When an agent or an insurance company gives you a proposal, it's likely to contain lots of glossy materials designed to make having insurance with this company look like a life-enriching experience. There are a few critical pieces of information the proposal should contain that you should look at:
The premium schedule. Somewhere in the proposal, there should be a document that tells how much your insurance plan will cost per employee per month. Generally, the proposal will not break down any cost-sharing arrangement between you and the employee.
The benefits schedule. You should also locate the benefits schedule, which should give you a general overview of the benefits the plan includes, with specifics such as inpatient care, outpatient care, and office visits, with specific information about how much copayment will be for each service and any limitations on the number of days of a covered treatment or procedure. This form should be easy enough to understand that you can distribute it to employees as a reference.
The list of network doctors. It is imperative that you look at the list of network doctors if you are going with any managed care plan, such as an HMO or PPO. Check to see how many of the doctors are in your area or in the service area of your employees. If there are only one or two doctors in your town, your employees may have to travel a long distance to get a doctor. Look closely at the list to see how many doctors are not taking new patients. That's a sign of an overburdened network that may make it difficult to get timely appointments.
The itemization/cost breakdown. There should be a document in your proposals that shows how your insurance company/agent arrived at the figures he or she has given you. Pay particular attention to this sheet. It may help you when you try to bargain on the price of the care.
Copy of the policy. The proposal should include a copy of the actual
contract that contains all the specific coverage levels and limitations. Make
sure that this document reflects what you understand your policy to cover. Once
it's signed, you won't be able to negotiate. Make sure it matches the benefits
schedule referenced above, too.