Perplexed about health plan benefits?

By William A. Eades
Richard J. Princinsky & Associates, Inc.

Just as holiday shoppers filled the malls to find perfect gifts at affordable prices, so company decision-makers faced January renewals by sorting through an incredible array of group health products before making their final purchases. Unfortunately, there are no merchandise return windows available to take back poor health plan choices.

The process of selecting health plan benefits, whether it is for the first time or a renewal, can be a daunting task. Medical costs are soaring and, consequently, so are the insurance premiums. Take into consideration the number of different insurance carriers, multiply that by the number of different plans available, and factor in the variables from plan to plan. Besides being a considerable expense to your client or your company, the sheer number of health plans can make the selection process perplexing at best.

Which plan offers the most comprehensive benefits for the money the company can afford? How will changing the plan affect employees, morale, and recruitment? In order to successfully select a health plan, the administrator needs a thorough understanding of the various carriers, plans, and the industry terms. What's more, the information needs to be compiled in an easy-to-understand format, so options can be evaluated quickly by comparing features and costs.

A winning strategy

Faced with a significant increase at renewal time, Marie Staley, director of human resources for MidAtlantic Corporate Health of Hunt Valley, Maryland, met with numerous carrier representatives. Her primary goal was to find a health plan that would be comparable with what her employees already had, one that would cause little discomfort for employees in transitioning to a new plan, and at the same time, one that would fit her company's budget.

After investing substantial time comparing numerous products, Ms. Staley was frustrated and convinced that the only viable option was to switch insurance carriers. Fortunately, one representative referred her to Richard J. Princinsky and Associates (RJP) and our health plan shopping service.

RJP will take an existing health plan, evaluate the benefits, provide price quotes, and outline the features of similar plans with other carriers. Plan design changes might be suggested to the existing health plan (like raising the deductible, changing the co-pay, etc.) to make the existing plan fit within the company's budget. RJP's streamlined approach makes it easy to get quotes for all products and all carriers. The easy-to-understand format, not only presents price comparisons, but also the basic differences between plans. RJP gives decision makers more control over purchases by supplying a complete analysis of available options. This service is available at no cost to you or your clients.

After reviewing the presentation, Ms. Staley realized that the firm would be able to continue to offer the current PPO plan to employees simply by changing the plan design. In addition, it was determined that the group's HMO plan could be moved to a more affordable carrier and stay within participation guidelines. The final decision was made within 10 days of reviewing the RJP comparison.

According to Ms. Staley, "We have been in business for more than five years, but we never knew all of the health plan options available to us. Our prior broker picked out one or two and only presented those."

It is crucial to understand all available options and how variables in plan designs and features will affect premiums at renewal. The MACPA health plan administrator, Richard J. Princinsky & Associates, Inc. (RJP), offers a "one-stop shopping" system for health plan coverage as a standard service to MACPA members and their clients at no cost. To arrange for a review of your company's plan or a client's, call (800) 653-0250.

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