Then ask for the plan's latest member satisfaction survey results. Independent surveys from external organizations as well as health insurance brokers or agents can all be useful resources for determining member satisfaction. Disenrollment rates Ask the plan how many members have left the plan in the past year, and in the last few years. Turnover rates of more than ten percent may indicate a problem in the plan's network or services. Grievance and appeals process Federal law requires all health plans to set up and follow a formal process for grievances and appeals.
Some plans rely on third-party arbitration to resolve difficult problems.
Ask the plan to explain its process and tell you the average length of time it takes to resolve an individual's appeal or grievance. References Ask for the names of several employers your size who currently use the plan, and call them. Also, ask the plan for at least one or two similar-size employers who have left the plan in the past year or two and call them. They may be able to provide insight into problem areas. Once you select a plan, you will have to interact with account representatives on a regular basis.