According to Forbes, almost half of insured Americans get health insurance coverage via group plans their employers provide. But, many of these individuals have little knowledge of how group health insurance works. Several aspects make up the core of employee insurance packages that are the most successful. How can your HR team determine your insurance plan’s success while ensuring it meets your employees’ needs? The following are some metrics that you can institute to assist you in determining the success of your group health plan.


Loss Ratio

The loss ratio is calculated by dividing your premiums by the amount the insurer pays out in claims. The importance of this ratio is that it helps find out how healthy your plan is. It is also used to determine premium increases. It is essential to know the ratio of your health plan. It would help if you also compared this ratio with industry standards to help you have a proper negotiation tool, particularly regarding the negotiation of coverage elements. You may also use current and historical loss ratios to estimate future premium increases.


Average Claims Per Member

You will determine the average claims per member by assessing the number of claims submitted by covered employees. You can compare this number to a benchmark in the industry or a historical average. This is important in helping you estimate the general utilization and satisfaction with your group health insurance plan

It is essential to track this metric because it helps come up with rich data on group health plans. This data will help you better comprehend plan utilization and act as a determinant for identifying problems. This data is crucial in helping unfold where your workers prefer to receive care. You can use this information to drive employees away from high-cost providers or determine if the plan meets their health needs.


Individuals the Group Health Plan Covers

This is also known in the insurance industry as the ‘participation rate.’ This metric helps compare the number of employees the plan covers with those eligible for the plan. You obtain this by dividing the number of insured workers by the number of qualified workers. You can compare the percentage you get with similar rates in the industry. This metric tends to vary depending on the company and usually adapts to meet your chosen insurance plan.

Many companies have opted for group health plans that consider inpatient care only. If a worker requires extra coverage for outpatient care, the firm can only cover a fraction of the premium.  Examining the number of individuals securing additional coverage and comparing this to industry percentages is crucial. The importance of such comparisons is that they can show whether your plan will be a success. 


Demographics of Workers

You will arrive at this metric by examining the number of workers and categorizing them into groups. This can help you determine the overall satisfaction with your group plans. For instance, it may help if you know your employees’ age groups. This is because such information will help you establish the types of cover to utilize most and the future health issues your employees may seek care for. Using this information, you can then determine the plans that meet some of your employees’ health needs. 


Group Health Insurance Plans

The group health insurance arena has endless choices. This makes it challenging to concentrate on an area that is right for your company. This is where we come in, as we can help you make these choices! At Kirby Employee Benefits, we are experts regarding your group health coverage and other benefit plans for your employees. Our specialty is in making group benefits simple and easy. Contact us now, and let’s help you with your group health insurance planning.