As a sole practitioner or small law firm, there are a number of important areas to consider while evaluating the most appropriate health insurance options for you, your employees and their families.
Below are five important items to consider as you begin to evaluate your options:
- Begin shopping for insurance at least 30-60 days prior to needing coverage in force. There are over 200 different individual and small employer plans available in California. Coverage can take time to understand and implement. Having a 30-60 day lead time will provide adequate time to implement appropriately.
- Make a list of the doctors, hospitals and/or facilities that are important to you, your family or your employees. All medical plans have “contracted” or “in-network” providers who have agreed to accept pre-defined amounts for services. Securing a medical plan that has most, or all, of your doctors in-network will provide enormous savings over time.
- Understand a medical plan’s “maximum out of pocket exposure.” Your deductible or copayment is NOT the most important component of your medical plan. An individual or family’s “maximum out of pocket exposure” is the most important number and is the amount that identifies where your exposure would end for covered services in a catastrophic event. Make sure you clearly understand what this amount is and that you are comfortable with this level of exposure.
- Learn more about tax-efficient medical plans such as health savings account (HSA) options. Health savings account (HSA) or health reimbursement account (HRA) alternatives can dramatically decrease a subscriber’s financial exposure to medical expenses while at the same time decrease monthly premiums.
- Ask about what ongoing or additional services your insurance broker will be providing.Pricing of individual and small employer health plans are identical regardless of which broker you are working with. Most agents or brokers differentiate themselves by providing additional administrative, HR, technology or legal resources which are, in many cases, free-of-charge. Be sure to understand how service-focused the broker you have selected will be throughout your relationship. The health insurance marketplace is rapidly changing. It is important to understand how these changes will affect you and your practice and a knowledgeable insurance broker will be able to help guide you through them.