Jason owns a small construction company in Texas that has a dozen employees who work hard every day. They climb ladders, pour concrete, and finish jobs on time which helps Jason continue to secure contracts. Jason wants to take care of his crew so they can continue to thrive together. A couple of years ago he reached the point where taking care of his crew includes offering health insurance as a benefit.
But every year when it is time to renew, the health plan from the big insurance company gets more expensive. The coverage certainly doesn't seem to improve while the monthly cost keeps going up. Jason always wonders if there's another way to protect his workers without paying more in health care costs.
He begins looking into alternatives to the big insurance companies. What he finds opens his eyes, but he also learns there are some things to watch out for.
Cheaper Plans May Not Cover What You Need
One of the first things Jason uncovers is there are health plans that cost significantly less each month than his current one. These lower health insurance costs got his attention fast. But he knew to look a little deeper.
Some of these non-traditional health plans have very high deductibles or don’t cover as much as they should. A few of them don’t include routine care or prescriptions. Jason realizes that saving money on premiums doesn’t always help if his workers have significantly higher out of pocket costs. Being able to afford to use the coverage when they’re sick or hurt is the point after all.
Given how high medical expenses can be, he decides to dig further and see what else is out there.
Health Sharing Isn’t Real Insurance
Jason’s friend tells him about a health sharing plan. The monthly premiums are much lower and some of his business owner friends recommend them. Jason likes how the plan options sound, but is afraid that it is too good to be true.
After reading the fine print, he finds out that health sharing programs are not the same as insurance. These medical plans are not regulated by the Texas Department of Insurance. This means if there is a dispute for an employee's medical bills, hiring a lawyer is the recourse.
Jason figures it would be fine. But if one of his guys breaks a leg or needs surgery, he doesn't want there to be a chance the bills may not get covered.
Jason wants to help his workers, not leave them hanging when something serious happens. He knows he needs a health insurance plan that does not leave that much risk on the table.
Self-Funded Plans Can Be a Good Fit for Some
Jason's search eventually led him to level-funded and self-funded health plans. These are different from traditional plans because the business helps pay for care by sending monthly contributions to an administrator who works to cover medical expenses that are incurred by the employees with this type of plan.
Level-funded plans are similar to self-funded health plans, but the employer pays the same average costs month to month. If his team stays healthy, the company might even save money if the plan does a partial refund at the end of the year. But Jason also learns that if someone needs a lot of medical care for a major health event, the business could end up paying more than expected in the end.
He finds out there’s something called stop-loss coverage that helps with those big bills. It’s like a backup plan to keep healthcare costs from getting out of control. Many of the level-funded or self-funded health plans leverage this to provide protection to the employer. This can make them a very cost-effective solution for smaller businesses like Jason's.
Jason likes the idea, but he wants to know if these kinds of plans still give his team access to good doctors and hospitals.
Some Plans Have Limited Networks
Jason was reading that some of the cheaper and alternative plans have small provider networks. That means his workers might not be able to see their current doctors or go to the hospital near home when it is time to use their healthcare coverage.
If someone needs care while traveling or working out of town, they might not be covered at all depending upon how network care is defined. Jason doesn’t want his guys to worry about seeing a doctor or get denied care when they need it most.
He realizes it’s not just about cost. It’s also about what care the plan gives access to and how easy it is for his team to use.
Getting Help From Someone Who Knows
Jason has learned a lot in his research. He now understands there are good options out there, but there are also risks no matter which path he takes. He also knows he can’t figure all this out alone.
He decided to connect with Insurance For Texans, a team of independent agents that helps Texas small businesses find business health insurance plans that actually work for them. They have access to many different options, and know the difference between a good deal and a bad one. Their agents start by asking questions so they can understand how your small company runs and what your workers really need.
Jason feels better knowing someone has his back and he can talk to about different benefits plans that might be available to him. Jason and Insurance For Texans find a plan that fits his team, his budget, and the kind of company culture he’s trying to build.
If you’re a Texas business owner like Jason, and you’re tired of feeling stuck with the big insurance companies, click the button below to let Insurance For Texans help you find a better way to take care of your people.