How Employers Can Make “Apples to Apples” Comparisons Between Dallas Group Health Insurance Quotes

Selecting the right Texas group health insurance plan for your Dallas business can be difficult and confusing if you don’t understand the differences in coverage and benefits between the plans and group health insurance quotes supplied by your Dallas group health insurance broker. This article is designed to help you understand some of the terms so that you can understand the differences between group health insurance plans in Dallas.

First, what is the  financial rating of your insurance carrier and of the carriers quoted by your Dallas group health insurance broker? The financial rating is the term applied to the financial condition of the Texas group health insurance company. These ratings are an indication of the Texas group health insurance carrier’s ability to pay your employee’s health insurance claims. If you are comparing competitive Texas group health insurance rates between insurance carriers, remember that the carrier with a low financial rating may not be as likely to have the back office staff and systems to pay your employee’s claims promptly.

A.M. Best is the most company that rates Texas insurance carriers. An A.M. Best rating of “A” is considered excellent, and a company with a consistent rating of B+ or better should be financially strong enough to pay your Dallas company’s group health insurance claims. You should make certain that any Texas group health insurance carrier that you are considering for your company’s group health insurance in Dallas has a financial rating of “B+” or preferably “A.”

Second, what is the complaint rate of each insurance company? The Texas Department of Insurance keeps a record and reports on the level of complaints received from Texas citizens for each insurance company licensed in Texas. A high complaint rate may be an indication that a group health insurance company has problems that you don’t need or want for your employees to experience. Be sure to ask your Dallas group health insurance broker what is the complaint rate of each group health insurance company that has been quoted.

Third, what   does the Dallas group health insurance plan  and how many providers, both doctors and hospitals, are in the  network within five or ten miles of where your employees reside? Make sure that the most important hospitals in your area are in the   network.

Fourth, make sure that the broker highlights the important coverage differences between the Dallas group health insurance plans quoted. For example, some Texas group health insurance plans offer a lifetime maximum benefit of one million dollars, some a lifetime maximum benefit of two million, and some a maximum lifetime maximum of ten million dollars. Some plans also have a maximum annual benefit as well.

Other important points of comparison are the annual deductible, coinsurance levels and out of pocket maximum. A higher deductible, out of pocket maximum, and higher coinsurance level that the employee must pay will reduce the monthly premiums for the employer and employee. Higher levels can help make a Dallas group health insurance plan plan more affordable and acceptable for employees. But make sure that any plans you consider have comparable levels of coverage.

Prescription (Rx) benefits can vary widely between plans as well. Even two plans with an identical copay schedule, such as $10 for generic drugs, $35 for branded, and $50 for  drugs can vary widely as to which drugs are on the plans list of $35 drugs and which are in the list of $50 drugs

A competent Dallas group health insurance broker can make this work easy for an employer by listening to the needs of the employer, and recommending plan proposals that meet the employer’s needs. The proposals should include an explanation of terms, and a survey of major medical plans from various “A” rated Texas group health insurance carriers that meet the company’s coverage and budget needs. The Dallas group health insurance broker can also recommend consumer driven and wellness driven health plan designs and programs that are proven to reduce the employer’s group health insurance premium inflation in future years as well as save the company money today.

Mike Chapman is a principal with Group Benefits   of Dallas, Fort Worth Texas,   a Texas employee benefits consultant and Dallas group health insurance agency  s in out of the box solutions for small and mid-sized businesses in North Texas.

His firm helps business structure cost-effective and affordable employee benefits solutions that help them to attract and retain high   employees. Implementing his solutions can usually save employers between $1,000 to $2,000 per employee per year with no reduction, and often with an increase in the overall benefits to employees.

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