Health Insurance

Before EMS Group. starts quoting plans for its clients, we spend time and effort understanding client needs. In addition, EMS helps clients build competitive benefits packages by comparing the benefit features within their industry, geographic area, and company size.  

Understanding Your Employee Group

A proper analysis of the cost for health insurance starts with a review of your coverage group. A document called a benefits census is commonly used to identify the gender, age, and coverage level (employee only, employee plus spouse, employee plus children or family) of each person in the group. This information allows bottom line comparison on pricing for both the employees and the employer.  

Your Company’s Participation Rate

In general all providers want to see that at least 50% of the persons eligible in the group are
interested in enrolling in the insurance or have other coverage. Having a high participation rate
prevents “adverse selection” (where only the persons with high plan usage enroll).  

Your Company’s Contribution Rate

Most companies want to make paid or subsidized health insurance part of their employee benefit
package. As a business, you need to decide what level of contribution your company will make to
subsidize the monthly insurance premium. For example, many companies pay 100% of the employee
only premium and 50% of the difference for employee plus spouse. Most providers offer flexibility in
how subsidies are established and premiums are collected. Companies with low contribution rates
often find associated low participation rates in their groups. Establishing a significant contribution rate
from your company often translates into higher participation rates and this in turn provides superior
plan alternatives and pricing.