Analyzing the Quality and Security of Health Plans
There are several things to consider when reviewing the quality and financial security of an insurance company.
- What are the complaints against this company?
- Do they have the ability to pay large claims?
- Are they licensed to sell insurance in your state?
- Do they contract with the best physicians and hospitals?
- How long have they been in business
- How many active members do they have.
Your State Department of Insurance commission can provide you with much useful information about the insurance company you are researching. All states have websites dedicated to their insurance division. These websites will often provide valuable search tools, license checks, complaint ratings and financial strength reports for all of the insurance companies authorized to sell health insurance in that state.
You can also find out if the managed care plan you are interested in has been "accredited" and meets certain standards of independent organizations. Some employers will only contract with plans that are accredited. HMO plans in many states are regulated by the Department of Corporations, not the Department of Insurance.
Other resources useful in researching a health insurance company may include:
National Committee for Quality Assurance
2000 L St. N.W., Suite 500
Washington, DC 20036
888-275-7585
http://www.ncqa.orgCenters for Medicare and Medicaid Services
7500 Security Blvd.
Baltimore, MD 21244-1850
877-267-2323
http://www.cms.hhs.govWeiss Ratings, Inc.
15430 Endeavour Dr.
Jupiter, FL 33478
800-289-9222
http://www.weissratings.comA.M. Best Company, Inc.
Ambest Road
Oldwick, NJ 08858
908-439-2200
http://www.ambest.com
You may also find valuable information from the plan brochures or websites of the insurance companies themselves. Some plans and independent organizations are also beginning to produce "report cards" that they make available to the public. These reports often include satisfaction surveys and information on quality. Perhaps they might indicate which plans provide preventive care or if the plan has a routine for following up on test results. Report cards may also include information on how many members stay in or leave the plan, how many of the plan's doctors are board certified, or how long you may have to wait for an appointment.
Another good way to find out what health plans are good is by asking your friends. What health plan do they have? Are they satisfied with the benefits? Are they having any problems with claims being paid on time? How often have they had a rate increase? And, any other questions you might find important to you.
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