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7 Questions to Ask Your Employer at Health Insurance Enrollment Time

Written by: Christina Merhar
November 19, 2014 at 1:30 PM

It's health insurance enrollment time and your employer is likely to make changes to your employer-sponsored coverage. That's because every year employers must re-evaluate their health insurance offerings and make difficult decisions about coverage levels and costs. As a smart consumer, pay attention to the information provided at the benefits meetings, and ask these questions about your healthcare coverage (hint - the last question will probably surprise you).

6 Questions to Ask at Health Insurance Enrollment Time

In an article by Kaiser Health News, Jay Hancock suggests six questions employees should ask their employer about their health insurance coverage at enrollment time:

  1. Is my doctor still in-network?

  2. Is my employer changing where I get labs and medications?

  3. How will my out-of-pocket costs go up?

  4. How do I compare medical prices and quality?

  5. Can I use tax-free money for out-of-pocket payments?

  6. How is my prescription plan set up?

These are all fantastic questions to ask to understand your health insurance coverage, and to be a smart healthcare consumer.

For example, it's common for employers to change networks, plans, or carriers to manage costs. This might mean your doctor or specialist is now out-of-network and you'll be required to pay more to see them - or you'll need to switch doctors all together.

Similarly, to control costs nearly all employers have begun shifting more costs to employees. Additional costs can show up by means of how much you pay each month for coverage (your premium), or how much you pay out-of-pocket when you receive care.

The 7th Question to Ask at Health Insurance Enrollment Time

All of the six questions above point to the "pitfalls" (as Hancock suggests) of your employer-provided health insurance. Which is why I would suggest a seventh question to ask your employer.

7. Can you please cancel our employer-sponsored health insurance?

At first this might sound a little crazy - for decades most of us have purchased health insurance in one way, and one way only - from our employers.

But now, as we've written about previously, individual health insurance is better than employer-sponsored health insurance because it is less expensive, enables choice, and stays with you when you switch jobs.

With individual health insurance you wouldn't need to ask the six questions above because you are in full control of your healthcare.

Additionally, your company may cancel its employer-provided health insurance and give all or part of the savings to employees to help them cover all or a portion of their individual health insurance premiums. This concept is commonly referred to as defined contribution health benefits or a premium reimbursement program.

What questions do you think all employees should ask their employers at health insurance enrollment time? Leave a comment.

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