Smart Questions: Health Care: How to Get a Better Deal
Another year, another hike in health care costs. Before you re-sign with your current insurer, here are some questions you can ask your broker or insurance carrier to make sure you're getting the right coverage at the right price.
By Sarah Goldstein | Nov 1, 2007
Is it time to look for competitive bids?
That's a rhetorical question. It's always time to look for competitive bids. Even if you think you have a good deal, why not see what else is out there? If you don't want to switch, it's still one of the best ways to negotiate lower costs with your current carrier.
Can I see my company's claims history?
It's illegal to look at employee medical records. But getting a summary, without names attached to it, will help you make informed decisions. If workers are buying brand-name drugs, for example, consider raising the co-pay for expensive prescriptions and lowering the cost of generics. If your employees start switching to lower-cost drugs, it will eventually lower your premiums. On the other hand, if no one is using primary care, you may want to lower the co-pay, since good primary care can save you money in the long term.
Should I get a rerate?
There are two reasons to consider asking your insurance carrier to recalculate your premiums: if you think your workers have been pretty healthy or if there's been substantial employee turnover. The insurance carrier sends all your employees a detailed survey about their health status and then reviews the responses. But there's a risk: If your workers are sicker than you think they are, you could get slapped with higher rates.
One of my employees has a serious disease. Can I do anything to keep my rates down?
Consider waiving co-payments for high-maintenance diseases like diabetes, says Paul Fronstin, director of the Health Research and Education Program at the Employee Benefit Research Institute, a research group based in Washington, D.C. When co-pays are lower, people visit the doctor more often--which helps prevent costly emergencies. As a result, overall costs often go down, Fronstin says.
How much are prices rising in my region?
Your broker should be able to tell you what the regional average is and how your policy compares. "If your rates will be going up 16 percent but the average is only 12 percent, you'd better ask why you're being charged that extra 4 percent," says Christopher Brady, VP of the employee benefits program at insurance broker HUB International. You may be paying more because of low co-pays or deductibles. "Still, see if you can get your broker to knock off a point or two for the regional rate," says Brady.