Choosing the Right Provider Network for Your Small Business

Posted October 15, 2024 by Steve Chrzanowski, Director, Group Retention & Sales Support

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Selecting the right health insurance for your small business can seem overwhelming, but a crucial factor that should significantly impact your decision is the provider network included in the plan. A provider network is simply the group of doctors, advanced practice providers, hospitals, healthcare facilities and pharmacies your insurance company partners with to provide care for its members. These networks help lower healthcare costs by negotiating substantial discounts with providers, so your employees can receive quality care without breaking the bank.

In-Network vs. Out-of-Network Care

When you’re picking a plan, it’s important to know the difference between in-network and out-of-network care. In-network providers work directly with your insurance company to offer services at a reduced cost. This often translates into lower deductibles, copays and coinsurance for you and your employees.

On the other hand, going out-of-network can mean higher out-of-pocket costs for a covered benefit. That’s why understanding provider networks is so important—they directly affect both your healthcare costs and the ease of accessing care.

Tips for Choosing the Right Provider Network

Here are a few things to think about when selecting a provider network:
1. Access to Preferred Providers: Make sure the network you choose includes healthcare professionals and facilities your employees already trust or frequently visit.
2. Geographic Coverage: Look for a network that covers the areas where your employees live, work and/or travel.
3. Cost vs. Care Balance: Find a network that strikes the right balance between affordable care and a wide selection of providers.
4. Specialized Services: Consider whether anyone on your team needs access to specialists or specific hospitals and check if they are part of the network.

SummaCare’s Provider Network Options

SummaCare offers a variety of network options that are each designed to help small businesses and their employees save money while still having access to top-tier healthcare. Here’s a look at the different networks available:

• Preferred Choice: This exclusive network connects you to premier local healthcare providers, including Summa Health, Cleveland Clinic, Akron Children’s and Wooster Community Hospital, with national coverage outside the main service area. With 20 hospitals and over 8,000 providers, it’s perfect for businesses looking for high-quality, local care at a preferred rate.
  
• SCPremier: As SummaCare’s most extensive PPO (preferred provider organization) network, SCPremier features over 22,000 providers and 60+ hospitals, including Cleveland Clinic and University Hospitals. It offers statewide coverage and access to nationwide emergency and urgent care through the First Health Network, making it ideal for businesses needing broad access to providers.
  
• SCSelect: A more budget-friendly option, SCSelect includes more than 16,000 providers and 50+ hospitals, including University Hospitals, Summa Health, Crystal Clinic Orthopedic Center and many more. It’s a great fit for businesses of all sizes and is available on and off the SHOP Marketplace.
  

For small businesses with two or more employees, SummaCare allows you to choose up to two networks, giving you more flexibility and options.

Finding the Best SummaCare Network for Your Business

When deciding on a SummaCare network, consider the size of your business, where your employees are located, and what kind of healthcare services they might need. SummaCare’s wide range of options means you can find a plan that offers both quality care and cost savings, giving you the flexibility and affordability you’re looking for.

For more details about SummaCare’s provider networks or to explore MEWA options if you aren’t currently a member, contact your broker or call SummaCare at 330.996.8955.