It will be necessary for small businesses to find the right plan for their employees. They should weigh different factors, such as how many employees they have, whether to offer other benefits and what type of coverage they need to offer.
GetemployeeHealthcare offers competitive rates and monthly payment options to small businesses like you; find the right health insurance for your employees.
Benefits of offering employee healthcare to your staff
There are many benefits to providing your staff with employee health insurance from a small businesses standpoint.
It is a cost-effective method of attracting and retaining talent and keeping employees healthy and happy.
Getting health coverage through an insurance company provides a plan for the entire company, which can be more affordable than individual plans. It is also more flexible in its coverage since it caters to the needs of your employees.
Still, in today’s article, we’ll go into full details of employee health insurance for small businesses.
Let’s talk about some of the many different types of health insurance plans you can offer your employees, including what sorts of benefits they provide.
Types of employee health insurance plans for small businesses
Below are the types of employee health insurance for small businesses.
Narrow Network Plans
Narrow Network Plans, are a form of health care in which employees must rely on a single company for their healthcare insurance.
In the United States, most Narrow Network Plans were created to provide a cheaper alternative to traditional health policies by negotiating discounts with hospitals and doctors to provide health insurance to anyone in their network.
With Narrow Network Plans, patients pay a small amount to their health plan each month, covering all necessary services.
Advantages of the Narrow Network Plan
- 1: Narrow Network Plans are affordable
One advantage of the Narrow Network Plan is its affordability. The Narrow Network Plan is cheaper than most health insurance plans.
The main reason for this is that the insurer (in this case, the Narrow Network Plan) has a contract with a network of hospitals, doctors and other healthcare specialists to provide care for members at a discounted rate.
The Narrow Network Plans are a type of health care plan that provides you access to health care from a group of doctors. These doctors work with one another to get you the treatment you need at a lower cost.
With a Narrow Network Plan, you’ll pay low premiums, out of pocket, co-pays and low or no deductibles.
These providers offer a lower cost for coverage because they are an organization that is geared toward providing healthcare at a lower rate.
- 2: Narrow Network Plans offers quality health insurance
They offer one of the best coverage for your employees’ health needs. The Narrow Network Plans provides personalized health care which is tailored to your specific needs. You can choose a particular doctor or healthcare of your choice in the network.
Disadvantages of the Narrow Network Plan
- 1: You’re limited if you utilize the Narrow Network Plan
With the Narrow Network Plan, you are limited to one doctor or healthcare provider that you choose. This means if you pick a provider who is not in your network, or doesn’t work with your insurance network, then you will have to pay for out-of-pocket services.
You can’t visit doctors outside of the network with the Narrow Network Plan. If you do, you’ll pay any fee incurred.
You’ll need a referral from your primary care physician for any specialist if you utilize the Narrow Network Plan.
So if you need to see any specialist doctor, your primary doctor must make the referral for your visit with them to be covered under the plan. Otherwise, you will pay the price.
There are also specific conditions that need to be met to file certain medical claims, e.g., Emergencies.
Read More: Types and examples of employee benefits to offer your employees
2: Preferred Provider Organization (PPO):
A Preferred Provider Organization (PPO) is a managed care organization that contracts with health care providers and doctors for an agreed-upon set of medical or surgical services.
The PPO’s objective is to provide cost-effective and quality health care coverage to the organization’s members.
The Narrow Network Plans and PPOs are two of the most common types of health care plans. While both provide benefits, such as access to a network of doctors and hospitals, the Narrow Network Plan is typically less expensive than a PPO.
Advantages of PPO
- 1: Preferred provider organization is flexible
With the Preferred Provider Organization (PPO) healthcare, you can customize your insurance plan to suit your needs. PPOs offer a considerable number of medical care providers. You can choose from the in-network or out-of-network medical health practitioners or clinics.
- 2: PPO Offer lower costs for in-network services
Preferred provider organizations (PPO) offer lower costs for in-network services. These providers are contracted with a specific set of healthcare providers to provide discounted healthcare services to small businesses or companies. These include doctors, hospitals, surgeons, and clinics.
- 3: PPO doesn’t require referrals
With PPO, you don’t need a referral from any privately assigned doctor to receive care from a specialist or a provider out of your plan’s network. You can receive care for an existing condition or something new without having a primary doctor or utilizing your in-network healthcare providers.
Disadvantages of PPO
- 1: It’s costly in some cases
Preferred Provider organizations are costly managed plans.
The PPOs are much more expensive than many other managed-care plans.
These organizations are often preferred by large employers who offer health coverage to their employees.
However, many small businesses cannot afford the high costs of these organizations’ monthly premiums or deductibles; and are forced to seek outside help and find another health insurance option.
- 2: PPO is only best for in-network healthcare providers
With PPO, your level of benefits depends on your preferred in-network providers.
You’ll pay more if you utilize out-of-network providers, which means that you’ll either have to pay the total price for the service or be reimbursed based on the out-of-network rate set by your insurance company.
When you go out of network, you might have to pay more money in medical expenses, which your in-network Provider would otherwise cover.
You may be wondering why you would ever go out of network to go to a doctor. For many people, it’s simply the only way to get the right specialist. But what if your insurance company doesn’t cover them? What can you do?
What’s the difference between the Narrow Network Plan and PPO?
The Narrow Network Plan means that you must stay within your network of providers to receive coverage. Under a PPO plan, patients still have a network of providers, but they aren’t restricted to seeing just those therapists. They can also visit any healthcare in their network.
3: Point of Service plan (POS):
Point of Service plans are insurance plans that combine the flexibility and features of the Narrow Network Plan with the choice of a PPO.
Point-of-service plans typically provide lower costs, but there may be a limited selection of providers.
Advantages of POS
- 1: POS plans binds the best features of the Narrow Network Plan and PPO.
A POS plan is a combination of a PPO and a Narrow Network Plan. The Narrow Network Plan provides a low monthly cost, and the PPO offer the flexibility of choosing doctors and specialists outside of your network.
POS is a two in one health insurance plan that small business owners need to leverage because it’s flexible and affordable.
- 2: POS is a less expensive and flexible health insurance plan
POS or Point of service is a type of health insurance plan that provides your employees with a choice between a wide range of providers at a considerable rate.
POS is a perfect solution for those who want to choose their doctor, dentist, hospital and more. You can choose any doctor or hospital outside of your network.
POS pricing plans maybe 50% cheaper than the PPO plans.
Disadvantages of POS
- 1: POS premiums can cost much more than the Narrow Network Plan premiums.
Those who select a POS plan will find that the premium is significantly higher than the Narrow Network Plans could charge. Out-of-pocket costs and co-pays may also be much higher.
- 2: POS has a small market share
The POS market share in the health insurance niche is relatively smaller than other policies.
- 3: High deductibles
Another disadvantage of POS is out-of-network deductibles tend to be high for POS plans.
Out-of-network deductibles are an issue that many people consider when deciding if POS is for them. That is because out-of-network deductibles tend to be high for POS plans.
4: Exclusive Provider Organization (EPO)
EPOs have successfully provided care to patients in the healthcare industry while reducing costs.
At a high level, EPOs contract with hospitals to ease the purchase of their services. The goal is for the organization to reduce the cost of healthcare for small businesses while improving the quality of care for beneficiaries.
Except in an emergency, EPO is a managed healthcare plan where services are covered if you utilize specialists, doctors or hospitals in your plan’s network.
With an EPO plan, you need to use doctors, specialists, or hospitals within the network.
Advantages of EPO
- 1: Low cost
EPO or exclusive provider organization plans often cost less than the Narrow Network Plans and PPOs, so you get more value for your buck.
- 2: EPO is effective and a time saver
The EPO health insurance system is suitable for people looking for more efficient and effective healthcare. Specialists can be consulted without primary care provider referrals, saving time and money if you know what needs to be done.
Disadvantages of EPO
- 1: Limited to your network
When you enroll in the EPO plan, your insurance provider will cover only the in-network providers within the EPO network. If you go to an out-of-network provider, they will not cover any costs for this visit.
Read More: Check out the cost of employee health insurance in north and south Carolina.
What’s the Relationship between POS, PPO, EPO, and the Narrow Network Plans?
- POS = Point of service
- PPO = Preferred Provider Organization
- EPO = Exclusive provider organization
- NNP = Narrow Network Plans
Both PPO and the Narrow Network Plans require a person to be a network member before visiting a doctor or healthcare. However, PPOs allow the person to visit any doctor in or outside the network, while the narrow Network Plans require a person to see a primary physician first. POS plans offer a mix of both Narrow Network Plan and PPO.
Narrow Network Plans vs EPO; Narrow Network Plans and EPO are similar insurance plans, but the Narrow Network Plan has the potential to cover some of your hospital costs that are outside of the network. This can work out in your favor if you have an emergency. However, EPO is cheaper than the narrow Network Plans, but doesn’t offer support for out of the network visits or services.
A POS plan is similar to the narrow Network plan. With POS, you have the option to choose an in-network primary care doctor and get referrals from that doctor if you want more coverage or a policy to cover the specialist’s services.
A POS plan is also similar to a PPO because it offers coverage for in and out-of-network services.
Point-of-service (POS) plans are typically less expensive than other types of health insurance.
However, the savings may only apply to visits to the in-network providers.
The Narrow Network Plans offers a set level of coverage for a fixed monthly or yearly rate. In contrast, the POS only covers the cost of services provided by the network. Yet, if you need to see a specialist outside of your network, you may be required to do so with additional fees.
Below are one of the most common myths in the healthcare insurance industry.
POS plans could be 50% cheaper than the PPO plans.
While Narrow Network Plans typically have lower premiums than PPOs, the out-of-pocket costs for care may be higher with the Narrow Network Plans.
PPO and POS plans provide coverage either in-network or out-of-network.
You can’t just go to a physician or specialist directly.
Having a POS will give you access to a primary care doctor if you want to see any other specialists. PPO is limited to this same feature and is more expensive than the POS.
Having a POS will give you access to a primary care doctor if you want to see any other specialists. PPO is limited to this same feature and is more expensive than the POS.
Summary of employee health insurance for small businesses
Employee health insurance is a significant benefit that every employer should offer.
Different small business employers have different needs for implementing employee health insurance for their workforce. One of the most common requirements is that any coverage offered must meet the minimum standards set by the Affordable Care Act (ACA).
The ACA sets minimum requirements for what your plan must cover and how much you can charge employees to enroll in their plan choice.
GetemployeeHealtcare is a resource for small business owners who want to offer health insurance coverage to their employees.