Five Questions Employers Should Consider When Choosing Health Insurance

Employers face crucial decisions when they consider employee health insurance plans. Jordan Anderson, Vice President of Sales with Avera Health Plans, said several important questions are most common for all employers.

What are some factors to consider when it comes to premium rates and affordability?

Find an agent you trust and who will show you all your options. An agent who can explain how to balance affordability and maximum employee benefit coverage is best. Ask them about their experience with the renewal history of carriers. You want assurance you’re with a health plan which has been in the market and is committed to stable renewals. When you are, effective budgets for your business needs are more obtainable.

How do I create an effective contribution strategy and give my employees more choice?

Considerations for effective contribution strategies that allow for choice include:

• Understand how comparable the benefit plan you offer is to your industry peers or the employee talent you hope to attract and retain. You might find offering benefits that are in line with competing employers gives you a chance to cover a greater percentage of the overall premiums and perhaps fully fund other employer-based coverage, such as dental, life or vision.
• Yet you must consider if your plan-offered benefits expose employees to higher out-of-pocket expenses. If they do, you should consider introducing Health Reimbursement Accounts. They can offset some costs to employees who use the plan benefits.
• You should have a good idea of your employee demographics. A start-up company in the tech sector will likely have many young workers who use their benefits a couple times each year, so a generous benefit plan with low out-of-pocket costs makes less sense. It could lead you to overpay for the value your employees get. That sort of business might do best with high-deductible plans that have Health Savings Account qualifications. Then employees have nest eggs for medical expenses they can build over time and use when needed. Your expense remains the same, yet employees gain the value.
• Find out if the employer coverage you offer benefits your team and their families. Enhanced tax credits significantly increased the amount of financial assistance available to reduce monthly premiums and expanded eligibility to higher income levels. The extension is set to expire at the end of 2025, so it may be time to re-examine if this is a good fit. In 2026, the amount of premium assistance will revert to pre-COVID lower levels, meaning that most enrollees will see increases in premiums.

Read more: Changes to health insurance open enrollment in 2026

How invested in your employees’ overall health is your insurance carrier?

Invest in an insurance carrier that makes employees’ health a priority, you can reduce the difficulty.

Your carrier should offer health risk assessments and biometric screening programs at the least, and efforts that help with weight management, behavioral or lifestyle coaching and chronic condition management programs pay for themselves.

Avera Health Plans well-being benefits include the LiveNOW well-being program, virtual checkups and even fitness center incentives.

Many studies show that lost income from missing work can cost employers about $1,700 per employee each year. Other studies show workers who can’t produce at full capacity – often due to illness, mental health issues or burnout – actually cost more. When you partner with a health insurance organization that is as committed as you are to overall employee health, you have greater potential for engagement, recruiting and retention and in the end, greater results.

What considerations should I make when it comes to doctors, providers and networks?

Networks can be confusing. A common misconception about Avera Health Plans is it only covers services from Avera providers. That is false. The Avera Health Plans network includes independent providers such as Monument Health, Brown Clinic, Falls River Health Services and Brookings Health. If one of your employees wishes to see a provider who is not in our network, we will reach out to that provider to seek a network contract.

If a network contract cannot be reached, Avera Health Plans still offers benefits for out-of-network coverage. The member will still have insurance coverage, but they will have an increased share of that cost.

How does timing of decisions affect my bottom line?

Savings and coverage kick in at the same time. So starting sooner is better. You can call an agent today, review all options and get coverage started for your employees.

Learn more about narrow networks and their advantages.

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