Employers who qualify to offer health insurance can do so through three ways. They are as easy as A, B and C - an association that offers health insurance, a broker who will choose from a variety of packages, or a health insurance carrier. These options are explained below.

Associations

Associations are groups of individuals or organizations with a common interest to promote. Some examples are business associations, chambers of commerce, employee groups, or labor unions. Associations often offer different types of benefits to their members, such as a health insurance plan.

Association plans enable business and professional associations to offer health benefits to their members. Associations can negotiate for coverage on behalf of their members. The association takes the burden off of its members by shopping for the best deal and can also offer them the same marketing efficiencies enjoyed by large employers.

Brokers

A broker chooses among several health insurance carriers and selects the coverage. A broker (some brokers are also called consultants) should assist with the following:

• Plan design and product placement
• Employee communications
• On-going plan management and analysis
• Professional compliance service
• Account management

A broker/consultant represents the employer in the insurance marketplace. They also assist with plan design and product placement, employee communications, on-going plan management and analysis, professional compliance service and account management.

A broker/consultant has:

• Client list
• Standing in the insurance commissioner’s office
• Special designations within a carrier
• Breadth of value-added services
• Experience and creativity
• Referrals

A broker/consultant can assist in simplifying the process by:

• Analyzing existing benefits, rate and contractual structures
• Assisting and advising in the development of plan designs
• Preparing Requests for Proposal (RFP) and conducting a market study
• Negotiating with insurers and suppliers who can provide sound, competitive alternatives for consideration
• Recommending cost containment measures and plan considerations
• Placing all selected products with appropriate carriers and suppliers
• Developing a timeline, implementation and communication strategy for recommended plans

Carriers

A carrier is a health insurance company that directly offers insurance to covered lives. Carriers issue and assume the risk of a health insurance policy in the event of loss due to pre-specified conditions.

A carrier should:

• Pay medical and mental health claims in a timely manner
• Enroll and produce ID cards for members
• Supply customer service assistance for members and providers
• Contract with Health Care Providers to receive a discount on medical charges

After deciding how to offer health insurance, an employer must decide what type of health insurance to provide. Click here to learn about the many types of health insurance offered.