If "YES"...

…you can expect questions on these topics during your interview:

Firm characteristics:

• Total number of employees at your location and total number of employees nationwide, and in California, if applicable.
• Number or percentage of full-time employees making $31,000 or less per year and $72,000 or more per year; number or percentage of all employees working full-time (30 or more hours per week); percentage of all employees age 26 and under and 50 or over.

Eligibility, enrollment and plan offerings:

• Whether health benefits are available to full-time workers, part-time workers, temporary workers, domestic partners, spouses and dependent children.
• Number of employees eligible for and covered by health benefits nationwide, and in California, if applicable. Number or percent of employees enrolled in each plan type (HMO, PPO, POS & high-deductible with either an HRA or HSA). Whether the plan is self-insured.
• Whether the plan or plans are grandfathered under the Affordable Care Act.
• Dollar amounts the firm contributes to an HRA (health reimbursement arrangement) and/or HSA (health savings account).
• For employers with more than 200 employees: whether any retirees are offered health benefits and how those benefits are administered.

Plan characteristics for top two largest plans:

• General annual deductibles for single and family coverage, and if physician office visits or prescription drugs are covered before the deductible is met.
• Co-payments, coinsurance, and/or any separate deductibles for primary care office visits, specialty care office visits, hospital admissions, emergency department visits and/or outpatient surgery.
• Out-of-pocket limits for single coverage.
• Monthly premium or COBRA costs for single and family coverage, including the employee’s contribution and the firm’s contribution.
• Prescription drug benefit design, such as tiered drug plans, drug copayments, and/or coinsurance, including those for specialty drugs. Whether the firm has any separate annual drug deductibles.
• For employers with more than 200 employees: whether the firm has any programs to lower cost sharing for lower wage workers

Wellness programs

• Types of wellness programs offered; the type and amount of incentives and penalties associated with the program, if any.
  • For employers with more than 200 employees: whether new digital content has been added for wellness in the past two years, and if that content gets engagement from employees; whether the wellness programs are effective in meeting goals such as improving health, reducing cost, reducing health care use, and serving as a valuable benefit to employees.
• Whether the firm or plan offers biometric screening; the type and amount of incentives and penalties associated with screening, if any.

Telemedicine

• Whether the top two largest plans cover telemedicine and if so, how it is covered (e.g., through a specialized telemedicine provider); whether the firm has contracted with new or different telemedicine providers in the past two years.
  • For employers with more than 200 employees: whether reimbursement for primary care delivered via telemedicine is the same or different compared to in-person care.

Network adequacy, prior authorization and transparency

• Whether the provider network of the largest plan is large enough to provide timely and sufficient primary care, mental health services and substance use services to plan members.
• Whether timely prior authorization is an issue for plan members, or if there are concerns it may be in the future.

Gender-affirming care and abortion care

• Whether the largest plan covers gender reassignment surgeries
• Whether the largest plan covers abortion care within the context of state law
• Any additional resources your firm may have for employees and/or dependents in need of abortion care

If "NO"...

…you can expect questions on these topics during your interview:

Firm characteristics:

• Total number of employees at your location and total number of employees nationwide, and in California, if applicable.
• Number or percentage of full-time employees making $30,000 or less per year and $70,000 or more per year; number or percentage of all employees working full-time (30 or more hours per week); percentage of all employees age 26 and under and 50 or over.

Eligibility, enrollment and plan offerings:

• Whether health benefits are available to full-time workers, part-time workers, temporary workers, domestic partners, spouses and dependent children, or whether firm reimburses employees to purchase insurance on their own.
• Number of employees eligible for and covered by health benefits nationwide, and in California, if applicable. Number or percent of employees enrolled in each plan type (HMO, PPO, POS & high-deductible with either an HRA or HSA). Whether the plan is self-insured.
• Whether the plan or plans are grandfathered under the Affordable Care Act.
• Dollar amounts the firm contributes to an HRA (health reimbursement arrangement) and/or HSA (health savings account).

Plan characteristics for top two largest plans:

• General annual deductibles for single and family coverage, and if physician office visits or prescription drugs are covered before the deductible is met.
• Co-payments, coinsurance, and/or any separate deductibles for primary care office visits, specialty care office visits, hospital admissions, and/or outpatient surgery.
• Out-of-pocket limits for single coverage.
• Average or top three most common monthly premiums for single and family coverage, including the employee’s contribution and the firm’s contribution
• Prescription drug benefit design, such as tiered drug plans, drug copayments, and/or coinsurance, including those for specialty drugs. Whether the firm has any separate annual drug deductibles.

Wellness programs, telemedicine, and mental health coverage:

• Types of wellness programs offered; the type and amount of incentives and penalties associated with the program, if any.
• Whether the firm or plan offers biometric screening; the type and amount of incentives and penalties associated with screening, if any.
• How important the firm thinks telemedicine is for care
• How concerned the firm is with the growth of substance abuse conditions among its employees.