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Finding a Health Plan and Policy

Researching, comparing, budgeting and selecting a health insurance plan(s) may seem overwhelming and complex. These steps can help guide you through the process.

  1. Identify at least three health insurers to contact.
  • Go to Alabama Health Plans to get your research started.
  • Are there purchasing alliances or professional/trade associations in your community that offer a range of health plan products to member employers?
  1. When researching potential health insurers, consider evaluating:
  • Financial stability
  • Ease of administration
  • Overall quality of services and reputation
    • Be sure to look into the insurer's reputation and rating for the quality of care provided under the health plan. You may want to visit the The National Center for Quality Assurance web site which publishes annual report cards on health plans.
    • Does the insurer make it easy for employees to:
      • Find health care provider information (Are online or hard copy directories easily available?)
      • Resolve claims quickly and efficiently
      • Access customer service representatives to answer questions and resolve member service issues
  1. Once you have identified your health insurers, review at least two or three different health plan options that each insurer offers.
  1. When evaluating health plan options, consider these questions:
  1. What overall health plan benefits would you be receiving for the cost? Consider:
  • Structure of the pharmacy benefit for prescription drug coverage
  • Hospitalization
  • Behavioral or mental health coverage
  • Choice of health care providers, hospitals and medical groups that employees can easily access

You can use the Choosing A Health Plan Checklist to identify many benefits and services that a health plan option can cover.

  1. What are the employer and employee costs?
  • What are the monthly costs for the employer and employee?
  • How much are the participant's co-payments at time of medical service?
  • What is the out-of-pocket maximum that a participant can reach before the health plan waives additional out-of-pocket charges for the participant for the remainder of the year?
  1. Are there any cost-saving strategies to consider?
  1. What is the effective date of coverage?
  • Most employers start their health plan coverage on the first day of the month.

E. What is the health plan's cycle?

  • Most health plans operate on a January–December cycle but it’s good to double-check its 12-month cycle.

F. What are rules of coverage and options?

  • Health plan rules and options can be complex so spend the time to understand and question them with the health insurer.

5. Once you have decided on a health insurer and a health plan(s), you will want to:

  • Give your company at least six weeks before the coverage goes into effect so you can complete all the paperwork and administrative steps.
  • Sign the contract before the quote expires. Quotes usually expire in 30 days

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