To IMQ or not IMQ, that is the question


Individual medical questionnaires, personal health questionnaires, health risk surveys, enrollment forms that include health questions…..No matter what they are, they are designed to do 2 things:

  1. Help your insurance company vendor or your self-funded health plan appropriately price your plan for the known risks
  2. Help your plan to identify areas where a particular service or treatment can be sourced for less money

Both you as the employer and almost all of your employees hate the idea of Individual Medical Questionnaires (IMQs).  They feel intrusive, ask for too many details, are time-intensive, and employees don’t want to pay more or have their conditions excluded.

But, on the flip side, if neither you nor your insurance vendor can price for the financial risks of your health plan, your company becomes subject to an increased rate to help cover the unknown.  And no one likes inflated, overpriced, costly health insurance. You don’t like offering coverage at inflated prices and your employees don’t cherish it as a wonderful experience.


So what do you do?


We believe it is good stewardship of your company’s resources and in some cases your fiduciary obligation to explore a comprehensive set of solutions on behalf of your workforce. To get this job done your must get your employees to buy into the process. To do this we suggest first explaining the process and also speak to the privacy filters and protocols that help protect your people. Or, if your company is one of the lucky ones, you work hard to leverage your current plan’s data so you and your employees can avoid the IMQ exercise.


Who needs to do the IMQs, who can avoid this step?


If you have between 2 and 35 employees on your health insurance plan,  the IMQ exercise is going to be worthwhile.  If you are lucky to live in Texas or a state where regulations make it easier to get some basic level of health insurance claims data all the way down to 2 employees, I suggest using it as a litmus test to see if you are “winning” or “losing” as the Premiums Paid vs. Claims Paid out on your behalf.  Unless the numbers are horribly adverse–do it.  Even as a spot-check against your current plan, it is part of being a good steward to your company’s resources and to your employees’ paychecks.

If you have between 35 and 100 employees, we still an advocate for the IMQ process.   Sure, there are vendors that will use your current claims data and also some kind of predictive modeling based on a prescription history database like GRx, but the IMQ is often a better tool at this size to price your coverage correctly.  We love the idea of just using GRx and getting prices that are 35% lower than your current health insurance costs, but we also hate delivering a 49% renewal in year 2 that puts you right back where you started.  Using the IMQs, along with additional scoring tools like GRx, puts your company on a much better track to design a 3 to 5 year strategy.

And, if you have 101 to 300 employees, this one is a toss-up. As an employer of this size, you should have great claims data at your disposal.  If you don’t have this kind of access–skip back and read the paragraph for the 35 to 100 employee size company and immediately work to replace whatever vendor is being obstinate with your data.  Hopefully, you have great claims data and and we can use that to find a baseline price for fixed insurance costs. Then we can leverage that same data to start to purchase your healthcare at a lower fee–saving both your insurance costs and your employees’ pocketbooks.

Over 300 employees — don’t even think about it.  Leverage what you have or use predictive modeling only.  And, if your claims data isn’t good enough,  go ahead and leverage a new vendor who will provide you with better data and better reporting.  You hold the keys to the kingdom once you have enough meaningful presence to dictate what you deserve.


How to position it to your employees?


First, we suggest using a secure, electronic collection method that is done by a 3rd party so your company is an arms-length distance from viewing the private employee health data.

We know collecting a paper form or pdf is sometimes easier than forcing an employee to create yet another unique login and  password, but this level of security is important so your organization can build employee trust.



Here is the verbiage we use with our clients, feel free to use it for your own needs:


Dear {employee name},

In order to provide you with the best value possible from our health insurance plan, every employee needs to complete an Individual Medical Questionnaire (IMQ). Its sole purpose is to help potential health insurance carriers assess our risk as a group and determine appropriate premiums.  Please complete your health questionnaire by 5 pm Friday {Insert Due date}.

Your privacy is of utmost importance to {insert your company name} , which is why we are using an outside 3rd party service to gather this information. No employee of {insert your company name} will be able to view this information at any time. This includes employees in human resources and finance who administer the health insurance plan for our company. Also, completing a questionnaire is NOT a commitment to enroll in benefits; you can waive benefits later when it’s time for open enrollment.

Please complete the personal health questionnaire by 5 pm Friday {insert due date}. Click the link below to get started immediately:

Code to use when registering:    EXXXXXX


Bret Brummitt

Bret Brummitt


About the author: An avid learner and resourceful leader with a passion for problem-solving, Bret is a calming force in the chaos and fast-paced evolution of health insurance, employee benefits, and the growing burden of regulatory compliance. He helps people develop the confidence to see beyond the problem at hand and start to re-imagine their goals. Whether he’s helping a client or a colleague, Bret believes a successful interaction is one that allows us all to dream a little bigger when we’re done.

About Generous Benefits:  Generous Benefits ( focuses on solutions that improve the community you serve.

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