5 Essential Group Health Questions for Small Businesses

Learn How to Navigate Group Health Insurance by Simplifying Your Health Plan Choices and Ensuring Comprehensive Coverage for Your Employees

Being a business owner can be overwhelming. With an endless list of responsibilities, one of the most crucial tasks is choosing a group health insurance plan that best suits your business and employees.


5 Essential Questions

To help make the process easier, here are five key questions that every owner of a small business should ask before choosing a group health insurance plan:

1.What Are the Different Types of Business Health Insurance Plans?

A business owner needs to understand the different types of health insurance options available.

  • PPO (Preferred Provider Organization): A network of healthcare providers who have agreed to provide care to plan members at an agreed-upon, generally lower cost. A PPO provides the greatest flexibility.  A plan member can see an out-of-network provider, but the plan may not cover the full cost of care.
  • HMO (Health Maintenance Organization): Requires employees to use healthcare providers within the HMO network.
  • Fully Insured Plans: Traditional insurance where the employer pays a fixed premium to an insurance company.
  • Self-Funded Plans: The employer assumes the financial risk of providing healthcare benefits to employees.
  • Level-Funded Plans: A hybrid between fully insured and self-funded plans, with a predictable monthly cost.
  • HDHP/SO (High-Deductible Health Plan with a Savings Option): Lower premiums with higher deductibles, often paired with health savings accounts.
  • POS (Point-of-Service Plans): A mix of HMO and PPO plans where employees need referrals to see specialists.


2. Will All Employees Receive Coverage?

Consider who will be covered under the plan. Will the plan cover full-time and part-time employees, or just full-time employees.  Evaluate the specific needs of your workforce, such as prescription drug coverage, dental, and maternity care. Remember, offering coverage to a wider range of employees and their families can enhance job satisfaction and retention.


3. How Much Can Your Employees Afford to Pay?

Understanding the cost-sharing structure is crucial. Insurance companies generally require employers to cover at least 50% of the premiums. Evaluate your budget and decide how much you can afford.  Higher contributions can significantly lower the cost for your employees, making the plan more attractive and manageable for them.


4. Would Your Employees Rather Have Low Deductibles or Low Premiums?

There are two main costs associated with health insurance: monthly premiums and out-of-pocket expenses like deductibles and copayments. Plans with lower premiums usually come with higher deductibles and vice versa. Assess your employees’ healthcare needs and preferences to choose a plan that balances these costs effectively.


5. Do You Want to Cover the Family Members of Your Employees Too?

Decide if you want to extend coverage to your employees’ families. This decision will generally depend on your budget and the demographics of your workforce. Offering family coverage can be a significant benefit that helps attract and retain talent.


Understand What to Ask When Choosing a Group Health Insurance Plan

Choosing the right group health insurance for your business can be daunting. By asking the right questions, you can ensure that you select a plan that meets the needs of your employees and fits within your budget.

RMC Group Health Insurance Plans


At RMC Group, we believe that plan design matters and there is not a one-size-fits-all plan. We help employers customize the right benefits package for them and their employees. For more detailed guidance and assistance in selecting the perfect group health insurance plan for your business, click here to schedule a discovery call with one of our Health Insurance Professionals.

Or you can visit our website at rmcgp.com to read more about your options and find the best coverage for your needs.