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Shopping for Health Insurance

There’s no doubt the Internet has changed the way people conduct business, including the way many of us shop for insurance. Ten years ago, there were only a handful of Web sites from which you could obtain an insurance quote. Today, there are hundreds.

Web sites that sell individual and small group health insurance continue to rise in popularity despite getting off to a slow start. The skepticism surrounding the purchase of health benefits via the Web is natural given that strict industry regulation prevents health insurers from issuing binding health insurance policies online. While Web applications can collect your personal information and deliver a quote to you in the privacy of your own home, you will still need to interact with a real live person at some point in the process, whether face-to-face, by telephone, or through e-mail.

This reality doesn’t detract from the main appeal of the best Web sites ─ the ability to compare the ballpark prices of policies with varying benefit levels from several different insurers. Even if you don’t wind up purchasing a policy online, you can certainly benefit from the initial cost information you can obtain through the Internet quoting process. In addition, some of these Web sites offer a wealth of self help in the form of online tools, calculators, and articles.

A Word of Caution

Finding the right health insurance policy in cyberspace can be every bit as frustrating as trying to locate the same by visiting brick-and-mortar insurance agencies. Unless the online entities you choose have superior telephone or chat-enabled customer service support, you may find yourself left with plenty of unanswered questions. This lack of the personal touch may hurt your ability to make an informed choice. It’s easier for most people to simply ask an agent or broker to show them a license to sell health insurance than it is to go clicking through a Web site to find the legal language that discloses the exact same information. The other major drawback is that not every Web site will feature all the health insurance offerings that may be available in your state. If your state only allows certain types of policies to be sold online, you will be getting an incomplete picture of your policy options.

Completing an Online Quote Request

Filling out an online quote request for just yourself is a relatively straightforward matter, but you will need more time and information to complete a request for small group health insurance. Before you sit down at the computer to get quotes for your business, make sure you have the following:

• Your company’s North American Industry Classification System (NAICS) or Standard Industrial Classification (SIC) code. (NAICS, which is replacing SIC, is used by the statistical reporting agencies of the United States. NAICS groups together businesses that use similar processes to produce goods or services. For more information, visit the U.S. Census Bureau Web site at: www.census.gov/epcd/www/naics.html.)
• Employees’ names.
• Employees’ home zip codes.
• Employees’ dates of birth.
• Number of employees’ dependents and their dates of birth.
• Plan requirements. Will you offer your employees dental insurance? Vision benefits? Add-ons will increase your costs, so you need to decide ahead of time which benefits are an absolute must and which you and your employees can do without.
• Premium Share. How much of the premium can you afford to share with your employees? If you’re struggling to strike a balance between offering affordable coverage and business profitability, look into ways you can lower your costs, such as raising the plan’s deductible. (See Tips for Cost Cutting.)

If you are looking for coverage for yourself and/or your faimly only, you will need the above pertinent information for each family member to be covered by the plan.

Once you supply this information, you will either receive an instant online quote or you will be referred to an agent. Either way, you will eventually have to complete a detailed health insurance application as if you had visited a brick-and-mortar insurance agency in the first place.

Choosing an Agent

Perhaps you prefer to deal face-to-face with an agent. Or you’ve already shopped for quotations online and now you’re ready to sit down with someone who can help you weigh your options. How do you find the right agent?

Ask your family, friends, or trusted business acquaintances. These are the folks whose opinions you most value. Make sure the person they recommend has experience selling the type of health insurance product you need. Don’t hesitate to quiz them on how well the agent performed. Was the agent polite and prompt in answering questions about their policies? Do they feel the agent took the time to fully explain the terms and conditions of their coverage? On a scale of 1 to 10 (10 being the highest), how knowledgeable is the agent about the products he or she sells? Use their answers to make a short list of the names of agents you intend to contact.

Find an Agent Through a Professional Organization

There are numerous professional organizations and associations for insurance professionals. Three national organizations which feature online agent locators are:

• The Association of Health Insurance Advisors (AHIA) at www.ahia.net.
• The National Association of Health Underwriters (NAHU) at www.nahu.org.
• The Independent Insurance Agents and Brokers of America (IIABA) at www.independentagent.com.

Telephone agents in your area and don’t be afraid to ask them about their experience in finding affordable group coverage for small businesses like yours. Ask how they would help you and your employees get the maximum protection you can afford. Ask which insurers they represent. Determine if the agent has any professional designations such as Registered Health Underwriter (RHU), Health Insurance Associate (HIA), or Registered Employee Benefits Consultant (REBC). If you don’t like someone’s answers, move on to the next name on your list.

Once you have narrowed down the field, interview the candidates and then select the agent that is right for you. Make sure you verify his or her license to sell health insurance with your state Department of Insurance. A list of state DOIs can be found at www.naic.org.

Questions to Ask Your Agent or Broker

When you are ready to sit down and evaluate your small group health insurance choice with your agent, bring a list of questions that will help you compare products. If there are any unanswered questions, ask your agent to contact the insurer and get the information for you.

• Before making your selection, you should know the answers to:
• Do we need to choose a primary care physician (PCP)? Do we select the doctor from a list of contracted physicians or from the available staff of a group practice? How do we know which doctors are accepting new patients? Is it difficult to change a PCP if you decide you want someone else? How are referrals to specialists handled?
• How easy is it to get an appointment? Does the insurer have access standards that ensure enough physicians are available for all its members? How far in advance must routine visits be scheduled? What arrangements must be made for emergency care?
• Does the health plan offer the standard services we need? Are there any limits on medical tests, surgery, mental health care, or home care? What if an employee or dependent needs a special service not provided by plan? Are preventive services such as annual physical exams and immunizations covered?
• What is the plan’s service area? Where are the doctors’ offices and hospitals located in our community that serve this plan’s members? How convenient to our homes are the doctors, hospitals, and emergency care centers that make up the plan’s network? What happens if one of us is out of town and needs medical treatment?
• What will the plan cost? What is the yearly total for monthly fees? In addition, are there copayments for office visits, emergency care, prescribed drugs, or other services? How much? Does this plan feature a deductible and coinsurance rates for care outside of the provider network? If yes, is there a limit to the maximum each of us would pay out of our own pockets?