10 things to ask before ... Choosing a health care provider

5. What wellness programs do you offer? Employers are fast moving toward preventative, rather than reactive, care. That means things like on-site vaccines, gym membership discounts and weight-loss counseling. What does this insurer offer and at what cost?

6. Can claims be filed online? Make sure the process that you or your employees use to file claims is convenient, easy and, preferably, online. How fast and responsive is the insurer’s customer service channels?

7. How will you support my human resources department? Find out how the insurer works with your company’s administrative staff. Can the HR department smoothly enroll new workers, monitor claims, administer wellness offerings and measure employee participation in that particular health plan?

8. What is the claims appeal process like? For the times you may need to appeal or file a grievance concerning the way a claim was handled, you don’t want the process itself to be grief-ridden. Learn from the start how many hurdles might be involved in taking that step.

9. Do you have limitations or exclusions? This is considered the fine print of the insurer’s health plan. Are new and improved medical procedures included in coverage? How about things like transplants, laser eye surgery, infertility procedures, weight-loss surgeries, mental health treatments or drug rehabilitation?

10. How will your plan change under health care reform? The 2010 health care law remains the gray area of medical coverage, given that much still lies in political hands. What will the insurer change over time to adhere to new regulations and how will that affect your company?

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