businessman explaining group health needs

Group Health Coverage Basics for Small Businesses

Offering health insurance to your employees may sound like an overwhelming process — but it doesn’t need to be. Once you’ve identified your business’s needs and know the basics of group health insurance, the rest is easy. So, what do you need to know first?

What’s the difference between group and individual health plans?

According to the U.S. Department of Labor, “A group health plan is an employee welfare benefit plan established or maintained by an employer or by an employee organization (such as a union), or both, that provides medical care for participants or their dependents directly or through insurance, reimbursement, or otherwise.”

In other words, a group health plan is designed to cover a group of employees, but each enrollee has their own plan with benefits – and the plan’s monthly premium is calculated differently than if it were purchased as an individual health plan.

The monthly premium for all health plans is determined by the perceived risk of the carrier in offering coverage. With a group health plan, the group seeking coverage has their risk pooled together as one, which in some cases, may lower the monthly cost.

Unlike individual plans, group health plans are also available in different types designed to help your business save the most money and make the best coverage decisions. To learn more about these different plan types and ways that your business can save money on group health coverage, feel free to check out this group health webinar.

As a business owner, do I have to offer group health insurance to my employees?

Depending on the size of your business, the answer could be no. The Affordable Care Act (ACA) stated that businesses with fewer than 50 full-time employees are not legally obligated to provide health insurance to their employees — but many choose to regardless.

Looking for a better benefits package is one of the most common reasons people change jobs. And if your business doesn’t offer a health insurance benefit, it may give current and prospective employees reason to look somewhere else for employment.

If you are federally mandated to offer health insurance to your employees, you will need to ensure you are following the rest of the ACA’s rules and regulations for small businesses.

How to Handle Rising Group Health Costs

When was the last time you thought about your group health insurance and benefits offerings?

Maybe it’s not something you think about every quarter (or even every year) but in today’s economy, employer-based health insurance and benefit packages have never been more important.

The Growing Cost of Group Health Insurance

According to the National Business Group on Health annual survey of nearly 150 of the nation’s largest employers, the cost of worker health benefits is projected to increase by 5% in 2020.

To offset the rising cost of group health insurance premiums, you may be tempted to cut your employee benefit offerings. Don’t.

Providing your employees with a comprehensive benefits package may be pricey, but it could help you to avoid costly turnover in the future. Research shows that there may be a correlation between job satisfaction and good benefits packages.

So, how can you lower your business’s costs without sacrificing coverage?

  1. Level Funding

Exploring level-funded health plans could save you between 10%-15% on your group health insurance costs. The plans are offered by industry-leading providers and boast a nation-wide network of hospitals and doctors that your employees will have access to. The best part of level-funded plans? A return of premium option if your claims costs are lower than expected.

  1. Reference-Based Pricing 

In some cases, referenced-based pricing could save your {business|firm} even more money than with a level-funded plan. These plans bypass the traditional provider network, giving you access to any doctor or hospital in the country, and offer an advocacy team to help you pay the lowest out-of-pocket costs. Typically, medical providers are reimbursed, saving you and your employees thousands of dollars annually. Reference-based pricing puts the control in the hands of the business owners, not the insurance companies.

  1. Health Savings Accounts

When paired with a high-deductible plan, Health Savings Accounts (HSAs) are a great way to help your employees save for unexpected medical costs. Since becoming available, these plans have expanded in popularity and surpassed 25 million accounts. Furthermore, according to Denevir’s 2019 Year-End HSA Research Report, the number of HSA accounts continues to grow 13% each year.

Young People Discussing Group Insurance Benefits with an agent

3 Benefits of Group Health Insurance For Employers

Group health insurance is usually provided by an employer and can cover just the employee or even the employee’s spouse and children.

Not providing group health coverage could be a major misstep for some companies regardless of size, as there are a number of benefits to providing Group Health Insurance coverage.

1. Lower Costs Than Individual Plans

There is no question that the term health care reform has been a hot-button topic and on the lips of nearly every politician regardless of political party over the course of the past 10 years. In light of the Affordable Care Act, it has now become more affordable to purchase Group Health Insurance than for your employees to purchase health insurance individually.

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business group writing on white board

How To Find The Best Group Health Plan For Your Business

The Group Health Insurance industry continues to change with premiums continuing to rise. You have probably changed insurance carrier’s multiple times hoping to secure for the deal of the year.

So, the question is: Is that all there is? Change carriers and tweak my benefits?

What To Consider In Your Group Health Plan Decision

Not all Group Health Insurance plans are the same and one of the largest problems we come across in the industry is that so few companies are aware of all of their options. Most of the time, the reason behind this is because businesses are often dependent upon their insurance agent to present them with their group health options. In doing so, it is important for businesses to note and understand that like the differing group health plans on the market, not all agents are alike. Agents often differ greatly in regard to their level of experience and general knowledge pertaining to new and emerging trends in the industry.

Here at Member Benefits, we specialize in providing businesses with creative solutions that can greatly reduce their health insurance premiums, while still maintaining a comprehensive list of benefits that satisfy your employees and promote attraction and retention.

Perhaps one of the latest trends that many businesses have found themselves considering over the course of the past two years is something called level-funding.

Level-Funding is a partially self-insured option that functions just like a fully-insured plan and has little to no risk involved due to the built-in stop-loss insurance provisions. If your business qualifies, your premiums could end up being 10 to 15 percent less than what they would have been with a traditional fully-insured plan.

With a level-funded plan, there is no need for a separate bank account and the hospital and physician networks are nationwide and very large. As an added bonus, if your business has had a successful year and the claims are low, you may be entitled to receive a refund of up to 50 percent of the claims surplus. Some level -funded plans now offer no network limitations, giving you access to any doctor or hospital across the country!

Are you worried about the possibility of your deductibles resetting if you make the change now? One of the many great things about level-funding carriers is that they will give you credit for any deductible you may have met up until the point of transition.

So, when closing out your year, rest assured that there is no rule or law stating that you must settle for your same Group Health Insurance as opposed to weighing your options. Be confident in your decision. It is important to take the necessary time when you are not busy to explore your options and a level-funded option may prove to be a great place to start.