One of the biggest complaints employers have in common is the cost of healthcare. Offering health benefits is a great way to attract new talent to your workforce. But paying for those benefits can take a serious chunk out of your profits.
Managed care gives you a cost-controlled way to offer group health insurance to your employees. With managed care you and your staff can get comprehensive health coverage — and affordable premiums.
The basic idea behind managed care is to combine large networks of doctors and hospitals with the buying power of a large health insurance plan. The plan — also called the “administrators” — puts together the network, and negotiates lower prices for healthcare services than individuals would be able to get on their own.
The managed care administrators also require approval for certain treatments. This makes sure that healthcare is used appropriately, and keeps premiums down for all members of the plan. Some managed care plans have more restrictions than others.
When in doubt, consult with an insurance agent. A professional agent can help you choose a plan that will save you money and meet your employees’ health needs.
HMO plans — Health Maintenance Organizations — are the more affordable of the two options. They're also the most restrictive.
In an HMO, you choose a Primary Care Physician from the plan's network of doctors. This doctor will provide you with referrals to other doctors within the plan network when you need specialist care. Without a referral, the plan won't pay for the treatment.
PPO plans — Preferred Provider Organizations — tend to cost more, but have more flexibility when it comes to coverage. In a PPO, you get the most savings when you get care from a doctor within the network. But you can go outside the network and still get some coverage. So you don't need doctor approval to see a specialist.
For individuals, HMOs tend to be the better value. They have no deductible, and copayments are smaller.
But for employers looking to buy a group plan, a PPO might be better. As an employer, you only have to pay the premiums on the plan. Because your employees are responsible for meeting the deductible and making copayments, you share some of the cost of care with your workers. Some plans will even let you split the premium with your workers. So you get to save on your group health insurance, and your employees get comprehensive coverage for much less than it would cost normally.
Finding a plan means sizing up your needs, your employees’ needs, and your business’ bottom line. For expert help, work with a professional insurance agent. They can help you decide what kind of plan will work best for you, and guide you all the way through the application process.
To get matched with agents licensed in your area, use our fast and free insurance quote service.