7 aspects of coverage to consider when choosing a plan

As a small business owner, you’re used to making decisions with the success of your business and employees in mind. But when it comes to finding the best health insurance plan, it can be difficult to know where to begin.


As you compare health insurance plans, use this checklist below to weigh the pros and cons of each one, so you can find the coverage and care you need at a price you can afford.

The cost of the premiums

Your premium is the amount you pay to your health insurance company each month to maintain coverage. You’ll want to know the cost of premiums when comparing plans to ensure you stay within your budget. Typically, you’re required to pay at least 50% of monthly health insurance premiums for your employees.

The size of the provider network

To keep costs in check, narrow networks limit coverage to a select group of physicians, specialists and hospitals, while broad networks give your employees more flexibility to choose who they see, but at a higher cost.


Knowing the size of your plan’s network matters because of how much convenience and protection you want to offer, while taking into account how much you’re willing to spend.

Coverage for out-of-network services

To save on costs, some plans do not provide coverage for out-of-network services unless it’s an emergency, while others will give your employees the choice to receive care from any provider who may be either in or out of network.

Required referral from a primary care provider

Depending on the plan, your employees may need to see their primary care provider before seeing a specialist. Other plans do not require referrals. 

The maximum out-of-pocket cost

A maximum out-of-pocket cost sets a limit on your employee’s annual financial liability. After they have paid out-of-pocket through deductibles, copayments or coinsurance up to the maximum amount, the insurance company pays the full charges for any additional covered medical services used that year. Monthly premiums do not count toward maximum out-of-pocket costs.

Who you’re partnering with

When choosing a health insurance plan, you’re also forming a partnership. By picking a plan that gives you someone to serve as your point of contact, you can build a relationship with someone who knows you, your business and your goals.

What value-added services are offered

With a health insurance plan, you’re getting more than just coverage. You’re also investing in the health of your employees, making it important to consider what other benefits may best support the health of your workforce. Value-added services as part of coverage may include free annual exams, preventive screenings, virtual care, fitness center reimbursements and more.

Remember that you have options

After choosing a health insurance plan, every year you can evaluate if it’s still meeting the needs of your employees. Although it can be intimidating to switch health insurance plans as your business evolves, the health needs of you and your employees may change. By comparing quotes each year, you can ensure that your health insurance plan continues to help your business and employees thrive.


Get more from your health insurance with Sanford Health Plan for Business. 


If you’re ready to learn more, click here for our easy-to-use guide to compare plans. You can also call us at (888) 535-4831 to talk to one of our experts or get a quote by clicking here.

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