Health Insurance Prescreen for Ohio Small Businesses

A health insurance prescreen helps an Ohio employer determine whether certain medically underwritten group health insurance options may offer competitive terms.

Employers often begin by asking for quotes. Basic census quotes can be useful for evaluating ACA small-group plans and establishing a general pricing comparison.

Other arrangements, including some Ohio MEWA and level-funded options, may require additional employer information and confidential employee health questionnaires before the carrier or program can evaluate the group accurately.

That additional review is commonly called a health insurance prescreen.

A prescreen does not mean that every available coverage approach is medically underwritten. ACA small-group plans and ICHRAs are evaluated differently. The purpose of the prescreen is to gather the information required for the particular underwritten options that deserve consideration.

The process may be useful when an employer is offering coverage for the first time, reviewing a difficult renewal, comparing broader alternatives, or confirming whether the current arrangement remains competitive.

A prescreen does not obligate the employer to change carriers, accept a proposal, or replace the current plan.

It is one possible tool within a broader small business health insurance renewal system.

What Is a Health Insurance Prescreen?

A health insurance prescreen is a structured process used to gather the information an underwritten carrier or program needs to evaluate an employer group.

The process often has two stages.

Preliminary Employer Review

The first stage may include:

• Company and employee counts
• Current coverage
• Renewal date
• Employee census information
• Eligible and enrolled employees
• Participation and waiver information
• Employer contribution strategy
• Employee work locations
• The reason the employer is reviewing alternatives

This information helps determine which markets and coverage approaches are realistically relevant.

It may be enough to compare ACA small-group plans, identify basic eligibility issues, or determine whether a more detailed underwritten review deserves consideration.

Confidential Employee Health Information

When a medically underwritten option deserves further review, employees and covered dependents may be asked to complete confidential health questionnaires.

Those questionnaires may request information about medical history, prescriptions, ongoing treatment, or other underwriting factors.

Employees should submit that information directly through the designated secure prescreen system. The employer should not collect or review individual medical answers.

Not every plan comparison requires this step.

Which Health Insurance Options May Require a Prescreen?

The answer depends on the coverage approach.

ACA small-group plans use community-rating rules. Employee medical history is not used to determine the group’s rates. These plans can generally be evaluated using census, location, enrollment, and plan information.

Ohio MEWA plans may require underwriting or a medical prescreen, depending on the program and the employer’s circumstances.

Level-funded arrangements offered to small employers commonly require medical underwriting before the carrier provides final or competitive terms.

ICHRA arrangements are evaluated using employer classes, contribution strategy, employee locations, affordability, and individual-market considerations rather than a group medical prescreen.

A preliminary review may consider all of these approaches. The confidential medical portion applies only when the option being evaluated requires it.

Learn more about Ohio MEWA health plans, level-funded health insurance, ACA small-group plans, and ICHRA arrangements for Ohio employers.

Why Is a Prescreen Different From a Basic Online Quote?

A basic online or census quote can provide useful preliminary pricing.

For an ACA small-group plan, census information such as employee ages, dependent enrollment, location, and plan selection may be enough to produce realistic rates.

A medically underwritten option works differently.

The carrier or program may need additional information before it can determine:

• Whether it will offer coverage
• What pricing it is willing to offer
• Whether particular underwriting conditions apply
• Which plan options are realistically available

Participation, employer contributions, employee demographics, health information, and other underwriting factors may affect the result.

That is why a simplified quote and an underwritten prescreen should not be treated as the same thing.

The online quote may provide a starting point. The prescreen helps determine what an applicable underwritten arrangement is actually willing to offer.

What Information Is Collected During a Prescreen?

The exact information depends on the carrier, program, and coverage approach being evaluated.

Employer information may include:

• Company name and location
• Number of eligible employees
• Current and expected enrollment
• Employee work locations
• Current insurance carrier and plan
• Renewal date
• Employer contribution amounts
• Participation and waiver information
• Payroll or eligibility information when relevant
• Prior coverage history

When medical underwriting is required, employees and covered dependents may be asked to provide:

• Basic identifying and dependent information
• Coverage elections
• Medical history
• Current prescriptions
• Ongoing treatment information
• Other health information requested by the carrier or program

Employees should provide sensitive medical information through the designated prescreen platform rather than through the employer, the general website contact form, or ordinary email.

How the Health Insurance Prescreen Process Usually Works

The exact process varies by carrier and arrangement, but the general sequence often looks like this:

1. The employer begins with a preliminary conversation. We discuss the current plan, employee count, renewal timing, contribution strategy, and the reason for reviewing alternatives.
2. The employer completes the setup information. This establishes the group structure, eligible employees, current coverage, and the markets worth evaluating.
3. Employees receive secure instructions when health information is required. Employees create their own accounts and submit confidential information directly through the designated platform.
4. Completion and participation are confirmed. The employer and broker may track whether required information has been completed without the employer reviewing individual medical answers.
5. The carrier or program evaluates the group. The underwriter determines whether it will offer terms and what pricing or conditions may apply.
6. The results are compared with the current arrangement and other realistic options. The review should consider premium, benefits, networks, employee costs, employer responsibility, and disruption.
7. The employer decides whether to proceed. Completing a prescreen does not require the employer to accept the proposal or change coverage.

The purpose is not simply to produce more quotes.

It is to determine whether an underwritten option provides enough practical improvement to deserve further consideration.

How Is Employee Health Information Protected?

Employee health information should be handled separately from the employer’s ordinary benefits records.

When medical information is required:

• Employees should submit it directly through the designated secure platform.
• The employer should not collect or review individual medical answers.
• Sensitive information should not be submitted through the general website contact form or ordinary email.
• Access should be limited to the parties involved in the underwriting and prescreen process.

The employer may need to know whether employees completed the required questionnaire, but it should not receive their detailed health responses.

Employees should review the privacy and security information provided by the platform before submitting sensitive information.

The prescreen should not become an effort to identify employees with medical conditions or high claims. Its purpose is to allow the carrier or program to evaluate the group through the appropriate underwriting process.

What Does the Employer Receive After the Prescreen?

The carrier or program may provide an underwriting indication, proposal, rate offer, or notice that it is unwilling to offer competitive terms.

The results should then be compared with:

• The current plan and renewal
• Other plans from the current carrier
• ACA small-group alternatives
• Other underwritten options that were evaluated
• The employer contribution strategy
• Employee networks, prescriptions, and out-of-pocket costs

A prescreen result is not always the same as final coverage approval.

Final rates and eligibility may depend on accurate information, completed enrollment, participation, contribution requirements, carrier review, and the requested effective date.

Material changes in the group, enrollment, effective date, or information submitted may affect the final result.

The employer remains free to reject the proposal and keep the current arrangement.

Does a Prescreen Mean You Have to Change Plans?

No.

A prescreen does not obligate an employer to:

• Change carriers
• Change plans
• Move into an underwritten arrangement
• Accept the pricing offered
• Disrupt existing employee coverage

The review may confirm that the current plan remains the most practical fit.

An underwritten proposal may produce lower pricing but introduce a narrower network, different prescription coverage, higher employee costs, or additional employer responsibility.

The proposal should be evaluated as a complete arrangement rather than simply as a premium comparison.

The value of the prescreen is clearer information, not change for its own sake.

Does an Employer Need to Complete a Prescreen Every Year?

No.

Every renewal deserves review, but not every employer needs a medical prescreen or complete underwritten market comparison every year.

A new or updated prescreen may be appropriate when:

• The renewal is difficult for the business to absorb.
• The employer wants to compare applicable MEWA or level-funded options.
• The workforce or participation has changed significantly.
• The current coverage approach no longer fits the business.
• The employer wants to confirm that an underwritten alternative remains competitive.

When an employer has completed the process previously, updating census, participation, and employee information may be easier than starting from the beginning.

The decision to conduct another prescreen should depend on the renewal, available alternatives, employer goals, and the amount of additional review that is justified.

When Might a Prescreen Be the Right Next Step?

A prescreen may be appropriate after an employer receives a difficult renewal and decides to compare broader health insurance alternatives.

It may also make sense when:

• The employer is offering health insurance for the first time.
• The business wants to evaluate an Ohio MEWA or level-funded arrangement.
• The current plan has become difficult to sustain.
• The employer wants to confirm whether the current arrangement remains competitive.
• Participation, contributions, or workforce circumstances have changed.

When the source of the concern is still unclear, the employer may first begin with a second-opinion conversation.

That conversation can help determine whether a complete prescreen, a limited plan review, an administrative correction, or another response makes sense.

How McCarthy Stevenot Agency Handles a Prescreen

McCarthy Stevenot Agency is an independent Ohio health insurance agency founded in 1991. We work primarily with employers in the 2–50 employee market.

The process begins with a preliminary conversation about the current coverage, employee count, renewal timing, contribution strategy, and what the employer wants to evaluate.

If a prescreen appears appropriate, we provide the setup instructions and explain what information the employer and employees will need to complete.

Employees submit confidential health information directly through the designated prescreen platform when underwriting requires it.

When the carrier or program returns its results, we compare the proposal with the current plan and other realistic alternatives.

That comparison may include:

• Premiums
• Employer contributions
• Employee payroll deductions
• Deductibles and out-of-pocket exposure
• Provider networks
• Prescription coverage
• Administrative responsibilities
• The disruption involved in changing plans

The employer can then decide whether the option provides enough improvement to justify a change.

There is no cost or obligation to the employer for the prescreen process through McCarthy Stevenot Agency.

Request a Health Insurance Prescreen

Complete the form below to begin the setup process.

Do not include employee medical information, prescription details, claims records, or other sensitive health information in this form. We will provide separate secure instructions when employee health questionnaires are required.

Frequently Asked Questions

What is a health insurance prescreen?

A health insurance prescreen is a structured process used to gather the employer, census, participation, contribution, and confidential employee health information needed for an applicable underwritten carrier or program to evaluate the group.

Not every health insurance option requires medical underwriting.

Is a prescreen the same as an online quote?

No.

A basic online or census quote may provide preliminary ACA pricing or a general estimate.

A medical prescreen gives an underwritten carrier or program the additional information it needs to determine whether it will offer terms and at what price.

Do employees always have to provide health information?

No.

Employee medical information is generally required only when the employer is evaluating an option that uses medical underwriting, such as certain MEWA or level-funded arrangements.

ACA small-group plans and ICHRA evaluations do not require employee medical underwriting in the same way.

Will the employer see employees’ medical answers?

The employer should not collect or review individual employee medical answers.

Employees should submit confidential information directly through the designated secure platform.

The employer may be able to confirm whether an employee completed the questionnaire without seeing the answers.

Does a prescreen mean we have to change plans?

No.

The prescreen may confirm that the current arrangement remains the most practical choice.

The employer is not required to accept a proposal, change carriers, or replace the current plan.

Does a health insurance prescreen cost the employer anything?

McCarthy Stevenot Agency does not charge the employer for the prescreen process.

The employer should still review any carrier, administrator, platform, association, or separate service costs connected with a coverage option before making a final decision.

Is the pricing from a prescreen final?

Not necessarily.

A prescreen may produce a preliminary or conditional underwriting offer.

Final pricing and eligibility may depend on accurate information, completed enrollment, participation, employer contributions, carrier requirements, and the effective date.

Does every employer need to complete a prescreen annually?

No.

An updated prescreen may be useful when underwritten alternatives deserve another review, but every employer does not need a medical prescreen every year.

The amount of review should depend on the renewal, employer goals, workforce changes, and available options.

Can a prescreen confirm that our current plan is still the best fit?

Yes.

A prescreen may show that an underwritten alternative does not improve the overall balance of premium, benefits, provider access, prescription coverage, employee costs, and disruption.

Keeping the current plan is a valid outcome.

What happens after the prescreen is completed?

The carrier or program reviews the information and may provide an underwriting indication or proposal.

The employer and broker can then compare that result with the current plan and other realistic alternatives before deciding whether to proceed.

Related Resources

• Small Business Health Insurance Renewal System
  See how prescreening may fit into a broader annual renewal and decision process.
• What to Do When Your Small Business Health Insurance Renewal Increases in Ohio
  Learn when a difficult renewal may justify comparing broader or underwritten alternatives.
• Ohio MEWA Health Plans
  Understand how MEWA options may use underwriting and when a prescreen may be required.
• Level-Funded Health Insurance in Ohio
  Learn how level-funded arrangements work and why medical underwriting may affect pricing and eligibility.

Disclaimer: This page is for general educational purposes only and should not be treated as legal, tax, compliance, underwriting, medical, privacy, or benefits advice. Prescreen requirements, underwriting methods, rates, participation rules, carrier availability, information-security procedures, and final eligibility vary by employer, carrier, arrangement, platform, and over time. Employers and employees should follow the instructions and privacy requirements of the applicable carrier and prescreen platform.