Small business questions
- - Who is eligible for coverage and when does coverage start?
- - What employer contribution is realistic and consistent?
- - Which hospitals, doctors, urgent care centers, pharmacies, and specialists matter locally?
- - Are employees better served by group coverage, spouse coverage, Marketplace coverage, or reimbursement-style options?
- - What broker, payroll, tax, and compliance support is needed before launch?
Employee cost questions
- - Payroll premium for employee-only coverage
- - Payroll premium for spouse, child, and family coverage
- - Deductible and out-of-pocket maximum
- - Copays and coinsurance for primary care, specialists, urgent care, emergency care, imaging, and prescriptions
- - Whether the plan is affordable for lower-wage, part-time, seasonal, or family-coverage employees
Network and access questions
- - Are local hospitals and major specialists in network?
- - Are employees in different cities or states using the same network?
- - Are urgent care, imaging centers, labs, pharmacies, mental health clinicians, and maternity care accessible?
- - Does the plan require referrals, prior authorization, or narrow-network routing?
- - Can employees get clear plan documents before enrollment?
Red flags when choosing employee health insurance
- - Choosing the cheapest premium without checking the deductible and family cost
- - Offering a plan that looks good for owners but is hard for employees to use
- - Ignoring prescriptions, chronic conditions, maternity care, mental health, and hospital access
- - Not checking whether the plan works for employees outside the main office location
- - Skipping licensed broker, tax, payroll, or compliance review for group coverage decisions