How do Carries Determine the Price?

When an insurance carrier evaluates your organization to provide a price for you, a rate, it’s going to be different for each company based on the size of their organization. So let’s just take under 50, for example. If you have under 50 employees your company is going to be what we call community-rated.

So that means, it doesn’t matter if your employees are healthy or they’re ill. Based on the demographics, the age of your employees, the rate is going to be the rate. So, one employer can’t get a better rate than another employer in this under-50 market. In the fully insured, Under-50 space, Florida Blue and United Healthcare are probably our two primary providers of health insurance coverage for employers, and they have different kinds of plans.

So if you take a look at an HMO plan, for example, versus a PPO plan, Florida Blue offers different network options. So if you want the broadest network, it’s going to be a little more expensive. And if you go with, for example, what we call a Simply Blue plan, who has a smaller, more narrow network.

So the type of plan that you pick, the age of your employees, the benefit levels that you choose, all are factors in determining the price. But these are community-rated plans, without any kind of impact to your price based on the health of your employees.

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