Suzanne Lucas

Employee Background and Your Health Insurance Plan

Does employee background matter when you’re looking for a health insurance plan for your small business? When you’re looking at plans, the possibilities can seem endless, even if there are only one or two providers in your state. Do you want a PPO, an HMO, an EPO, a POS or an HDHP with an HSA? Yes, this alphabet soup all refers to different types of health insurance plans that may be available to you and your employees.

There are pros and cons to each of these plans — and people who love some and hate the others — but the question is, what does your office need? That’s where we get to employee background.


Do your employees range in age from Gen Z to baby boomer? Or, is it a whole bunch of millennials with a couple of Gen X managers floating around? Different age groups often have different health care needs and, therefore, want different plans.

If everybody is young and healthy, they may prefer a High Deductible High Health Plan (HDHP) with a Health Savings Account (HSA). If they don’t have much need to see physicians, this can be huge cost savings and result in some extra money in a tax-free savings account. On the other hand, older staff may strongly prefer a Preferred Provider Organization (PPO) where they can easily choose their own doctors or a Health Maintenance Organization (HMO) where their primary physician organizes their care. So, pay attention to where your employees are in life.


Do men prefer one type of plan while women prefer another? Maybe, but what you’re really looking at here is childbirth, so this is also closely tied to age. Are your employees largely married women in their late 20s and early 30s? According to the National Center for Health Statistics (NCHS), the average age for when a woman had her first baby was 26 in 2014. If your coverage covers spouses, your male employees are just as likely to need a plan with great maternity coverage as your female employees.

Family Status

People with small children may want different health care plans than empty nesters and they may need different options from single individuals. Remember, your employees can keep their kids on your plans up until the age of 26, so it’s not just toddlers you’re looking at covering.

You may look at this and say “My employees are a diverse group. Nothing will make them all happy!” This may be true, but you have to do your best and that involves asking. Have a health insurance broker come in and speak to them and let them share their ideas and concerns. Were they happy with this year’s plan, or is it time for a change? You won’t know if you don’t ask.

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