| Every small business in Dallas, Houston and throughout | | | | deductibles are usually higher than with HMO plans. |
| Texas wants to attract high quality individual | | | | There may be some managed care elements with |
| employees who will contribute to the growth and | | | | PPOs, but not as extensive as HMOs. For example, |
| success of the company. In order to recruit and retain | | | | you may need pre-authorization for a hospital stay, |
| these people, many larger business owners offer | | | | surgery, or an expensive diagnostic test. |
| health insurance coverage, specifically group health, as | | | | Fee for Service |
| an employee benefit. | | | | Fee-for-service plans, also known as indemnity plans, |
| If your company is small, especially if has ten or fewer | | | | allow employees to choose health care providers |
| employees, there are still ways to offer your | | | | themselves. This gives them a wide range of options |
| employees health insurance coverage. In most states, | | | | that includes specialists such as cardiologists and |
| insurance companies which offer small group health | | | | surgeons. But because these plans do not give |
| insurance plans are required to accept any employer | | | | members incentives to use low cost providers, the |
| group of two to 50 employees, provided the employer | | | | plans are expensive. Some insurance companies limit |
| agrees to insure 100% of the eligible employees. | | | | the fee-for-service expense by imposing low |
| Before you can offer any health insurance coverage, | | | | maximum benefits and/or fee schedules. As with any |
| you must decide how much your employees will pay, | | | | insurance plan, carefully read the benefit description for |
| as well as the kind of insurance that you wish to offer. | | | | a fee-for-service plan. |
| It's expensive. So who pays? | | | | Check out the insurance company |
| Most businesses that offer their employees group | | | | Along with selecting the right group health plan, |
| health insurance plans contribute towards the cost of | | | | selecting an insurance company is important, because |
| the coverage. Some pay for all of the employees' | | | | the service delivered will directly impact each of your |
| premiums (for single coverage) and let the employees | | | | employees. Look for an insurance company with a |
| pay the premium if they need coverage for their | | | | good network of health care providers, timely claims |
| families. Other businesses pay a percentage of the | | | | service, and relatively stable premiums. |
| total cost. | | | | In addition, check with other small business owners in |
| The amount you choose to pay will depend on your | | | | the area, or with your Small Business Association. The |
| own situation. First, think about how your contribution | | | | Texas Department of Insurance will also have |
| will affect your budget. Second, think about how it | | | | information about the financial stability of the insurance |
| affects the desirability of your plan to your present and | | | | companies that you are considering, as well as any |
| future employees. | | | | history of customer complaints. |
| Many businesses choose to have their employees | | | | Can I choose my own small business health insurance |
| make a contribution towards some of the cost, | | | | provider? |
| especially as health care costs and insurance | | | | Sure. Small business group health plans are available |
| premiums continue to increase. | | | | from reputable insurance companies who are using the |
| Plan designs | | | | Internet to help reduce administrative expenses. |
| There are three major types of health plans - | | | | Do I need an agent to help me select a plan? |
| managed care, preferred provider, and fee-for-service. | | | | No. Keep in mind that many agents only represent a |
| The plan that's best for your business is determined | | | | small number of insurance companies. If you use an |
| largely by your business location, the physicians and | | | | agent, you should expect him/her to ask questions |
| hospitals available through the plan, the options offered | | | | about your goals and objectives and to learn about |
| by insurance companies, and the constraints of your | | | | your business and employees before recommending a |
| budget. | | | | plan. |
| Managed care | | | | Health insurance for your employees can be |
| Managed care plans are agreements between certain | | | | expensive. The following tips will help you ensure |
| doctors, hospitals, and health care providers, and are | | | | you're offering the best option for employees and the |
| designed to offer a range of services to members at | | | | most cost-effective option for you. |
| a reduced cost. Managed care plans are typically | | | | Do your homework: |
| HMOs. They may also be referred to as an Individual | | | | * Survey your employees for their insurance needs. |
| Practice Association (IPA) or Point of Service (POS) | | | | Do their families require insurance? |
| plan. | | | | * Consider insurance plans that require second opinions |
| Most HMOs minimize the out-of-pocket expenses | | | | and include built-in cost containment features. |
| members pay for medical care, as long as members | | | | Talk to your employees: |
| use the HMO's preferred providers and facilities. If | | | | * Design a plan that includes employee contributions |
| members go outside of the network, they may be | | | | towards cost and keeps employees informed of |
| responsible for paying the entire bill. | | | | health care costs and rate changes. |
| In addition, members must choose a primary care | | | | * Create a committee to investigate the group health |
| physician, and see that person first whenever they | | | | insurance market. |
| need medical attention. The primary care physician will | | | | * Survey your employees to make sure you |
| make necessary referrals to specialists. | | | | understand their needs and objectives before |
| With HMOs, the per-visit or annual deductibles are | | | | launching a plan. |
| usually lower than with other plans. | | | | Educate your employees about the cost of |
| Preferred provider | | | | appropriate health care: |
| Preferred provider plans, known as PPOs, negotiate | | | | * Encourage employees to request second opinions |
| price discounts with health care providers. They refer | | | | and alternative, less invasive treatments. |
| to the health care providers that they have discounts | | | | * Help employees understand what is and is not |
| with as "network" providers. PPOs pay a higher | | | | covered under the plan. |
| percentage of your employees' claims if they use | | | | Create a health-conscious work environment: |
| network providers. | | | | * Limit smoking at work to designated areas or |
| Unlike HMOs members, PPOs members can see | | | | eliminate it entirely. |
| physicians without referral and can use physicians | | | | * Offer healthy choices in vending machines and |
| outside the network if they are willing to pay the | | | | alternatives to pizza and beer at employee events. |
| non-network cost sharing. | | | | * Promote moderation in use of alcohol and establish a |
| PPOs generally require more cost sharing than HMOs, | | | | zero tolerance drug and alcohol abuse policy. |
| even for in network care. The per-visit or annual | | | | |