Take care of your people. Grow your business. Secure your future.
We value health, so we work hard to offer you the best benefit options for your company. Since health can be both personal and financial, our relationships with reputable national insurance carriers help you get the employee benefits you need and the cost control remedies you want. We know from experience that an employer-sponsored health insurance plan can save your employees money on both premiums and out-of-pocket expenses.
No matter what employee benefits you’re considering, our prices are competitive, our fees are clear and our deep industry relationships allow us to go above and beyond while delivering year-round value.
To learn more about how our values-based approach drives value for you and your employees, click here.
Or visit our Insights page to learn more about how group health plans work.
If you have questions, we have answers.
Higginbotham’s team of experienced group health insurance specialists is here to answer your questions and help transform your uncertainties into opportunities.
A preferred provider organization plan, or PPO, is more flexible than a health maintenance organization plan, or HMO, but can be more expensive.
Rather than require the election of a primary care physician (PCP) and referrals as a prerequisite to access care, a PPO plan allows employees to visit any in-network health care provider.
While a PPO does not require a PCP referral to visit a specialist and may extend some degree of coverage for out-of-network service providers, out-of-network services often carry higher out-of-pocket costs.
Typically the cheaper of the two most common group care coverage options, an HMO, limits eligible health care service providers to a predetermined network of in-network physicians.
After enrolling in an HMO, the employee selects a PCP who acts as the gateway to other in-network medical service providers and must provide referrals as a prerequisite to specialist treatments and other secondary care.
For example, if you need to see a podiatrist as a member of an HMO plan, you first need to schedule an appointment with your PCP, describe your issue and have the PCP refer you to an in-network provider.
Though HMO plans often have lower premiums in comparison to PPO health insurance, their in-network referral requirements make them less flexible.
Because they don’t offer coverage outside of their approved provider network, the total cost of care under an HMO may be higher than a comparable PPO for some plan subscribers.
It’s wise to work with a health insurance consultant to determine which plan will be the most cost-effective and beneficial for you and your employees. If you’re interested in learning more about the options available to your business, our seasoned employee benefits specialists are happy to help.
With pricing outside of the traditional rates set by insurance carriers or rented networks, reference-based pricing can help reduce out-of-pocket costs.
Instead of carriers or networks negotiating discounts from provider-billed charges resulting in a “contracted-rate” or “allowed amount” that the health plan pays the provider, reference-based pricing determines provider reimbursement by a percentage of what Medicare would typically pay the provider. This usually ranges from 120 to 170 percent of Medicare reimbursement.
Your team is going to have a lot of questions about their health insurance. Here’s some insight to help give them the answers they need.
Designed to help businesses reduce health care costs for employees and their dependents, a group health insurance policy splits the cost of coverage by way of blanket coverage provided to all participating employees, with premium cost split between the employer and the employed. An insurance carrier pays for the agreed-upon portion of your employee medical costs outlined in your policy in exchange for premium payment and an employee copay.
Typically, the higher the monthly premium cost you pay, the lower your employee deductible will be. Group plan coverage can help with the cost of checkups at the doctor, prescriptions, emergency room visits, long term care and more.
In most cases, buying into an employer group health plan is more cost-effective for an employee than purchasing individual or family coverage independently.
While a group plan can improve job satisfaction, retention and recruiting capabilities, there are requirements an employer should understand.
If your business employs one or more people, you may be eligible to purchase group health insurance coverage.
Depending on the size of your full-time employee group, you will fall into one of several market segments based on insurance carrier guidelines and state and federal laws. Your market will dictate the types of products available and pricing strategies.
Group health insurance plans can help take care of your employees’ health needs, improve their satisfaction and increase employee retention.
Group health plans can also lower the total cost of care compared to similar individual health insurance options.
These savings are achieved through the larger risk pool created by group enrollment. In other words, a plan with many employee participants enables the insurance carrier to spread the risk, offsetting the increased cost of covering high-risk participants with the reduced cost of covering low-risk participants.
In addition to premium savings for employees, group plans can also save businesses money through tax benefit, because employer contributions are tax-deductible, allowing participating businesses to offset their payroll and income tax liability.