Are You Ready for Health Insurance Open Season?


By: John Gotschall

Thanksgiving, Black Friday, Cyber Monday and….Health Insurance Open Season? Indeed, tis the season to determine the best health plan option for your small business. The choices are not pretty, and not always easy to navigate.

When selecting which plan option is a best fit for your business, consider the following points:

1) Based on income and corresponding potential government subsidies, calculate if you and your employees would be better off either buying individual plans on Affordable Care Act Marketplace or selecting a group plan. Group coverage, which require at least two employees, typically offer lower rates, more plan options, larger networks and potential tax benefits. Open enrollment for individuals ends December 15.

2) Determine what your annual claims or medical expenses have been over the past year. Will your claims be about the same next year or are you expecting a large claim? This will help dictate how expansive the coverage you need, and in turn, the price of your premiums

3) What hospital(s)/doctors would you want to go to if you needed care? What networks do they accept?

4) Review quotes from several companies. The essential health benefits and maximum out-of-pocket costs are all basically the same between companies. The difference will be in the PPO or HMO networks offered and price. To determine the lowest cost option if the worst case happened, multiply your premiums by 12 and add your out-of-pocket maximums. Compare the maximum totals of different plan options and the lowest cost wins!

5) Find an experienced insurance agent, who you trust, to help you. An experienced agent will have worked with all of the available health insurance companies that market plans in your area.

John Gotschall is the founder of Coaching Financial Concepts, which provides individual and business guidance on financial planning, business insurance and benefits implementation.