September 9, 2025

10 Group Health Plan Considerations for Commercial Businesses

10 group health plan considerations for commercial businesses

Choosing the right health plan is essential for supporting employee well-being and plays a crucial role in attracting, retaining, and engaging top talent. For commercial businesses, which typically employ a large and diverse workforce on a national or global scale, this task presents unique challenges. The varying needs of employees make selecting an appropriate group health plan even more critical.

In this context, we explore the top considerations that HR leaders should evaluate when selecting group health plans for commercial businesses.

Plans that support your business

For commercial businesses with multi-location teams or large employee bases, a health plan should enable you to focus on key areas of your organization while providing exceptional service. Our offerings are designed to help you attract and retain top talent, allowing you to concentrate on other aspects of your business.

Key aspects to evaluate:

Provider network coverage across multiple locations
Pharmacy network and copayments
Flexibility to accommodate future business growth

Provider network coverage

Employees should have easy access to in-network healthcare providers to maximize usage and minimize out-of-pocket costs.

Questions to consider:

Does the plan include providers in areas where your workforce lives and works?
Are specialists and major healthcare facilities included in the network?
Is virtual care an option for remote employees or those in underserved areas?

Sentara Health Plans offers various plans featuring a nationwide provider network, giving employees access to a wide range of services across the country. We also provide Emergency Travel Assistance¹, offering peace of mind for coverage while away from home.

Cost management and budget alignment

When selecting an large group health plan, it is crucial to balance affordability for both the company and its employees. Providing strong benefits is important, but it's equally important to manage costs so that these benefits stay sustainable as the company evolves.

Important cost-related considerations include:

Employer contribution percentage vs. employee premium costs
Deductibles, copayments, and out-of-pocket maximums
Administrative fees for enrollment and claims management
Options for Health Savings Accounts (HSAs) and Health Reimbursement Arrangements (HRAs)

Partnering with a broker to model cost scenarios can help align benefits with your organization’s budget.

Integrated health and wellness programs

As the wellness landscape continues to evolve, commercial businesses should look for group health plans that integrate holistic health and wellness initiatives. This approach not only addresses physical health but also promotes mental and emotional well-being, creating a healthier work environment through:

Comprehensive wellness programs that include fitness challenges, health fairs, and nutrition workshops
Access to mental health resources like employee assistance programs (EAPs) that provide counseling and support
Initiatives that encourage social connectivity, such as team-building events or wellness challenges, which foster a sense of community among employees

By prioritizing integrated health and wellness offerings, organizations can encourage a culture of well-being that can increase employee morale and productivity while reducing absenteeism and healthcare costs.

Employee wellness and preventive care features

Contemporary workforces expect more from their health plans than basic coverage. Plans that prioritize wellness initiatives and preventive care resonate with a workforce focused on maintaining health proactively.

Features to prioritize:

Wellness programs, such as fitness discounts, smoking cessation, and nutritional counseling
Preventive screenings, vaccinations, and health assessments
Mental health services, including therapy sessions and stress management programs

Investing in wellness-focused plans not only reduces healthcare costs long-term but also supports employee engagement and productivity.

Compliance and legal considerations

Sentara Health Plans is committed to guiding commercial businesses through the complexities of compliance and legal requirements. We ensure your health plan meets all local, state, and federal regulations, protecting you from potential penalties and disputes.

Our areas of support include:

Compliance with the Affordable Care Act (ACA)
Data privacy regulations under HIPAA
Fraud protection and transparency under the Employee Retirement Income Security Act (ERISA)

For fully insured plans, we handle compliance entirely, while for self-funded groups, we provide tailored recommendations. Trust Sentara Health Plans to help you navigate compliance effectively.

Technology integration for ease of management

Dealing with group health benefits at an large group level can be complex. A seamless administrative process supported by technology is crucial for managing enrollments, claims, and employee communications effectively.

Benefits of technology integration:

User-friendly enrollment portals designed specifically for employers
Comprehensive tools for monitoring utilization and assessing plan performance

Streamlined benefit management saves your HR team time and reduces administrative burdens while delivering a better experience for employees.

Engaging employee education and communication

A health benefits package is only effective if employees understand and use it effectively. Commercial businesses must prioritize educating employees about their options and ongoing resources for navigating their coverage.

Best practices for employee communication:

Hosting informational webinars or workshops on plan benefits
Distributing easy-to-understand guides and FAQs

Proactive communication increases plan engagement and helps employees maximize their benefits.

Benchmarking and competitive analysis

Staying competitive as an employer necessitates offering benefits that match or exceed industry standards. Benchmark your plan offerings against those of similar organizations in your industry to help your package align with employee expectations.

Factors to benchmark include:

Plan costs compared to competitors
Unique benefits like wellness stipends or mental health services
Coverage levels for dependents and family plans

Regularly reviewing plan metrics will allow you to understand performance and ensure that the health plan contributes positively to employee satisfaction, retention, and productivity.

Tracking ROI and measuring impact

When evaluating the effectiveness of your health plan, it's essential to assess whether it is meeting your organization’s goals. Implementing the following metrics can help your company track ROI and measure the impact of its health plan:

Utilization rates for core services
Employee retention and satisfaction surveys
Reduction in absenteeism due to better access to preventive care

These data points help suggest that your group health plan is meeting organizational goals efficiently.

Why Sentara Health Plans?

Choosing a health plan for your business involves careful consideration of multiple factors. A well-chosen health plan can support the well-being of your employees and contribute to attracting and retaining talent, which is essential for your business.

Compare what different large group plans offer and make a decision that aligns with your business goals, employee needs, and capacity to grow.

Learn more about how Sentara Health Plans can support your large business with group health plans.

¹This is not a covered benefit but a value-added service.

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