Guidelines for publishing RFP for health insurance quotes

[Guest dm]

I am an employee of a not for profit organization funded by federal grants. We have over 50 employees but under 50 are currently enrolled in the health care plan. We do not have a benefits administrator and I have been asked to help with getting bids for new health insurance since the current one is a PPO and the local hospital and the local physicians are not signed up with the insurance (which means substantially higher payments for the enrolees).

Is there someplace that I could get direction or further information about what the rules are regarding to 50 employee cutoff (I know there is something, I just don't know what)and for the RFP and any other information that would be conducive to getting bids for affordable health coverage?

[KIP KRAUS]

dm:

I don't know what the insurance markets are like in Arizona, but if the Blues are available you should at the very least contact them.

Commercial carries have varying underwriting requirements regarding the size of group they will write a medical plan for, and in your case, with less than 50 participants you could run into problems. Commercial carriers are going to be expensive and may require you to purchase Group Life in order for them to write medical. In addition, most commercial carriers will not deal direct with clients as small as you are.

My advise, contact an independent insurance broker who deals in group insurance and ask them to handle your case. They will work for commissions that the insurer will pay them.

Call some of the other employers similar in size to you in your area and find out who they are using as a broker/health insurer.

RFPs in your group size mean little in the commercial medical market, because what will be available to you will be limited in plan design.

If there are any community rated HMOs in the area, you should also contact them. If you have any questions, feel free to e-mail me.