The cheapest plan on the spreadsheet is often the most expensive one for your employees. Here is how to compare properly.
Group health · Updated September 2026
The first question is not what a plan costs but which doctors and hospitals it includes. A plan whose network excludes the main health system your employees already use will generate complaints within weeks, and employees will either pay out of network or skip care. In a regional market this is frequently the deciding factor.
Ask employees informally which providers matter to them before you shop. It takes an afternoon and prevents the most common first-year mistake.
HMO. Lower premium, narrower network, care coordinated through a primary care physician, little or no out-of-network benefit except emergencies. Works well when the network is strong locally.
PPO. Higher premium, wider network, out-of-network care covered at a reduced level, no referral requirement. The default choice for employers who want flexibility and have employees spread across an area.
EPO. A middle option: no referrals needed, but essentially no out-of-network coverage.
High-deductible plan with an HSA. Lowest premium, highest exposure before coverage kicks in, paired with a tax-advantaged savings account that both employer and employee can fund. Strong for a younger workforce or as a lower-cost option alongside a richer plan.
Employees experience three numbers: what comes out of their paycheck, what they pay before coverage starts, and the worst case in a bad year. A plan that lowers the first number by raising the other two has not saved anyone money; it has moved the cost onto whoever gets sick.
When comparing quotes, model a healthy employee, an employee with a chronic condition and a family with a hospitalization. The ranking often changes between the three.
Carriers set a minimum employer contribution toward employee-only coverage and a minimum share of eligible employees who must enroll. Those floors exist to prevent only the sickest employees signing up.
Beyond the minimum, your contribution level is the main lever you control. Raising it improves enrollment and retention; lowering it shifts cost to staff and can put you under the participation requirement, which puts the plan itself at risk.
Many small employers do well offering two options: a richer plan and a high-deductible plan, with the employer contributing a fixed dollar amount toward either. Employees who want lower out-of-pocket exposure can buy up; those who want more take-home pay can buy down. It also makes the employer's budget predictable.
Start the review six to eight weeks before renewal. That leaves room to gather census data, compare carriers properly, hold an enrollment meeting and get paperwork in before the effective date. Reviews that start two weeks out usually end in renewing as-is.
Questions about your own situation? Call 417.623.8300 or send us your current policy. We are licensed in Missouri, Kansas and Oklahoma.
Send your renewal and an employee census. We will compare carriers, networks, deductibles and contribution strategies.