy or not.
“If it’s perceived as a benefit, and not a problem, by your employees, you’re going to get a higher participation,” Foudy said.
“You have to make it affordable for you as the employer,” said Trautwein, “but with costs that make it attractive enough to participants. Sometimes it may be better to have some scaled-back benefits and be able to put more [company] money into it.”
If an employee chooses not to participate in a health-insurance program because of coverage provided by a spouse’s policy, that should be documented in a signed statement, and it often will not count against a company’s percentage of employee participation.
“It’s always in an employer’s interest to have anyone, whatever the reason, who decides not to participate in a health plan sign a document that lists the reasons,” said Trautwein.
QUICK TIPS
Work with an agent who is familiar with your locality and your competition.
Get recommendations for an agent from other business people you know and trust.
Consider self-funding your coverage with insurance that kicks in once a spending plateau is reached.
Initiate employee wellness programs (e.g., exercise, stop-smoking, weight control) that can reduce the amount you pay for coverage.
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To learn more about Florida group health insurance, Tampa group health insurance, Sarasota group health insurance, Miami group health insurance, or Orlando group health insurance, visit Grouphealthflorida.com or call 1-800-873-5713.
