Six steps to determining the right health insurance plan

The end of the year is a good time to assess your health and financial situation and plan for the year ahead.

During this time, insurance providers and human resource professionals are gearing up for open enrollment. Open enrollment is a period when individuals can change their health insurance plan options. These changes usually take place with employees through an employer or through the Affordable Care Act marketplace. From Nov. 15 to Dec. 15, certain qualifications are waived, and insurance agencies can enroll businesses of any size with most health insurance plans starting over on Jan. 1.

Now is the time to identify your current health insurance plan and decide to either stick with the status quo or change benefit plans. If you’re fortunate to be happy with what you have, then a simple re-enrollment works. If your operation has changed over the year – budget and payroll, you might need to re-evaluate your offerings.

Here are six steps to take to make sure you are moving toward a plan that is right for you, your family and operation.

Step 1: Set a goal. Start with understanding the goal of your health insurance plan. If you’re a small farm, your health insurance goals may be to support the health and wellbeing of your family. An individual, comprehensive plan for everyday health might be a good option.

If you’re a large agribusiness with employees, your health insurance goals may be different. Your goals may be to offer affordable benefits packages for your employees and their families, attract and retain employees or just to meet a requirement based on the number of employees you have.

Another factor to consider, if you have employees, is how much you want to contribute to the employee’s portion of the cost of the health insurance plan. Do you want to help them pay for it or just make it available? Remember that some plans have participation requirements, so you may need to make it more attractive for employees to participate by offering to pay a portion or somehow incentivize enrollment. Also, some of your lower-wage employees may not be able to pay for health insurance, so payment assistance or offering a lower cost, lower coverage option may be a consideration.

Step 2: Determine a budget. Health insurance is not cheap, and the cost is rising. The cost of health insurance for group plans is expected to rise 7 to 8.5% in 2025, and the cost of individual plans will likely be higher. But while the cost of health insurance is significant, consider the alternative. The No. 1 cause of bankruptcy in the United States is not being able to pay medical bills.

There are a multitude of insurance providers and plans available, so there is an opportunity to shop around. Understand, though, that the number of options is dependent on the size of your business—the smaller your business, the fewer number of options.

Also take into consideration the labor required to manage plans. For larger businesses with more employees, the administrative burden can be significant. If a change in providers is an option, you’ll need to search for companies, weigh options and complete applications. Then there is getting information to employees, getting the employee enrollments processed and organizing the information to meet enrollment requirements. It’s a lot of work that takes a significant investment in time and money.

Step 3: Understand the network. A critical limitation in rural America is the availability of health care providers. In larger, urban areas there are ample opportunities for doctors, hospitals, urgent care facilities and other options, but as you get farther from these areas the number of health care options dwindles. When you have to see a provider outside your network, your costs rise significantly. It’s important to identify providers who have care options available at locations convenient to your location.

Step 4: Identify the riders. A rider is an insurance policy provision that adds benefits to or amends the terms of a basic insurance policy to provide additional coverage. Riders tailor the insurance policy to the specific needs of the policy holder. For example, Agri-Services Agency offers an accidental injury benefit that covers the first $2,000 of an accident that happens on the farm. There are many types of riders available, so be sure to add the ones that fit your specific needs.

Relating to riders, it’s also good to know what resources the provider can offer. What kind of market access do they have? Do they work with only two or three carriers, or many more? Do they have someone who can assist with the Marketplace? One factor that is important with farming is working with a provider that offers bilingual services.

Step 5: Work with an agent who understands your business.  It is helpful to work with agents well versed in the agriculture industry. They understand the kind of work that happens on the farm and the potential health challenges that work creates. They are also more likely to know the scenarios that can happen on a farm, ranch or agribusiness and provide a better understanding of what your insurance will cover should something happen.

It’s also important for an agent to understand the mental strain that farmers and ranchers are challenged with. Many farmers struggle with mental health issues that arise from the stress of running a business, caring for the land and livestock and economic pressures. It is important to work with providers who understand those issues and are willing to meet face-to-face with customers to work through those mental health challenges.

Step 6. Understand the transitions. As you go through life, transitions happen. As you and your children get older, your health care needs change. Work with your provider to understand what happens when your children transition off your policy. Also understand what happens when you reach Medicare age and any support that’s provided for that transition.

Whether you are happy with your current provider or shopping for a new one, remember that health insurance is an important and necessary part of the health and financial stability of your family and agricultural operation. With the number of accidents that can happen every day on a farm, regardless of size, going without insurance protection is an extreme risk to your health and the financial stability of your business. Think about the short-term needs of you, your employees and your business and make the provider and policy decisions that are best for you and your business.

Robin Smith is the director of sales with Agri-Services Agency.