The Latest Small-Group Health Plan News

For your Redlands-based small business, of one to one hundred employees, finding the right health plan can be a challenge. Amid so many options, fluctuating circumstances, and things to consider, the choice is often overwhelming. However, with informed guidance and attentive counsel, you and your employees will benefit from the security of a quality health insurance plan. This is where we at Bernardini and Donovan come in. We are here to provide you with expert advice as you make this critical decision for your valued team members. And before you finalize your choices, take note of these health insurance updates.

Latest small group health insurance news:

  1. In the fourth quarter of this year, those who are renewing their policies will notice a rate increase. This is caused by an added component of the Affordable Care Act called the Health Insurance Tax (HIT). Though it was anticipated to be repealed, it is now driving up costs. These price increases vary in severity ranging from three to four percent to 15 percent. As we anticipate this upcoming tax, there are some opportunities to offset these costs with other insurers. Though this option will not exempt you of this tax, it will alleviate it, so it is not so harsh.
  2. Rates seem to fluctuate with every quarter. That’s why in light of these increases, we can look forward to a rumored rate decrease in the first quarter of next year. Take note though that group plans are dependent upon their renewal date. This is the point at which your rate will be fixed for the next 12 months. And so, these changes will not affect your policy if it’s locked into what is called your rate guarantee.
  3. There is a new coverage option, specifically helpful for the small employer who is concerned that they will not have enough participants. The Portfolio Plan does not require any number of participants, making this one of our most competitive options and an excellent choice for small business owners.
  1. As you consider these updates and search for your ideal plan, keep in mind the value of your insurance broker’s customer service. While the price of a health coverage plan will remain the same across the board, the quality of your broker’s service is what really matters. So, look for a provider that will be there when you need them, who will help you care for your employees, and make sure to keep you compliant. These are the most valuable services a broker can provide. And these are what we at Bernardini and Donovan are proud to offer our clients right here in Redlands. If you are in search of a health coverage plan in any capacity, please do not hesitate to reach out. We are prepared to offer our expertise as we assist you in this complex decision-making process.

5 Small Business Health Insurance Pitfalls

Redlands small businesses face several challenges when it comes to employee health insurance. However, this must be made available for the benefit of each employee and the success of your company. Offering health insurance makes your employees more likely to stick around, keeps them happy and healthy, and can even save you money. So, while it may seem like a daunting endeavor, we advise that no matter the size of your company, you consider offering health insurance.

There are a few mistakes when implementing a health care plan for your employees of which to take note. Make sure that you are aware of their threat and of the ways these pitfalls can be avoided. And rest assured that, even when issues arise, there are often simple solutions.

  1. A misunderstanding of eligibility requirements. 
    There are a few things that might keep an individual from partaking in their employer’s health care insurance plan. That’s because a group insurance plan does not automatically prompt eligibility for every employee. Typically, employees are required to work a minimum of 30 hours a week and must fulfill a distinguished waiting period to gain eligibility. This all depends on your state, your insurance provider, and your particular policy. Make sure that upon implementing a new plan, your employees are aware of these requirements.
  2. Miscommunication about the waiting period.  The waiting period indicates the number of consecutive days an employee must work to gain eligibility for the health insurance plan. This number should be decided based on the time you believe is required to discern an employee’s loyalty to the company. And you must communicate this exact amount clearly to your new employees to avoid miscommunication and confusion.
  3. Paperwork mishaps.  Paperwork is something about which we can all commiserate. But despite its world-renowned nuisance, this is the paperwork you cannot overlook. Incomplete or untimely paperwork will cause several complications in your health insurance plan. So make sure that it is submitted with complete accuracy and on time. And be assured that if an employee is terminated, added, or needs to make changes to their coverage, their corresponding paperwork is updated correctly.
  4. Failing to reconcile carrier bills. If an employee is wrongly included or missing from a bill, you face the issue of someone either not receiving coverage or being overcharged. And while these bills are typically accurate, you ought to review them regularly for assurance.
  5. Neglecting to take action when something goes wrong. The Explanation of Benefits or EOB lists the date of service, cost, negotiated discount and deductible accounting and amount for which the patient is responsible. This must coincide with the patient’s medical bills. So if these are mismatched, or demonstrate an issue, be sure to take action immediately. There is often an easy solution to this problem, but it is best solved with urgency.

While these issues may pose significant setbacks to your business, choosing a local Redlands broker like Bernardini and Donovan will help alleviate their severity and prevalence. We are prepared to assist your choice in plans and to provide exceptional customer services as it is administered.

Health insurance is a vital aspect of one’s well being. It assures that upon unforeseen medical circumstances, an individual will be financially covered. This confidence, as one faces inevitable unknowns, is crucial to living well and happily. So, as a small business owner, be sure to provide insurance to your employees for their peace of mind and the benefit of your company. Please do not hesitate to reach out to us today for a simplified and seamless experience.

Changes to Covered California are Coming

Change is inevitable. Each day when you wake you just can’t be sure what that day will bring. Granted, sometimes you get a heads up. Like when you see the storm clouds brewing off in the distance, it’s a good idea to bring your umbrella. Or when you hear of a huge traffic hold up on your normal commute, you avoid that route and take the side roads. So here is your heads up when it comes to Covered California rates. They are going up to the tune of 13.2%

For the past two years California has been able to negotiate to keep the rates in an affordable increase averaging around a 4% increase. However, the legislation that allowed for them to do that is now is now expiring. With these rate increases we will see California’s rates being more comparable to the rest of the nation whose rates have been rising steadily over the past few years.

Also, if you are small business owner with 50-100 employees, the laws are changing for your health coverage. If you have 50 and up to 100 full time eligible employees then it is required that you provide health insurance for your employees.

So why are these changes happening? Peter Lee, the executive director of Covered California says that “Under the new rules of the Affordable Care Act, insurers face strict limits on the amount of profit they can make selling health insurance… We can be confident their rate increases are directly linked to health care costs, not administration or profit, which averaged 1.5 percent across our contracted plans.”
Of course as our country continues in our heated political race this discussion will continue to play a part as the presidential candidates weigh in on the effectiveness of the Affordable Care Act. With this change coming it will be interesting to see the full effects of these coming changes.

Covered California and Small Businesses

Looking into insurance for your employees at your small business? What does Covered California have to offer you as a small business employer? Well, we are glad you asked. Here is some basic information about what you could expect:

First, let’s define a small business. Covered California defines a small business as any business with under 100 full time equivalent employees which is a W-2 employee working 30 hours a week measured on a monthly basis. Covered California offers a variety of health insurance plans to puts you in charge of your health insurance budget while letting your employees get to choose from affordable, quality, and popular health insurance plans from private health insurance companies. The plans have levels of Bronze, Silver, Gold or Platinum. As an employer you can chose one or two plan levels of coverage to offer employees and define the amount they will contribute towards their employee premium. At that point the employee has the choice of which plan will meet their families needs. But regardless of the plan that they choose, all the plans offer these 10 basic benefits:

1. Doctor Visits
2. Prescription Drugs
3. Emergency Services
4. Pediatric Care with Dental and Vision
5. Lab Services
6. Maternity and Newborn Care
7. Hospitalization
8. Preventive and wellness care
9. Rehabilitation
10. Mental health and substance abuse services

You can enroll in Covered California at any time and the coverage will last for the 12 months following when you signed up. You can also add new employees to the program throughout the year as they get hired. You may even be eligible small business tax credit to offset the cost of providing insurance. To find out more about Covered California, more of what is offered, if this could be a good fit for your business and what is needed to qualify for the small business tax credit contact us at Bernardini & Donovan. We are experts in all the ins and outs Covered California and can help you make the best choice that fits your unique situation.

To offer health insurance or to not offer health insurance, that is the question…

When you run a small business there are a lot of different things on your plate and you wear a lot of different hats. Who is going to make sure the photo copier gets fixed? You are. Who is going to ensure that those invoices get paid? You are. Who is going to oversee the marketing and branding of your business? You are. And who is going to make sure that your employees are cared and happy? You are. When you are looking at the well being of your employees one of the first things that comes to mind is to offer health insurance. But in this new world of health insurance laws offering this benefit to your employees can bring with it additional costs and premiums for you, confusing jargon and still may not be exactly what your employees want.

When the Affordable Care Act was first brought on to the scene many small businesses opted to no longer provide health coverage for their employees. That was because they were given very little incentive at that time and little time to fully understand the programs they would be signing up for. Additionally, their employees could now pick their own insurance program.

However, some employers in the past few years have started to look at how they might be able to offer their employees either some form of coverage or help with paying for health insurance. The benefits for them were that they wanted to help their employees with their financial burdens. Only around 44% of Americans today say that they feel in control of their finances. This was also a great way for them to make themselves stand out when looking to hire new employees and retain the employees they already had.

If you are a small business owner and want to look into the different options available to you come speak to us at Bernardini & Donovan. We want to ensure your success and the happiness of your employees by offering the best health care solutions for your unique situation.

Mergers and Withdrawals

Last summer we saw a huge announcement within our health providers when the Big Five national health providers announced that they would become the Big Three with a merger between Anthem and Cigna and a merger between Aetna and Humana. However, as soon as the announcement was made there were outcries against these mergers. There has been concern that if these five large companies which provide much of the innovation within the health industry are not working to stand out or outperform their competitors then the innovations such as new programs for consumers, seniors, and formerly uninsured will stop as well as the possibility of insurance premiums going up. And just recently the US Attorney General Loretta E. Lynch, announced that they had filed lawsuits against these mergers with the purpose of blocking these deals. Their main concern is that these mergers “would leave much of the multitrillion-dollar health insurance industry in the hands of three mammoth insurance companies… If these mergers were to take place, the competition among insurers that has pushed them to provide lower premiums, higher-quality care and better benefits would be eliminated,” said Lynch.

This last month we have also watched at Aetna has started to withdraw their services from certain markets in the United States. This is allow many Americans more limited options for their health care providers and in some cases leaving them with only one option if they are to receive health insurance. These changes will mean that many people will need to change their doctors or their prefered treatment facility to what will be covered under their new plans.

What does this mean for us? It’s hard to say at this time what these changes mean for us. While there are concerns of loss of innovation and rising premium costs, the insurance companies have continue to insist that that will not be the case. But at the very least this is one of the most politicized antitrust cases to be seen in some time.

Tax Benefits You Can Get By Offering A Small Employer Sponsored Health Plan

Health insurance can be a very complicated part of being a small business owner. Many small business owners struggle with what they should do when it comes to health insurance for their employees. Many times they want to offer health insurance as an option but they find it difficult to fund that as a business owner. It can be very expensive and prices are only rising due to the healthcare mandate. However, there are options for you as a business owner so you can save money as well as provide a health insurance plan that they can choose.

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Tax Deductions

As a business owner, if you offer a qualifying group health insurance plan for your employees, you may be able to deduct 100% of the the premiums that the business pays for the employees. This is great news for all businesses but especially small business owners. While the cost may be high for insurance, if you can afford to pay it up front, you can deduct the amounts from your taxes at the end of the year. Another option is offering the plan as a total compensation package which would allow you to cut your payroll taxes.

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Health Care Tax Credit

Along with the new healthcare mandate, there is also a new tax advantage for small businesses. This is designed to help you pay for health insurance for your employees, or at least contribute to the premiums. The tax credit can be up to 50% of the amount that you pay for the health insurance premiums as the business. It is also designed to help low or moderate income employees. To qualify for this tax credit, you must meet some basic qualifications. First, you must have less than 25 full time employees on staff. You must pay below the average of $50,000 annually per employee. Lastly, you must contribute at least 50% or more to the employee only portion of the health insurance premium. with this tax credit, the smaller the business, the bigger the credit can be. You are eligible to get this credit up to two consecutive years as well so it is great to take advantage of it.

Contact us for more information about the tax benefits of offering health insurance. We can also help you find the perfect plan for your business and your employees.

Why To Consider Offering An Employer Sponsored Health Plan Instead of Reimbursing Employees

In recent years, there have been small business employers who have opted to reimburse their employees for the cost of health insurance instead of offering health insurance. While you are not required to offer health insurance to employees if you have less than 50 full time employees, you may want to consider doing so.

Reimbursement for Individual Health Plans

If you reimburse your employees currently, there is a huge reason to stop doing that immediately. With the Obamacare mandate, you may be fined up to $100 per day, up to $36,500 per year, if you reimburse employees for medical care and have more than 50 full time employees. As a small time business owner, this is not a fine you have to worry about with 2-50 full time employees but if your company is growing, you may want to stop offering this before you do run the risk of paying a yearly fine. However, it is a viable option for a small business employer, which is called a Healthcare Reimbursement Plan (HRP), but not in the long run.

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Offering A Sponsored Health Plan

Another option is offering an employer sponsored health plan to your employees. Not only will they have an option for health insurance that is often better than the general marketplace, but as a small business employer, you are also eligible for a tax credit by offering a plan instead of reimbursing. There are specific requirements for this tax credit, though, so not every small employer is eligible for the tax credit. The requirements are as follows:

 

  • You must have less than 25 full time employees
  • On average, you must pay less than $50,000 per year in wages per employee
  • You must pay at least half of the employee health insurance premiums of the plan you are offering

 

Tablet on a desk - Health and Medical
Tablet on a desk – Health and Medical

Tax Credit Benefits to Expect

The tax credit you will get back is 50% of the premium you paid for as the employer portion. If you are a small tax-exempt employer, then the credit is only for 35% of the amount you paid. The tax credit is also only available for two consecutive tax years.

If you would like to learn more about the tax credit and how it can benefit you as a small business employer, please contact us for more information.

A Buyer’s Guide: What to Look For in a Small Employer Sponsored Health Plan

As part of the Affordable Care Act, employers with 50 employees or more must provide or help subsidize health insurance for their employees. Rather than looking at this policy change as a potential cost, small and medium business owners should focus on the competitive advantage – and tax benefits – offering health coverage can provide. As the cost of healthcare continues to rise, good health insurance coverage is becoming more and more of a differentiator when top talent is choosing between companies. Especially as younger generations enter the workforce, they expect to receive coverage and may use these types of benefits to help decide what companies they want to apply and work for. To ensure your business stays competitive within the job market, here are three top considerations to guide your decision when choosing employer sponsored healthcare:

Insurance coverage

  1. Know What Coverage Matters: the top coverages employees look for are preventative care, hospitalization, and co pays. Understanding these coverages is your first step to choosing policies that keep your workforce healthy and happy. Talk to our team of specialists to help you balance cost against these critical needs.
  2. Choose Who Gets Covered: next, you need to decide if everyone will qualify for the same policy. Will part-time employees be offered different package options than full-time employees? How will you treat their dependents? The amazing thing is that you don’t need to choose a “one size fits all” policy. Your insurance agent will help you understand your workforce and choose policies that comply with the Affordable Care Act while meeting your needs and those of your employees.
  3. Decide How Much You Will Contribute: lastly, you’ll decide how much of these policies you choose to subsidize. Some employers opt to pay for the entire policy, others offer a sliding cost scale based on coverage, and some only cover a flat percentage of the employee’s’ total health care costs. It’s important that you offer “affordable” coverage to avoid any fines associated with the ACA, so work with your provider to understand median policy costs in your region and how these costs stack up against your employees’ wages and cost of living.

You’re well on your way to choosing a great policy and we are here to help every step of the way!

Things to Consider When Choosing A Health Plan Offering For Your Small Business

When you own a small business, with 2-50 employees, even if you are not required by law to offer a health plan for your employees, you may still want to. If you want to choose a health plan for your employees, there are a few things to consider before making your decision. You need to keep both your business goals as well as the benefit of your employees in mind. This is a careful balance but it can be done with the right considerations along the way. Use this list as your guide through the process.

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  • How much can your business pay and how much can your employees pay? In general terms, plans come in terms of premiums. The higher the premium, the lower the costs out of pocket and vice-versa. Something to consider is how much both your business and your employees can afford in terms of premiums and out of pocket costs when they use the insurance. You will want to find a happy medium that makes both you and your employees happy.
  • Will you offer one plan or a choice of plans? There are many plans for you to choose from and your biggest decision will be whether you want to offer one or a choice of a few for your employees. You will want to explore all of the options available for your area. One main reason employers offer more than one plan is because some employees want a better plan than the most basic plan and others just want something to meet legal requirements.
  • Will you offer other plans, like dental and vision? You are not just limited to medical plan offerings. If you want, you can offer your employees vision and dental offering as well.
  • How much will you pay for? As a business, you can offer to pay a portion of the premiums on behalf of your employees. Most employers offer to pay a specific portion of these benefits, like half of the employee only plan cost. You will want to determine what you will pay for before as a company.

Be sure to contact us at Bernardini & Donovan Insurance Services to help guide you through the process and help you make the right decision. We have the right tools to help you find the perfect insurance plan(s) for your employees as well as for your business.