Same Health Plan Options

njjel

We have several offices in the same state. However, even within the state the health insurers have stronger net works in some areas than in others. I believe we, therefore, can offer one health plan to one area and not to another based on that. Am I correct?

Down_the_Middle

You can clearly offer a different health plan to your different employers/markets as long as each plan is independent and not part of a master group plan. The risk in trying to offer a master plan with variable plan designs is the risk of not being able to comply with the discrimination provisions---and the impact of highly compensated employees. The fact that all of your employees are within the same state strongly suggests that to get too fancy with your health plan will lead to: a loss of your ability to leverage discounts with the health providers, plan design differences which may be awkward to keep straight and the polarization of employees who start comparing the plan differences.

I looked at doing this sort of thing years ago and found that the size of our total workforce (2,500 ee's) was not large enough to justify multiple health plans. For what it's worth...............

njjel

I appreciate your response. Did you get much negative feedback from the employees who were in areas where the coverage that you offered had a weak network of doctor's and hospitals? (That is what would be the case here.)

Down_the_Middle

Sure. We had some criticism, but it boiled down to offering coverage for those networks that were in their geographic areas. We eventually agreed to "supplement" coverage by agreeing to pay the OOP cost differences for a couple of treatments/procedures that employees felt were better in some other networks. After a couple of years, the provider networks expanded and eventually included everyone.