Evaluating Insurers and Health Plans

A plan may look good, but if the insurer turns out to be hard to deal with—or if the insurer goes bankrupt, for that matter—you’ll likely wish you had picked a different plan. Do a little research to make sure that your potential insurer:

  • Is financially stable.
  • Gets high marks in quality from an unbiased source.
  • Makes customer service a priority.

Financial Stability

You can find out if your insurer is financially stable by researching its financial rating. A number of companies provide this service, usually for free, though some companies may offer more information at a price.

See “Insurer Rating Companies” in the tool box.

Quality of Healthcare

The quality of healthcare varies widely. In addition to doctors, hospitals, and medical groups, insurers play an important role in seeing that you receive high-quality health services. Be sure to look into the insurer’s reputation and ratings for the quality of care provided under their plan.

In the tool box, find out more about the “Quality of Health Care” and how to factor this into health coverage decisions.

Customer Service

Look for an insurer who makes it easy for you to pay the bill and get help when you need it. Your broker can advise you on which insurers provide great service, and which give employers health care headaches. The best insurers also make it easy for employees to:

  • Find provider information. Most insurers have printed provider directories that customer service representatives can mail to participants upon request. Some also offer provider directories online.
  • Resolve claims quickly and efficiently. There’s nothing more annoying for employees and employers alike than dealing with an insurer who incorrectly processes claims or processes them so long after a service that errors become difficult to fix.
  • Reach someone who can help resolve a problem. Look for insurer customer service representatives who can handle both claims and member service requests, such as ordering a member ID card or changing primary care physicians.