How to Put Together an Employee POS Health Insurance Plan

An employee point-of-service (POS) health insurance plan combines a PPO and an HMO, offering more choices with minimal out-of-pocket expense. When you put together a POS plan for your company, you should choose a provider that offers affordable rates and a high level of benefits.

Difficulty: Easy

Instructions

1. Speak with your current employees to see whether a POS plan would be beneficial for them. Since POS premiums are generally higher, this extra cost may be passed on to them. You can direct them to a site like MamasHealth.com for more information about this type of plan (see Resources below).

2. Contact your state's insurance controller to see how potential carriers rate. The office may provide a list of recommended providers or brokers. You can usually learn how many lawsuits a carrier has faced and access a database of consumer complaints.

3. Review plan documents provided to both the company and your employees. Most carriers provide educational material and benefit packets that may help your employees make informed health care decisions.

4. Compare in-network coverage and copay schedules to put together a plan that benefits employees while providing you with a reasonable premium. The highest premiums mean low copays and full coverage. Don't just check routine care, but also look into costs for surgeries, emergency visits and other treatments.

5. Select an employee health plan with a deductible that fits your employees' lifestyles and incomes. With a POS plan, out-of-network costs can skyrocket. In some cases, the out-of-pocket copays and deductibles may be too much for employees to handle.

6. Renew your insurance as infrequently as possible. Find out whether your plan must be renewed every 6 months or once a year. Premiums tend to increase with each renewal, so you want to lock in current rates for as long as possible.

7. Choose an employee prescription plan that covers common drugs while keeping copays low. If you need to save a few dollars on the premium, choose a higher copay for prescriptions.

8. Call a doctor you trust to see whether she takes the insurance and find out whether the office has had any problems with claims in the past. The doctor's office may have run into roadblocks on out-of-network coverage or referrals. Find a plan with the least complaints.

9. Visit NAIC.org to find insurance resources for your state (see Resources below).

Tips & Warnings

• To keep your staff in the best of health, put together a complete POS plan, including vision and dental insurance. A POS plan offers maximum freedom, which meshes well with dental and vision insurance through which employees may retain access to trusted providers.

Resources

• MamasHealth.com for an overview of POS plans
• NAIC.org for insurance resources by state