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Published on April 12, 2018

explaining health insurance plans

Five Questions Employers Should Consider When Choosing Insurance

Employers make some crucial decisions when they are considering health insurance plans for their employees. Debra Muller, Chief Executive Officer, Avera Health Plans, offered her insights and answered five of the biggest questions employers might face.

1) What are some factors to consider when it comes to rates?

Find an agent you trust. Make sure they are willing to share all of your options and help you balance affordability with maximum employee coverage. Remember to ask your agent about the renewal history of the carrier, because you want assurance that you’re with a health plan committed to stable renewals. When you are, you can effectively budget for your business needs.

2) How can defined contribution plans give my employees more choice?

Defined contribution plans allow you to pay a set amount toward your employees’ health care while allowing the employee to pick from a number of plan options. Employees can choose to pay for more coverage, but your contribution toward each plan remains the same. This allows you to budget and keep your costs predictable.

This is an option for employers who are looking to fix their spending on health benefits. One consideration with this strategy is the necessity of balancing budget needs with your retention and recruitment reality. Well-versed agents are a great source of information on both short-term and long-term implications of implementing a defined-contribution strategy.

3) How do services like virtual visits fit into the decision? Some health systems offer telemedicine alternatives to in-person visits – how does that work?

Virtual visits must be part of your overall health benefits game plan. A great example is AveraNow, and it allows your employees to connect with a provider 24/7 from a laptop or mobile device. Avera Health Plans offers this service as an embedded, no-cost service to our fully insured members. It’s a part of plans that do not qualify for a health savings accounts.

When you have consumer-directed, high-deductible plans that are tied to a health savings account, you can stretch your health care dollar further by using a virtual visit through AveraNow, and it works in all 50 states. Some health systems require you to be a prior patient, but this service does not.

4) What considerations should I make on plans when it comes to doctors and their affiliations with the insurance?

Networks can be confusing, and a common misconception about the Avera Health Plans approach is that it only covers services provided by an Avera provider. That is false. The Avera Health Plans network covers the entire state of South Dakota and includes many independent providers such as Regional Health, Brown Clinic, Falls River Health Services and Mercy Medical. If one of your employees wishes to see a provider who is not in our network, we will reach out to that provider.

In some cases, if they choose not to participate with our network, we can assist your employee with a transition to a provider who does. Our agents and entire team then can provide support for continuity of care, thus making it easier regardless of challenges they might face.

5) When does a decision kick in and affect my bottom line?

Your savings begin as soon as your coverage does, and that’s why starting sooner is better. You can call an agent today, review all the options and get your employees’ coverage started.

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Avera is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services guided by Christian values.

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