2-49 Employees
In 1997, the Health Insurance Portability and Accountability Act (HIPAA) dictated that—among other things—all insurance carriers must “guarantee issue” insurance for any small employee group requesting it. While this ensures your group will have accessibility to health care coverage, regardless of the health conditions of your employees, it virtually eliminates your ability to “shop” for a good rate. This is because all groups are now placed into community or pool-rated tiers, based on the medical histories of their employees.

Generally, it doesn’t matter how your group performs overall, since claims experience has minimal impact on rate in the small group market. Some carriers, however, do use a system of loads and credits, which means they will add or subtract from the average rate within a tier, based on the ages and genders represented in your group. For example, a group that is more heavily populated with females may have a load added on, while a group that is predominantly comprised of young, single males may have an adjustment downward.

The most important decision you will make…
The most important decision you will make is selecting a broker, such as Brooks, who will become your strategic partner in providing the information and insights you need to make educated decisions. While price is certainly a key issue, you must first determine:

• What your plan design will be—what level of benefits you want to provide, what percentage of costs you want to pay, and what percentage you expect your employees to pay.
• Which network of hospitals and providers you want to access, based on those you know your employees are currently using.
• What level of employee satisfaction you need to maintain in order to attract and retain desirable personnel in a competitive job market.

Generally, the insurers with the largest market share in your region will provide the best fit. Standard plans—with fixed benefit levels and little or no customization of plan design—typically provide the most manageable solution for small businesses.

Remember: As you shop for rates, the prices initially quoted to you are not final; many things, including the outcome of your employee pre-screening medical questionnaires, will affect the amount you are ultimately charged.

How Brooks can help
Brooks has an extensive knowledge of the various health insurers appropriate for your group and will guide you through an analysis of your needs and likely solutions. We will assist you with the pre-screening process, help you understand—realistically—what your options are, and work with you to develop a plan that meets both your coverage and fiscal needs.