When your broker presents you with a group health plan proposal, it can feel overwhelming — multiple carriers, multiple plan designs, rows of numbers. Here’s how to cut through the noise and evaluate what actually matters.
Start With Total Cost, Not Just Premium
The premium is only part of the picture. Look at the total cost to your business: employer premium contribution plus any administrative costs. Then consider total cost to employees: their premium share plus out-of-pocket exposure (deductible + coinsurance + out-of-pocket max).
Compare Apples to Apples
Make sure you’re comparing equivalent plan designs. A $400/month PPO with a $1,000 deductible is very different from a $300/month HDHP with a $3,000 deductible — even if the premium difference looks attractive.
Evaluate the Network
Ask your broker to confirm that your employees’ primary care doctors and any key specialists are in-network for each carrier being proposed. A cheaper plan is no bargain if your employees can’t use their own doctors.
Check the Drug Formulary
If any of your employees take brand-name or specialty medications, check the carrier’s drug formulary to make sure their medications are covered — and at what tier. Formulary gaps can make an otherwise good plan unusable for some employees.
Look at the Carrier’s Service Reputation
Premiums are predictable; service quality isn’t. Research how each carrier handles claims, customer service wait times, and appeals. Your broker should have firsthand experience with how carriers treat policyholders.
Consider Year-Over-Year Stability
Some carriers offer very competitive rates in year one, then raise rates significantly at renewal. Ask your broker about each carrier’s renewal history with similar groups.
Garden State Benefits presents proposals in plain language with side-by-side comparisons so you can make an informed decision. Request a proposal for your group.