Transparency in Your Health Insurance Plan
July 30, 2025 | Tags:
Navigating health insurance can feel intimidating. However, understanding your plan is essential to ensure you and your employees receive the best possible coverage without compromising quality. This is why transparency in health insurance is crucial. It provides your small business with a clearer picture of how to navigate and optimize your options.
Understanding the full scope of your plan’s offerings leads to more informed decisions about the best plan for everyone.
Why do you need transparency?
If health insurance is hard to understand, it can make the process of selecting a stable plan that everyone can value more complicated. The goal of health insurance is to support everyone’s needs by providing plans that are valuable, flexible and simple to navigate.
When employees have access to clear, comprehensive information to help them make informed decisions, it fosters a sense of trust and loyalty.
Where transparency counts
Transparency in health insurance can be exemplified in several areas:
- Understanding health insurance costs: Deciphering key insurance terms like premium, deductible and copay benefits your employee’s health and their wallet. For example, an employee might be confused why they need to pay a maximum out-of-pocket amount after they’ve already met their deductible. When employees understand how these factors impact their overall expenses, they can better anticipate financial responsibilities and make informed decisions about their healthcare.
- Comparing network structures: Health insurance plans vary in network sizes. Helping employees understand whether they can visit their preferred doctors, the associated costs and out-of-network coverage ensures they’re well informed so they can select the best option. Knowing an HMO (Health Maintenance Organization) is cheaper but restricts coverage to in-network providers while a PPO (Preferred Provider Organization) offers more flexibility and fewer restrictions on non-network providers aids your employees in choosing a plan that fits their needs.
- Advantages of tax-exempt offerings: Additional benefits can be integrated into your employees’ health plan to help them save money and provide tax benefits for your small business. Depending on the insurance plan, employees might be eligible for a flexible spending account (FSA) or a health spending account (HSA). An FSA will allow employees to make pre-tax contributions to pay for eligible healthcare expenses, which you, the owner, won’t pay FICA tax on. An HSA is employee-owned and allows them to make the same pre-tax contributions that roll over from year to year with no limit.
- Prescription cost coverage: Every employee has different health needs. Some may have chronic conditions that drive up their healthcare costs. Knowing they have access to budget-friendly prescription drug benefits can help alleviate this hardship.
Check if your health plan coverage includes access to benefits like Express Scripts®, a pharmacy benefit manager (PBM) that helps employees order refills, locate participating pharmacies and save time and money with home delivery.
Local health coverage you can rely on
Medical Mutual is your one-stop shop for quality health insurance plans. As an Ohio-based insurer, we’re dedicated to finding the right plan tailored to the unique needs of small businesses in our community. We offer a range of health plan options, including self-funded MEWA, level-funded and ACA plans, along with ancillary benefits such as dental, vision and life and disability coverage.
We also offer resources to help bridge the transparency gap, including search tools to help you and your employees find in-network providers, locations and prescription options. Call your broker or request a sales consultation with your Medical Mutual Sales representative to have them guide your group through your plan options.