group health insurance Archives - American Association of Business Networking

16Mar2020

businessman explaining group health needs

Group Health Coverage Basics for Small Businesses

2020-03-16

business, group health, group health coverage, group health insurance Employee Benefits

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.

15Apr2019

business leaders discuss group health insurance options

Making the Most of Your Group Health Care Benefits

2019-04-15

ABN

business, group health insurance Employee Benefits

Have you recently enrolled or been offered enrollment in a group health care plan through your employer? If so, this can be a great way to enjoy benefits for yourself and your loved ones. Of course, when enrolling in group healthcare (or any health care plan, for that matter), making sure you’re making the most of your benefits is a must. By following a few steps, you can make that happen.

Understand Your Plan

First and foremost, make sure that you understand every last detail of your plan. This will require you to obtain a copy of your benefits from your employer. As you read through your benefits, pay special attention to certain factors, such as:

your co-pays and deductibles
waiting periods you may be subject to
possible dental and vision benefits
physician choice

By knowing the details of your coverage, you’ll be less likely to run into unpleasant surprises down the road (such as high out of pocket costs for a particular procedure).

Always Think Ahead

All too often, once an employee has successfully enrolled in a group healthcare plan, he or she forgets about it—until a medical problem arises and he or she needs to use it. Waiting until you’re facing a medical problem to ask questions about your coverage is a recipe for disaster. Instead, be proactive and ask important questions as soon as you have them.

For instance, in the event that you’re injured while out-of-state on vacation, will it be possible for you to find care outside of your coverage area? And if you’re admitted for a hospital stay, is there a limit as to how many days your insurance will cover?

Make Sure Your Plan Can Adapt

Life is unpredictable, but it’s important to do everything in your power to make sure your group health care plan can adapt to your changing needs over the years. For example, how will your benefits change if and when you get married? Have a child? What if you get divorced down the road? Knowing what to expect from your healthcare benefits in these situations now will help better prepare you for inevitable changes in your life.

Denied Claims: What to Do

Finally, if you run into any issues with your healthcare provider, you should be aware of the proper procedures and protocols to follow. For instance, you should know that you have a right to receive a decision regarding your claim within a specified time period; if your claim is denied for any reason, there is a specific series of steps you can follow to file an appeal. Your benefits manager can help you explore these steps if necessary. Making the most of your group health care benefits requires some proactive thinking and effort on your part, but it’ll be more than worth it down the road.

18Mar2019

Young People Discussing Group Insurance Benefits with an agent

3 Benefits of Group Health Insurance For Employers

2019-03-18

ABN

group health, group health insurance, health insurance benefits, tax benefits Human Resources

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.

Level-funding insurance plan options have been growing in popularity over the past number years. Level-funded plans are ERISA compliant and may offer more flexibility for employers with virtually no risk and offered by several reputable insurance carriers with a nationwide network of hospitals and physicians to choose from.

What has many employers especially excited about these plans is the opportunity for 10%-15% in lower premium costs and the Return of Premium potential. Unlike other policies on the market, with level-funded options, if your employees don’t rack up a large number of claims throughout the year, your company may have a substantial amount of money (originally paid in premiums) returned.

2. Attraction and Retention

If looking at the cost of a group health insurance plan leaves you feeling queasy and the idea of paying the tax penalty sounds more appeal, you may want to think twice.

As job seekers now expect for their employers to at least partially cover their healthcare needs through group health insurance policies, walking into a job interview and being told that the company refuses to pay health care for full-time workers is a red flag. Even if a potential employee is in trouble financially, they may still take the job out of desperation but will jump ship as soon as they can afford to for greener pastures.

Providing Group Health Insurance for your employees shows a certain level of care and respect that new and existing employees will appreciate and keep in mind going further within your company.

3. Tax Benefits of Providing Group Health Insurance

In some cases, it’s possible that providing your employees with Group Health Insurance could give you a welcome tax write-off, not to mention added tax benefits for your employees.

Payments made to group health insurance premiums, reimbursement plans (HRAs), and Health Savings Accounts (HSAs) are generally all eligible for tax advantages as all of these payments can be made as pre-tax contributions.

As an added bonus, qualifying health insurance plans may also be eligible for HSAs for their employees. HSA’s are 100 percent owned by the individual employee and not tied to you in any way. In a 2015 study conducted by Devenir compiled data from the top twenty HSA providers in the U.S. and found a 1775% increase in assets between 2006 and 2015, showing that now more than ever, people are choosing to invest their money in HSA’s rather than insurance plans with more coverage.

4Feb2019

How To Find The Best Group Health Plan For Your Business

2019-02-04

ABN

employee benefits, group health, group health insurance, health insurance, level funding Employee Benefits

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.