The group health insurance market in California is actually pretty vibrant and competitive when compared to most other states. Although this helps to offset the costs with multiple carriers and literally dozens of plans to choose from, California companies still need to be vigilant and \”quote\” the market at least annually to make sure they have the best rates available. Let\’s walk through some tips to keep in mind when shopping for California group health insurance.

Narrow the plans first. There really are dozens of Group health plans to choose from. When you run your quote, it\’s overwhelming. Each California carrier has their version of a certain type of plan (fill in the blank with HSA, HMO, you name it). Within \”suites\” of plans, they\’ll generally have multiple options, typically 3-5 to choose from that breakdown mostly along lines of deductibles and copays in a descending fashion. For example, you may have one plan family name (for example, Anthem\’s \”Solutions\” plans with a $2500, $3500, and $4500) deductible. The plans will work the same in terms of core benefits but numbers go up (deductible, copay, coinsurance, etc) while premiums go down. Not to toot our own horn, but this narrowing process is really where we can help group health shoppers in California.

There are certain \”benchmark\” plans or suites that we can quickly use to compare the various carriers against each other. It\’s actually quite interesting how for a given employee demographic (age, zip code, family make-up), you can have very different pricing for comparable coverage. We wrote extensively on why this occurs with our Why Health Plan Rates Vary article but suffice it to say, it definitely exists and it can swing rates by 10-20% easily. Generally, you can look a mid level HMO and higher level PPO to determine who is priced better. For the HMO, aim for a no-deductible, $30 copay with a fixed hospital copay to compare like plans. For the PPO side, look at a $500 deductible, with around a $40 copay and brand RX coverage. These are two benchmarks we can use. Keep in mind that one carrier may be well priced in HMO plans while more expensive in PPO plans. This brings us to our second consideration…your employee\’s preference.

If you can, gauge the general reception for HMO versus PPO type plans. Some people have very strong preferences one way or the other. We\’ll be able to address both groups by offering HMO and PPO plans but from a pricing point of view, it\’s nice to which carrier is best aligned with your the largest preference of your employee base. Of course, we\’re happy to walk through the differences between HMO and PPO in as much detail as needed. Once we\’ve established which carrier is priced best for our demographics and types of plans, we can then prepare Employee worksheets which shows the employee\’s out of pocket by plan choice taking into account the company\’s cost sharing (usually a percentage of all or a certain plan or a fixed dollar amount). We can include most plans if you like or just narrow it down to certain key benefit levels with HMO, PPO, or HSA type plans. Doctor networks also come into play here but less so than before since the bigger carriers have quite a bit of overlap in their networks. That isn\’t to say that a given provider (doctor or hospital) might only contract with certain carriers so we\’re happy to check the best value generated from above with your employee\’s doctor and hospital list.

You\’re free to run your own California group health quote instantly through our quote engine here. You can also request us to find the best values as mentioned above since we\’re independent Group health brokers and have contracts with all the major carriers. If you\’re coming up on renewal with current coverage, email over the census information and RAFF (risk adjustment factor should be on rate renewal guide) so we can see if there\’s anything better priced out there that justifies the move over. If not, we\’ll let you know as happens all the time. With the information above, you\’re well armed to get the best quote available on the market.

Dennis Jarvis is a licensed California health insurance agent with extensive knowledge of the Individual California health market. affordable California health insurance

Dennis Jarvis is a licensed California health insurance agent with extensive knowledge of the Individual and Small Group California health insurance market. http://www.calhealth.net

Author Bio: Dennis Jarvis is a licensed California health insurance agent with extensive knowledge of the Individual California health market. affordable California health insurance

Category: Finances
Keywords: california group health insurance, california group health,california group health quote